Workplace bullying in the nursing profession: A cross-cultural scoping review

Exploring nursing students' experience of bullying and its consequences and coping strategies from a qualitative perspective

Workplace bullying is a serious challenge for nursing students, with negative impacts on their physical and mental health, leading to reduced self-esteem and quality of patient care. In response to bullying, individuals use various coping strategies. Therefore, this qualitative study aimed to elucidate the consequences of bullying and investigate the coping strategies employed by nursing students. In this study, 20 nursing students were selected using purposive sampling. Data was collected through semi-structured in-depth interviews and analyzed using the Graneheim and Lundman method (2020). In this method, units of meaning were identified, and codes and categories were extracted. Data management was carried out using version 0.9.5 of the MAXQDA software. The findings were categorized into two main themes: "Consequences of Bullying" and " Bullying Coping Strategies." Subcategories extracted from the study included "Negative Outcomes," "Positive Outcomes," " Self-Centered and Passive Strategies," and "Active and Interactive Coping Strategies." Sub-subcategories included " Reduction in Learning," " Decline in Quality of Care," "Psychological Harm," "Physical Harm," "Disruption in Social Interactions," "Development of Positive Thinking," " Enhancement of Self-Efficacy," " Self-Direction," "Acceptance," " Ignoration," "Situational Humor," "Protest," " Discussing of Job Description," and " Report to Competent Authorities." The findings of this study indicate that bullying in educational workplaces has negative effects on the physical, mental health, and learning process of nursing students, jeopardizing the quality of patient care. These results also emphasize the necessity of focusing on active and passive coping strategies adopted by nursing students. Therefore, structural reforms in the nursing education system, implementation of effective prevention policies, training of mentors, and providing psychological support for students are recommended.

A Scoping Review of Workplace Bullying in Emergency and Intensive Care Settings

OBJECTIVE

To evaluate the prevalence, contributing factors, and outcomes of workplace bullying in critical care settings, for purposes of this study defined as emergency departments and ICUs, and identify practice strategies or research interventions to mitigate workplace bullying in these practice settings.

BACKGROUND

Workplace bullying among nurses leads to adverse nurse and patient outcomes. Nurses working in critical care settings frequently endure stressors related to life-or-death circumstances. Although other nurses experience stressors, the frequency and intensity of these stressors differ from those experienced by nurses in other practice settings.

METHODS

Researchers conducted a scoping review to evaluate the depth and breadth of existing research on this topic.

RESULTS

Twenty-two studies met the inclusion criteria and were included in the review. The work environment largely influences bullying among critical-care nurses. Most studies were exploratory/descriptive. Only 2 studies tested an intervention to address bullying.

CONCLUSIONS

Future research should focus on developing and testing interventions to reduce workplace bullying and mitigate its effects.

The effects of bullying on nurses' turnover intentions, patient care, and somatic health complaints: Examining the importance of staffing adequacy and stress mindsets

BACKGROUND

Bullying in nursing is a pervasive and persistent problem that contributes to elevated stress levels and a range of negative employee outcomes, including poor job attitudes and deteriorating well-being. Prior research has largely focused on the harmful consequences of bullying, with limited attention to the factors that may buffer these effects. Addressing this gap is critical for identifying pathways to support nurses and improve healthcare environments.

PURPOSE

This study examines how organizational and individual resources can mitigate the adverse outcomes of workplace bullying among nurses. Specifically, it investigates whether staffing adequacy (an organizational resource) and stress mindset (an individual resource) moderate the indirect effects of bullying on turnover intentions, perceived patient care quality, and health complaints, via stress.

METHODS

A two-wave survey was conducted with 422 nurses employed in various healthcare settings across the United States. The study employed a moderated mediation model to test the relationships among workplace bullying, stress, and outcome variables, while examining the moderating roles of staffing adequacy and stress mindset. Stress mindset refers to an individual's belief that stress can either be enhancing or debilitating.

DISCUSSION

Findings reveal that bullying indirectly increases turnover intentions, diminishes perceived quality of patient care, and elevates health complaints by increasing stress. Importantly, both adequate staffing and a stress-is-enhancing mindset can buffer nurses against these negative effects. However, the protective effects of a stress-is-enhancing mindset are only evident when staffing is perceived to be moderately to highly adequate. When staffing is low, a positive stress mindset alone is insufficient to offset the consequences of bullying.

CONCLUSION

This study highlights the importance of both organizational and psychological resources in reducing the harmful effects of workplace bullying in nursing. Bullying exerts its influence through stress, but this pathway is moderated by both staffing adequacy and stress mindset. To safeguard nurse well-being and performance, healthcare organizations should prioritize adequate staffing levels and support interventions aimed at cultivating more adaptive stress mindsets among nursing staff.

Barriers to reporting workplace violence: a qualitative study of nurses' perceptions in tertiary care settings

BACKGROUND

Workplace violence (WPV) remains a formidable concern among nurses worldwide, with up to 60% in Saudi Arabia reportedly experiencing some form of aggression. In tertiary care hospitals, robust hierarchies and cultural norms intensify underreporting, thwarting evidence-based prevention and obscuring vital data.

AIM

This qualitative study investigated the perceived barriers to WPV reporting among nurses in tertiary care settings in the Aljouf region of Saudi Arabia, specifically addressing how organizational and cultural factors converge to discourage formal incident reporting.

METHODS

A qualitative descriptive design was employed, guided by Ajzen's Theory of Planned Behavior and the Social Ecological Model. Thirty-six registered nurses, purposively sampled from three tertiary hospitals, participated in six semi-structured focus groups conducted in Arabic or English, depending on participant preference. Data were thematically analyzed in NVivo, with methodological rigor ensured through triangulation and inter-coder reliability.

RESULTS

Three principal themes emerged: (1) Emotional and Psychological Barriers (78%), encompassing distress, anxiety, and fears of professional blame; (2) Organizational Ineffectiveness (65%), marked by convoluted reporting processes and perceived managerial indifference; and (3) Cultural and Hierarchical Influences (57%), reflecting deference to authority and normalization of violence. These themes illustrate how attitudes, subjective norms, and perceived behavioral control shaped by socio-cultural dynamics collectively contribute to persistent underreporting.

CONCLUSIONS

Mitigating WPV underreporting in Saudi tertiary care hospitals requires streamlined, user-friendly reporting channels, leadership accountability, and holistic psychosocial support. Implementing interprofessional education aimed at dismantling hierarchical imbalances can foster a zero-tolerance ethos toward violence. Longitudinal and comparative research should further examine evolving reporting behaviors to refine context-specific, culturally attuned strategies for addressing WPV.

CLINICAL TRIAL NUMBER

Not applicable.

Exploring the causes of workplace bullying among nurses in pediatric intensive care units: a qualitative study

INTRODUCTION

Workplace bullying (WB) is a significant occupational hazard for nurses, especially in high-stress environments such as pediatric intensive care units (PICUs). WB adversely affects nurses' physical and mental health, patient safety, and overall quality of care. This study aimed to explore the causes of WB among nurses working in PICUs.

METHODS

This qualitative study used a conventional content analysis approach. Eleven nurses from the PICUs of the Children's Medical Center Hospital, affiliated with Tehran University of Medical Sciences, participated in the study. Participants were selected through purposive sampling. Data were collected through semi-structured face-to-face interviews, continuing until data saturation was achieved. The data were analyzed using Graneheim and Lundman's five-step approach. Lincoln and Guba's four criteria-credibility, confirmability, dependability, and transferability-were used to ensure the study's rigor.

RESULTS

The analysis of the data revealed two main categories: [1] the "Imposing and Stereotypical Atmosphere," which encompasses sub- categories such as power imbalances, work-related challenges, immature behaviors among staff, and passive reactions of nursing managers; and [2] the "Victim's Achilles' Heel," which emphasizes weaknesses in clinical and communication skills as contributing factors to WB.

CONCLUSION

The study identifies organizational and personal factors as causes of WB in PICUs. Nursing leaders can implement targeted interventions aimed at improving workplace culture, monitoring interpersonal relationships, enhancing communication skills, and promoting the clinical skills of staff. These strategies can reduce WB and create a healthier work environment for nurses.

Resilience as a moderator of the effects of types of workplace bullying and job performance

BACKGROUND

Workplace bullying is a problem that can occur in any occupation or organization and is a stressful and negative experience for employees; resilience helps employees to better resist workplace bullying. The purpose of this study was to examine whether resilience moderates the effects of workplace bullying on job performance and to determine whether this moderating effect differs between three types of bullying: personal, work-related, and physical bullying.

METHODS

A self-administered, paper-based questionnaire was distributed to full-time nurses at three regional hospitals in Taiwan. Cross-sectional data on workplace bullying behaviors, resilience and job performance were collected from 422 nurses using a questionnaire survey. Data were collected using the Job Performance Scale, the Negative Acts Questionnaire, and the Resilience Scale (CD-RISC-10), and the resulting data were analyzed using SPSS 21 and the PROCESS macro.

RESULTS

Resilience moderated the positive relationship between personal, physical bullying and job performance (b = .11, p < .05; b = .17, p < .05), but did not moderate the effects of work-related bullying.

CONCLUSIONS

The findings of this study highlight the need for organizations to be proactive in preventing work-related bullying and to promote and enhance individual resilience. Managers need to be aware of the detrimental effects of work-related bullying, which can damage employees' physical and mental health and contribute to workplace toxicity.

Workplace Bullying Experiences of Nurses From Diverse Sexual Orientation and Gender Identity Groups

AIM

To examine nurse workplace bullying relative to diverse sexual orientation and gender identity groups.

DESIGN

Observational cross-sectional study.

METHODS

Using an annual organisational satisfaction survey from 2022, we identified free-text comments provided by nurses (N = 25,337). We identified and themed comments for specific bullying content among unique respondents (n = 1432). We also examined close-ended questions that captured organisational constructs, such as job satisfaction and burnout. We looked at differences by comparing diverse sexual orientation and gender identity groups to the majority using both qualitative and quantitative data.

RESULTS

For the free-text comments, themed categories reflected the type of bullying, the perpetrator and perceived impact. Disrespect was the most frequent theme with supervisors being the primary perpetrator. The reported bullying themes and workplace perceptions differed between nurses in the diverse gender identity and sexual orientation group compared to other groups. Nurses who reported bullying also reported higher turnover intent, burnout, lower workplace civility, more dissatisfaction and lower self-authenticity.

CONCLUSION

Diverse sexual orientation and gender identity groups are understudied in the nurse bullying research, likely because of sensitivities around identification. Our design enabled anonymous assessment of these groups. We suggest practices to help alleviate and mitigate the prevalence of bullying in nursing.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

IMPACT

We examined differences in perceptions of nurse bullying between diverse sexual orientation and gender identity groups compared to majority groups. Group differences were found both for thematic qualitative content and workplace experience ratings with members of minority groups reporting less favourable workplace experiences. Nurse leaders and staff can benefit from learning about best practices to eliminate bullying among this population.

REPORTING METHOD

STROBE guidelines for cross-sectional observational studies.

Workplace bullying among medical laboratory professionals in Ghana: insights from self-reported experiences, challenges to mitigation structures, and coping strategies

BACKGROUND

Workplace bullying is a major concern in Ghana's healthcare sector, often arising from power imbalances and an excessive emphasis on achieving results at the cost of employee well-being. While bullying among healthcare professionals like doctors and nurses is well-documented, little is known about its prevalence among medical laboratory professionals, who play a vital role in patient care. We assessed bullying in this group to inform strategies for mitigation.

METHODS

We conducted a cross-sectional survey involving 378 medical laboratory professionals. The survey included demographic information, workplace characteristics, the Revised Negative Acts Questionnaire (NAQ-R), and questions about bullying perpetrators, mental health breaks, and anti-bullying policies. Data analysis involved descriptive statistics, the Kruskal-Wallis test, and logistic regression. Results were reported as frequencies, percentages, and odds ratios with 95% confidence intervals (CIs), and statistical significance set at p < 0.05.

RESULTS

44% of the medical laboratory professionals reported experiencing bullying; 29% faced frequent bullying, while 71% encountered it occasionally. Common issues included ignored opinions, unmanageable workloads, gossip, and exclusion. Non-clinical administrative managers were the most frequent perpetrators. Diploma and bachelor's degree holders had higher odds of being bullied compared to master's degree holders (AOR = 6.13, p = 0.013; AOR = 2.56, p = 0.007). Rural professionals had higher odds than urban counterparts (AOR = 2.23, p = 0.007).

CONCLUSION

The high prevalence of workplace bullying among medical laboratory professionals highlights the need for effective policies to enhance workplace conditions and patient care.

Retaining a Multicultural Nursing Workforce: A Self-Determination Theory Perspective

INTRODUCTION

The increased globalization of nurses has prompted organizations to explore innovative strategies to retain their workforce. However, due to cultural variations and increased workforce diversity, a one-size-fits-all retention strategy may not be effective.

METHODOLOGY

In this paper, we discuss nurse migration and retention to identify points of intersection and possible theories that can be applied.

RESULTS

Nurse migration and retention share a common motivation thread, indicating that a motivation theory could effectively integrate both concepts. Self-determination theory (SDT) is particularly relevant as it suggests that the needs for autonomy, competence, and relatedness influence motivation and retention and that these are universal, transcending cultural boundaries.

DISCUSSION

Addressing migrant nurse retention is crucial. The continued international recruitment poses a threat, as any intake by host countries further depletes the already scarce pool of nurses in some source countries. The perspective offered by the SDT may prove instrumental in developing effective strategies for retaining migrant nurses.

Moral disengagement, moral identity, and counterproductive work behavior among emergency nurses

BACKGROUND

Morality is a fundamental component of nurses' daily work. Nurses' cognitive tendencies toward moral disengagement in high-stress work environments can easily lead them to engage in counterproductive work behaviors that are not conducive to the organization. However, there is limited research on how to mitigate the impact of moral disengagement on counterproductive work behavior.

OBJECTIVE

The objective was to explore the impact of moral disengagement on counterproductive work behavior, as well as the reverse regulatory mechanism of moral identity on the relationship between moral disengagement and counterproductive work behavior.

RESEARCH DESIGN

This was a quantitative, cross-sectional study.

PARTICIPANTS AND RESEARCH CONTEXT

From September to October 2023, nurses from emergency departments of major hospitals in Hunan Province were recruited, and 500 questionnaires were distributed and collected using the WeChat app Credamo Seeing Numbers.

ETHICAL CONSIDERATION

All study procedures were approved by the Ethics Committee of Hunan Normal University (No. 2023-388).

FINDINGS

Moral disengagement had a positive effect on counterproductive work behavior directed at the organization (CWB-O) as well as counterproductive work behavior directed at individuals (CWB-I). Moral identity was not significant in moderating the relationship between moral disengagement and CWB-O. Moral identity had an inverse moderating effect on the mechanism of action between moral disengagement and CWB-I.

CONCLUSION

Counterproductive work behavior guided by moral disengagement is detrimental to organizations, and moral identity can inhibit the effect of moral disengagement on CWB-I. Nursing administrators should focus on improving nurses' moral identity and improving the healthcare workplace environment so that moral identity can better exert its inhibitory effect on counterproductive work behavior among nurses.

Influence of Workplace Bullying and Bystander Types on Speaking Up for Patient Safety Among Hospital Nurses: A Cross-Sectional Study

AIMS

To explore the influences of workplace bullying experiences, witnessing workplace bullying and bystander types on Speaking up for patient safety (SUPS) among hospital nurses.

DESIGN

Cross-sectional study.

METHODS

A survey was conducted in September 2021 using a structured questionnaire about workplace bullying experiences, witnessing workplace bullying, bystander types, and SUPS. The questionnaire was administered to 200 bedside nurses from two tertiary university hospitals in South Korea.

RESULTS

One hundred and ninety-nine responses were analysed. A hierarchical regression model, incorporating organisational factors, workplace bullying experiences, witnessing workplace bullying, and bystander types explained approximately 44.0% of the variance in nurses' SUPS. Witnessing workplace bullying and the perpetrator-facilitating bystander negatively influenced SUPS, whereas victim-defending bystander had a positive influence on SUPS.

CONCLUSIONS

Findings suggest that witnessing workplace bullying and the bystander types of nurses working on patient care units are more impactful on nurses' SUPS than individual experiences of bullying. Notably, the victim-defending and perpetrator-facilitating bystander types were identified as key factors influencing SUPS.

IMPLICATIONS FOR THE PROFESSION

Nurse managers should understand the roles of witnesses and bystanders working on a patient care unit, and how these roles may extend beyond traditional views of perpetrators and victims. Developing strategies to support and effectively manage witnesses and bystanders working on patient care units may promote positive SUPS behaviours among clinical nurses.

IMPACT

What problem did the study address? Speaking up for patient safety (SUPS) in clinical settings is critical in maintaining and enhancing patient safety. However, a negative work environment, such as one that promotes workplace bullying may hinder nurses' willingness to engage in SUPS. Because many nurses involved in workplace bullying may be witnesses or bystanders rather than direct perpetrators or victims of such situations, this study explored the potential influences of workplace bullying, including the roles of witnesses and bystanders, on SUPS. What were the main findings? SUPS was influenced more by witnessing workplace bullying and specific bystander types, namely victim-defending and perpetrator-facilitating bystanders, than by workplace bullying experiences. Where and on whom will the research have an impact? These findings highlight the importance of addressing the roles of witnesses and bystanders in workplace bullying. Nurse managers should broaden their focus beyond perpetrators and victims to include the roles and views of all nursing staff within a department. By effectively managing witnesses and bystander types, they can foster an environment that enhances SUPS behaviours among nurses.

REPORTING METHOD

This study adhered to STROBE guidelines.

PATIENT OR PUBLIC CONTRIBUTIONS

No Patient or Public Contribution.

The moderating effect of psychological capital on the relationship between nurses' perceived workplace bullying and emotional exhaustion: a cross-sectional study

BACKGROUND

Workplace bullying (WPB) is common in nursing profession, leading to adverse effects on nurses' health and teamwork. Although it has been suggested that psychological capital (PsyCap) could potentially moderate the relationship between WPB and emotional exhaustion, there is currently a lack of direct empirical evidence supporting this claim. Therefore, this study aims to examine how PsyCap moderates the relationship between WPB and emotional exhaustion in nurses.

METHODS

A cross-sectional study was carried out involving 1068 nurses using a general information questionnaire, Negative Acts Questionnaire-Revised, Psychological Capital Questionnaire-Revision, and emotional exhaustion subscale of the Chinese version of Maslach Burnout Inventory-General Survey. The PROCESS macro was utilized to examine the moderating effect of PsyCap.

RESULTS

WPB led to emotional exhaustion among nurses (β = 1.488, P < 0.001), and PsyCap moderated this positive relationship (β = 0.300, P < 0.001). The group with high PsyCap exhibited lower levels of emotional exhaustion. However, as the perceived WPB increased, the disparity in emotional exhaustion between the high and low PsyCap groups diminished.

CONCLUSIONS

WPB significantly contributes to nurses' emotional exhaustion. PsyCap mitigates this impact, but this effect is limited in organizations with high WPB. it is recommended that nursing managers mitigate the detrimental impact of WPB on nurses' emotional well-being by both strengthening nurses' individual PsyCap and implementing comprehensive strategies to reduce WPB behaviors.

"The Whole Culture of Nursing Needs to Change": A Descriptive Phenomenology of Nurses Being Bullied

Workplace bullying impacts at least half of the nurses worldwide. Despite the link to increased nurse turnover, few intervention studies have addressed bullying in the workplace. Since most studies report cross-sectional designs that provide little insight into the complexities of this phenomenon, the purpose of this descriptive phenomenology was to describe the lived experiences of nurses as they were actively being bullied in the workplace. Semi-structured interviews were conducted through Skype until data adequacy was realized with 12 participant interviews. Giorgi's six-step method was used to analyze the data in Atlas.ti. A central theme, "The whole culture of nursing needs to change" described an organizational culture where managers were unable to identify or unwilling to respond to workplace bullying. The four themes identified from the data included "going to work can be really hard," "not good for patient care," "learning to live with bullying," and "changing the culture." Leaders of organizations should implement comprehensive anti-bullying programs to assess bullying in their workplace and to provide bullied nurses with reporting options. Nurse managers need to prevent workplace bullying by intervening when aware of bullying and cultivating a culture of mutual respect.

Evaluation of the relationship between adversity quotient, professional identity, and perceived humanistic care of head nurses in Master's Degrees in nursings

Background

High-level nursing talents play an important role in solving nursing scientific problems and leading nursing innovation, so the construction of high-level nursing talents has become a necessary guarantee for the health strategy in the new era. Managers have high expectations for master's degree in nursing, hoping that they will develop in all aspects of research, teaching, and professionalism, etc. However, the high expectations of managers have led to unclear job orientation, high clinical and scientific research pressure, and low recognition of nurses' sense of professional value from the outside world, which have led to the lowering of master's degree of professional identity and the tendency to leave the profession, which is not conducive to the stabilization of the nursing workforce.

Purpose

To explore the influence of adversity quotient, perceived humanistic care of nurse leaders on professional identity of nursing masters, and to clarify the relationship model between the three.

Methods

A convenience sampling method was used to conduct an online questionnaire survey on 160 master's degree nursing students in Ningbo and Shanghai from July to September 2022 using the general information questionnaire, adversity quotient, career identity and perceived humanistic care of nurse leaders scale.

Results

Adversity quotient, occupational identity and perceived humanistic care of nurse leaders were all at a moderate level. Adversity quotient (r = 0.430, P < 0.01), perceived humanistic care of nurse leaders (r = 0.443, P < 0.01) and occupational identity were positively correlated, and perceived humanistic care of nurse leaders could affect occupational identity through the mediating effect of adversity quotient, with the mediating effect accounting for 31.8%.

Conclusion

Nursing managers should create a good organizational atmosphere, build a training system for adversity quotient courses, conduct regular assessment and humanistic care to improve the ability of nursing masters to face adversity and enhance the awareness of their own professional values.

Australian nursing students' experiences of workplace violence during clinical placement: A cross-sectional study

AIM

To identify the nature, degree and contributing factors of workplace violence (WPV) incidents experienced by Australian nursing students during clinical placement.

DESIGN

Descriptive cross-sectional study.

METHODS

Data were collected from 13 September to 25 November 2022. Eligible participants included all nursing students enrolled in nursing degrees at any Australian university who had completed at least one clinical placement. An adapted version of the WPV in the Health Sector Country Case Study survey was used.

RESULTS

A total of 381 nursing students across eight states of Australia completed the survey. More than half of the students had experienced an episode of WPV; patients were the most frequent perpetrators. Personal factors of patients, staff and students, organizational factors and cultural norms within the workplace supported acts of WPV.

CONCLUSION

Student nurses (SNs) most often experience violence from patients during direct care. Patient encounters are the core component of clinical placement. Education providers have a responsibility to effectively prepare students to be able to identify escalating situations and manage potentially violent situations. Registered nurses who supervise students during clinical placement require support to balance their clinical role with student supervision.

IMPLICATIONS FOR THE PROFESSION

Experiencing WPV can negatively impact relationships between students, healthcare professionals and care recipients. This results in personal distress, decreased job satisfaction and potentially the decision to leave the nursing profession.

IMPACT

What already is known: SNs are exposed to WPV during clinical placement.

WHAT THIS PAPER ADDS

More than half the SNs in this study experienced violence inclusive of physical, verbal, racial and sexual harassment. Patients were the predominant perpetrators. Implications for practice/policy: Interventions at individual and systemic levels are required to mitigate WPV.

REPORTING METHOD

This study is reported using the STROBE guidelines.

'God is always on my side': internal and external predictors of workplace bullying targets' help-seeking behavior in a religious context

Workplace bullying is a pervasive issue that affects millions of individuals worldwide, leading to severe psychological and social consequences. This study examines the factors influencing the decisions of religious individuals who have experienced workplace bullying, with an explicit focus on their choice to seek help from their religious community. The study involved respondents from various religious groups, most of whom were Roman Catholic. The research employs a cross-sectional design, integrating quantitative analysis with qualitative insights. Data from 1,231 respondents were analyzed via descriptive statistics, correlation, regression, and content analysis methods. The main coping strategies identified were self-coping and seeking help within a close, trusted environment. Attitudes toward the religious organization (subjective norms) consistently predicted help-seeking decisions more accurately than access to religious counseling (perceived behavioral control) or personal values. This research provides one of the first empirical insights into how religious communities can actively mitigate the psychological impact of workplace bullying, offering a novel perspective on the intersection of faith and mental health. The findings suggest that religious organizations could be crucial in supporting victims by enhancing outreach and counseling services, contributing to a holistic approach to workplace well-being. These findings have significant implications for religious communities, highlighting their potential to support their members in times of active distress.

Preceptor's experience in supervising undergraduate nursing students in mental health: A qualitative study

Preceptorship is considered an essential component in undergraduate nursing student's clinical placement, especially those in speciality units such as mental health. During the preceptorship relationship students are granted the opportunity to work alongside experienced nurses in the ward observing their interactions with patients and other professionals. In addition, students are able to build clinical confidence and competence. There is currently a gap in the literature around the preceptorship experience in the mental health clinical environment which warrants further exploration. The aim of this study was to explore the experiences of Registered Nurses precepting undergraduate nursing students during mental health clinical placements. A qualitative, exploratory approach was performed. A total of eight registered nurses working in an acute in-patient mental health unit in a large regional hospital, were recruited and interviewed using a semi-structured interview technique. Thematic analysis was utilised to analyse the data resulting in the development of four overarching themes; (1) Time consuming and additional workload, (2) creating a safe environment, (3) providing and receiving feedback and (4) precepting is not a choice, it is an expectation. The results highlighted that preceptoring students was considered to be an extra workload that required significant time and effort. Preceptors also expressed concerns about student safety, emphasised the importance of feedback and acknowledged preceptorship as an expectation of registered nurses working in mental health. These findings underscore the necessity for further research to delve deeper into the experience of preceptors in mental health settings.

Consequences of Workplace Bullying From Nurses' Perspectives: A Qualitative Descriptive Study in Iran

AIM

The aim of this study is to explore Iranian nurses' experiences regarding the consequences of bullying.

DESIGN

A qualitative descriptive study is carried out using conventional content analysis and Granheim and Lundman's method.

METHODS

Data for this study were collected through 12 in-depth, semi-structured individual interviews with nurses employed at a teaching hospital in REDACTED, western Iran. Purposeful sampling was employed until data saturation was achieved. Data management was conducted using MAXQDA software.

RESULTS

The participants consisted of 12 nurses, with a mean age of 36.1 ± 8.6 years. Their experiences of workplace bullying were analysed and categorised into a main theme called 'Consequences of Workplace Bullying', with two categories identified as 'Organisational Consequences' and 'Individual Consequences'. The organisational consequences were further elaborated through two subcategories: 'work performance consequences' and 'patient care consequences'. The individual consequences category included subcategories including 'psychosomatic consequences', 'psychological consequences' and 'family consequences'.

CONCLUSION

Workplace bullying among nurses can have negative impacts on patients, nurses and organisations. In order to mitigate these effects, nurse managers can take proactive measures by implementing management strategies and fostering a positive work culture. By addressing the underlying factors and promoting a supportive environment, the adverse consequences of workplace bullying can be reduced or prevented.

PATIENT OR PUBLIC CONTRIBUTION

Yes.

Nothing personal, it's the organization! Links between organizational culture, workplace bullying, and affective commitment

Extensive attention in organizational research has been dedicated to workplace bullying, primarily focusing on its frequency and impact on both the victim and the bully, emphasizing interpersonal dynamics. This study extends current research by shifting the focus to the organizational level, examining the relationship between organizational culture and affective commitment, mediated by workplace bullying. Utilizing data from two surveys (N = 650 in 2012 and N = 553 in 2017), the study reveals that dimensions of organizational culture, such as assertiveness, performance orientation, and ingroup collectivism significantly influence work-related workplace bullying. Performance orientation and assertiveness are positively associated with increased bullying, whereas ingroup collectivism serves as a deterrent. In turn, work-related bullying negatively impacts affective commitment, while a culture characterized by high ingroup collectivism not only links negatively with bullying but also links positively with affective commitment. This work is one of the first studies to investigate the interplay among several dimensions of organizational culture, workplace bullying, and affective commitment, underscoring the importance of supportive organizational cultures in fostering healthy work environments.

Upward Bullying as Experienced by Chinese Nurse Managers: A Qualitative Study

Aim

To understand the current situation of upward bullying in the Chinese nursing field and explore the manifestations, reasons, and outcomes of upward bullying experienced by Chinese nurse managers.

Background

Workplace bullying, a serious social problem, is characterised by recurring incidents of intimidating, aggressive, and hostile behaviour. Bullying in the nursing profession exhibits all or some of the above traits. The evidence of upward bullying by subordinate nurses against nurses in positions of authority or power is limited in China.

Methods

This qualitative study was conducted with semistructured, in-depth interviews involving 12 hospital nurse managers in Wuhan, Hubei Province, between June and August 2023. The data were analysed using the Colaizzi seven-step analysis method with Nvivo 12.0 software as a support.

Results

We grouped our findings into three main categories: manifestations of upward bullying; reasons for upward bullying; and outcomes of upward bullying.

Conclusions

Nurse managers in China are exposed to upward bullying in many forms and for complex reasons. More emphasis needs to be given to creating a positive work environment for them to facilitate their managerial role. Implications for Nursing Management. This study probes the realities of upward bullying against Chinese nurse managers and highlights the need for managers to develop the skills needed to identify, manage, and prevent bullying from subordinates. By contributing to the development of interventions and strategies that address workplace bullying, this study shows promise for enhancing managerial effectiveness and improving the nursing practice environment.

Factors Influencing Hospital Nurses' Workplace Bullying Experiences Focusing on Meritocracy Belief, Emotional Intelligence, and Organizational Culture: A Cross-Sectional Study

Aims

To identify the factors influencing hospital nurses' workplace bullying experiences (victim and perpetrator aspects) focusing on meritocracy beliefs, emotional intelligence, and organizational culture.

Background

Workplace bullying remains a major issue in nursing despite decades of research and policy-making. Therefore, comprehensively understanding the individual and institutional factors affecting workplace bullying from both the victim and perpetrator perspectives is crucial.

Methods

In October 2022, 379 nurses working in South Korean tertiary hospitals were surveyed using a self-reported online questionnaire. Meritocracy beliefs, emotional intelligence, workplace bullying experiences, and nursing organizational culture were measured using the Meritocracy Belief Scale, Wong and Law Emotional Intelligence Scale, Negative Acts Questionnaire-Revised, and Positive Nursing Organizational Culture Measurement Tool, respectively.

Results

Gamma regression analysis revealed that, for workplace bullying, the factors influencing the victim aspect were the experience of witnessing bullying in the workplace, organizational culture, and meritocracy beliefs. In contrast, the factors affecting the perpetrator aspect were emotional intelligence, meritocracy beliefs, and experience of bullying at work.

Conclusion

Decreasing nurses' degree of meritocratic hubris in a positive organizational culture and increasing their emotional intelligence are necessary to prevent and intervene in workplace bullying. Implications for Nursing Management. Targeted approaches are needed to address and mitigate the detrimental effects of factors influencing workplace bullying. These approaches could include interventions that improve nurses' emotional intelligence, assess their level of meritocracy beliefs, and offer opportunities for self-reflection on meritocratic hubris. Such initiatives may be necessary to effectively tackle workplace bullying and promote a healthier nursing work environment.

The relationship between organizational justice and bullying behaviors among nurses: the role of nurse managers' caring behaviors

BACKGROUND

Organizational justice is pivotal in fostering a fair and supportive workplace culture, which strengthens the connections between managers and nurses, among nurses themselves, and ultimately, between nurses and their patients. Assessing the perceived levels of organizational justice and managerial behaviors can identify key areas for improving nurses' commitment and loyalty, while simultaneously reducing incidents of workplace bullying.

PURPOSE

This study aims to investigate how bedside nurses perceive organizational justice, nurse managers' caring behaviors, and their exposure to workplace bullying. Additionally, it seeks to explore the relationship between organizational justice, nurse managers' caring behaviors, and nurses' perceived exposure to workplace bullying.

METHODS

A descriptive-correlational study was conducted in the inpatient care unit of a Saudi hospital. A convenience sample of 256 nurses participated, completing the Organizational Justice Questionnaire (OJQ), the Caring Factor Survey: Caring of the Manager (CFS-CM), and the Negative Acts Questionnaire-Revised (NAQ-R). The collected data were analyzed using descriptive statistics and regression analysis.

RESULTS

Descriptive statistics revealed moderate levels of perceived organizational justice and managerial caring behaviors among nurses, alongside low reported exposure to workplace bullying. Significant correlations were found among the studied variables, indicating that higher perceived organizational justice was associated with higher managerial caring and lower workplace bullying (p < 0.05). Mediation analysis demonstrated a significant indirect effect of organizational justice on workplace bullying through the mediating role of nurse managers' caring behaviors (a×b = -0.0652, p < 0.001). Furthermore, the direct effect of organizational justice on workplace bullying remained significant even when accounting for the mediator (c = -0.5509, p < 0.001).

CONCLUSION

This study highlights the vital role of organizational justice and managerial caring in cultivating a positive work environment and mitigating workplace bullying. Implementing clear policies and procedures while promoting fairness and equality in resource allocation, decision-making processes, and interactions are essential strategies for fostering positive attitudes and work behaviors among nurses.

Perceived Academic Team Leaders' Authentic Leadership and Team Members' Psychological Safety: A Cross-Sectional Online Survey

Background

Current research has mainly concentrated on the psychological facets of authentic leadership and the sense of psychological security it cultivates.

Aim

This research assessed the perceived academic team leaders' authentic leadership and team members' psychological safety.

Methods

Using a quantitative cross-sectional study, the study was conducted in 2022 using an online survey. A convenience snowball sample of 105 nursing faculty members was recruited from various Jordanian universities.

Results

The nursing faculty highly praised their leaders' authentic leadership on a 5-point scale. Yet, they felt a lack of psychological safety for themselves. While the academic nursing team leaders were commended for their readiness to hear others' suggestions before making choices, they should work on resisting group influence. These leaders must convey their feelings openly and truthfully. Concerning their own psychological safety, the nursing faculty felt their distinctive abilities and talents were recognized and utilized when collaborating with team members, which was the most highly rated feature. Conversely, the least-rated aspects were holding mistakes against faculty members and having trouble requesting assistance from others. The nursing faculty's sense of security and comfort significantly impacts their psychological wellbeing. Interestingly, their level of psychological safety is found to have a significant but negative correlation with their marital status, providing a rich and new insight into psychological safety; married females with children are prone to more work burnout, which might lower their psychological safety. On the other hand, a positive and moderate correlation is observed between psychological safety and the size of the team they work with. Surprisingly, the team size is the only factor that predicts the psychological safety of nursing faculty members; this occurs by enhancing the team's creativity and learning behaviors. However, the model itself is not very effective and only accounts for a small portion (6.30%) of the variation in their psychological safety scores, suggesting other unmeasured factors likely play a more significant role in nursing faculty members' psychological safety, such as personality traits, stressors, and job satisfaction.

Conclusion

The authentic leadership displayed by nursing team leaders does not directly impact the psychological safety of nursing faculty members. The study addresses a critical and contemporary issue within the nursing academic field, providing useful preliminary insights. However, its methodological limitations, including sample selection and the weak explanatory power of its model, suggest that further research is needed. The results highlight the urgent need for immediate interventions to improve the chaotic academic environment they are currently facing, such as enhancing workplace friendship and authentic communication and using entrepreneurial and nonauthoritative leadership styles. Future studies could benefit from diverse samples, longitudinal design, and deeper analysis of contributing factors to psychological safety.

Effectiveness of cognitive rehearsal programs for the prevention of workplace bullying among hospital nurses: a systematic review and meta-analysis

BACKGROUND

To solve the problem of workplace bullying among nurses, it is necessary to review the effects of interventions and generalize the findings. We conducted a systematic literature review and meta-analysis to evaluate the effects of cognitive rehearsal programs on workplace bullying among hospital nurses.

METHODS

Data were collected from March 30 to April 11, 2021, and 11,048 journal articles published in South Korea and internationally were examined across eight databases. Nine articles were selected for inclusion in the systematic literature review; five of the nine studies were included in the meta-analysis. For randomized controlled trials, the risk of bias was evaluated, and for non-randomized controlled trials, the study quality was evaluated using the Risk of Bias for Non-randomized Studies version 2.0. Egger's regression test was performed to determine publication bias.

RESULTS

Of the nine articles selected for this study, two were randomized controlled trials and seven were non-randomized controlled trials. The I2 value was 18.9%, indicating non-significant heterogeneity. The overall effect size of the cognitive rehearsal programs was -0.40 (95% confidence interval: -0.604 to -0.196; Z = -3.85; p = .0001) in a random-effects model, indicating a large effect size with statistical significance.

CONCLUSIONS

Therefore, cognitive rehearsal programs that address workplace bullying among hospital nurses are effective. Health policymakers must implement cognitive rehearsal programs in a policy manner to address the problems of bullying in the workplace.

Why do nurses leave their jobs? Understanding person-related hostility in the healthcare sector of Pakistan

Nursing is considered indigent and oppressed because of uneven organizational hierarchies and unsatisfactory work environments. This study aimed to highlight the critical aspects of organizational culture in the nursing profession and, in general, those propagating hostile behaviours among female nursing staff that result in dissatisfaction and intention to leave the organization. A quantitative research approach was applied and a survey research strategy was used to collect the data. Convenience sampling was applied and data were collected from female nurses who were easily accessible and willing to participate in the research. A total of 707 questionnaires were collected from 14 hospitals and the data was analyzed using SmartPLS 4. Lack of administrative support and gender discrimination positively affected person-related hostility. In contrast, person-related hostility mediated the relationship between gender discrimination and lack of administrative support with the intention to leave. Direct or indirect person-related hostility factors can severely damage organizational reputation and quality and may cause the loss of employees with specific organizational knowledge and exposure. Losing an experienced employee to a newer one cannot replace the costs incurred on hiring, training, and providing knowledge to older employees. HR managers in organizations should devise strategies and policies that allow for the timely resolution of issues of nursing staff based on fair work performance.

Factors that contribute to turnover and retention amongst emergency department nurses: A scoping review

BACKGROUND

Internationally, the emergency nursing workforce shortage is of critical concern.

AIM

To synthesise the evidence and assess the scope of literature regarding factors that contribute to turnover and retention amongst emergency nurses.

METHOD

A scoping review using the Joanna Briggs Institute approach was undertaken. Fivedatabases (Embase, MEDLINE, PsycINFO, CINAHL, and Business Source Complete) were searched for papers published in English between January 2011 and June 2023 where the population was nurses, context was the emergency department, and the concept was turnover or retention. A quality appraisal was performed on included studies.

RESULTS

A total of 31 articles met the inclusion criteria. Twenty-six studies focussed on turnover and five studies focussed on retention. Factors that contribute to ED nursing turnover included workplace violence, personal aspects (e.g., burnout or depression), organisational characteristics, and environmental/ job characteristics. Factors that contributed to ED nursing retention included mentoring programs, the advancement in nursing skills, and the transition to practice speciality (emergency) programs.

CONCLUSIONS

A large body of literature exists regarding ED nurses' reasons for leaving their area of practice, yet limited evidence exist on retention. Research exploring factors that promote retention of emergency nurses that leads to subsequent stability and growth in the emergency nursing workforce is needed.

Impact of workplace bullying on job burnout and turnover intention among nursing staff in Greece: Evidence after the COVID-19 pandemic

Introduction

The prevalence of workplace bullying, job burnout, and turnover intention among nursing staff increased during the COVID-19 pandemic. However, to the best of our knowledge, there are no studies that have measured the relationships among variables of interest after the pandemic.

Objective

Our intention is to investigate the effect of workplace bullying on job burnout and turnover intention in nursing staff.

Methods

We conducted a cross-sectional study during January-February 2024 in Greece. We obtained a convenience sample of 450 nurses. We used the 22-item Negative Acts Questionnaire-Revised to assess workplace bullying. We measured job burnout with the single-item burnout measure. We measured nurses' turnover intention with a valid 6-point Likert scale.

Results

The study sample included 450 nurses with the mean age of 39.1 years (standard deviation [SD] = 10.2). The mean workplace bullying score was 7.7 (SD = 2.0), while the mean job burnout score was 7.7 (SD = 2.0). Among our nurses, 57.3% showed a high level of turnover intention. After eliminating confounders, we found that increased workplace bullying (adjusted beta = 0.031, 95% confidence interval [CI] = 0.023 to 0.039, p < 0.001) was associated with increased job burnout. Moreover, multivariable logistic regression analysis showed that increased turnover intention was more common among nurses who experienced higher levels of workplace bullying (adjusted odds ratio = 1.057, 95% CI = 1.043 to 1.071, p < 0.001).

Conclusion

We found a positive relationship between workplace bullying, job burnout, and turnover intention. Nurse managers, organizations, and policy-makers ought to consider such findings to intervene and decrease workplace bullying by improving working conditions.

Impact of Workplace Bullying on Quiet Quitting in Nurses: The Mediating Effect of Coping Strategies

Workplace bullying is common among nurses and negatively affects several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data in February 2024. We used the Negative Acts Questionnaire-Revised, the Quiet Quitting Scale, and the Brief COPE to measure workplace bullying, quiet quitting, and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies were negative predictors of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses' managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.

Inductive process of moral distress development in viewpoints from surgical nurses: a mixed-method study

BACKGROUND

Moral distress is a multifactorial and complex phenomenon influenced by various individual, cultural, and systemic factors. This study aimed to investigate the frequency and intensity of nurses' moral distress, explore their experiences, and develop the conceptual model of risk factors of moral distress in surgical units and operating rooms.

METHOD

This is a sequential mixed-method study conducted at four teaching hospitals affiliated with the Qom University of Medical Sciences. In the first step, the moral distress of nurses in surgical units and operating rooms was investigated by a survey. The participants included nurses who worked in the operating room and surgical units. (n = 180). The data was collected by a Moral Distress Scale-Revised (MDS-R) questionnaire. In the second step, the experiences of nurses regarding risk factors of moral distress were explored using semi-structured interviews and analyzed using the conventional content analysis by Graneheim and Lundman's approach.

RESULTS

One hundred eighty nurses participated in this study. The mean total moral distress scores ranged from 12 to 221, with a mean (SD) of 116.8 (42.73). The causes of moral distress cited with the highest frequency and intensity related to the 'role of healthcare providers'. The experiences of the participants in the theme 'Inductive process of moral distress development' were categorized into three categories: 'Melting into the faulty system', 'Power and the system as distress promotors', and 'Perceived unpleasant consequences'.

CONCLUSION

The results indicated that the frequency of moral distress in operating rooms and surgical units was at a moderate level and the distress intensity of nurses was at a moderately high level. The results indicated that in the investigated system, the "inductive moral process of distress development" was continuously understood by the participants. This process was influenced by systemic and individual factors. Weak assertiveness, conservative compromise, and desensitization to unprofessionalism as individual factors were effective in causing distress. Risk factors at the systemic level led nurses to melt into the faulty system and created adverse outcomes at the individual level. The lack of systemic support and the stabilization of mobbing by powerful system members had a negative impact on the individual factors of distress development. Also, these factors directly cause negative consequences.

Association between Workplace Bullying, Job Stress, and Professional Quality of Life in Nurses: A Systematic Review and Meta-Analysis

Workplace bullying affects workers' lives, causing several mental and physical health problems and job-related issues. Therefore, a summary of the evidence on the consequences of workplace bullying on workers' lives is essential to improve working conditions. The literature lacks systematic reviews and meta-analyses on the association between workplace bullying and job stress and the professional quality of life of nurses. Thus, we aimed to quantitatively summarize the data on the association between workplace bullying, job stress, and professional quality of life. We performed our study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The review protocol was registered with PROSPERO (CRD42024495948). We searched PubMed, Medline, Scopus, Cinahl, and Web of Science up to 4 January 2024. We calculated pooled correlation coefficients and 95% confidence intervals [CI]. We identified nine studies with a total of 3730 nurses. We found a moderate positive correlation between workplace bullying and job stress (pooled correlation coefficient = 0.34, 95% CI = 0.29 to 0.39). Moreover, a small negative correlation between workplace bullying and compassion satisfaction (pooled correlation coefficient = -0.28, 95% CI = -0.41 to -0.15) was identified. Additionally, our findings suggested a moderate positive correlation between workplace bullying and job burnout (pooled correlation coefficient = 0.43, 95% CI = 0.32 to 0.53) and secondary traumatic stress (pooled correlation coefficient = 0.36, 95% CI = 0.11 to 0.57). Our findings can help nursing managers and policy-makers to draw attention to workplace bullying by implementing effective interventions, so as to reduce the bullying of nurses.

Global prevalence of bullying and associated factors among nursing students during clinical practice: A systematic review and meta-analysis

OBJECTIVE

This meta-analysis aims to estimate the global prevalence of bullying among nursing students during clinical practice and identify associated factors.

DESIGN

Systematic review and meta-analysis.

REVIEW METHODS AND DATA SOURCES

We conducted a comprehensive literature search across ten databases (PubMed, Cochrane, Web of Science, Embase, CINAHL, PsycINFO, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG) from their inception to January 3, 2023. Two researchers independently screened potentially eligible studies, extracted data, and assessed study quality. Data were analyzed using random-effects or fixed-effects models. Subgroup analyses and meta-regression explored the influence of participant and study characteristics on bullying prevalence. Publication bias and sensitivity analyses were also performed.

RESULTS

We included 28 studies (N = 9511) from 13 countries on five continents. The pooled estimate of bullying prevalence among nursing students during clinical practice was 65.60 % (95 % CI 55. 75 to 74.27), with no evidence of publication bias (t = 1.51, p-value = 0.14). Subgroup and moderator analyses highlighted the impact of country, continent, publication year, and assessment tool on bullying prevalence.

CONCLUSION

Nursing students face a high prevalence of bullying during clinical practice. Addressing this issue in nursing education requires prioritizing associated factors, fostering a culture of safety, providing effective training, and promoting individual resilience. These actions can prevent and mitigate bullying, creating a supportive and empowering learning environment for future nurses.

Nursing Leaders' Knowledge and Awareness of Bullying and Lateral Violence: A Qualitative Study

Introduction

Bullying and lateral violence are prevalent phenomena within the nursing profession, exerting significant impacts on patient safety, the nursing profession and the organisation. The pivotal role of nurse leaders is paramount in both the prevention and resolution of these issues.

Aim

The aim is to explore the level of awareness and knowledge of bullying and lateral violence of nurse leaders in a public hospital in Switzerland.

Methods

A qualitative descriptive study has been conducted. Data were collected from February to August 2020 using semi-structured interviews and focus groups that were recorded and transcribed verbatim. Two researchers independently utilised Braun and Clarke's thematic analysis to code, categorise and synthesise the data. The sample of nursing middle-management leaders was purposive.

Results

The study involved 35 nurse leaders as participants. Through data analysis, 15 themes were identified, which were further grouped into five major themes: characteristics of the phenomena, facilitating and hindering factors, emotions/experiences, strategies and supports. The results highlighted that nurse leaders may have a lack of knowledge about these phenomena, leading to challenges in their identification. The awareness achieved by the nurse leaders highlighted their need to understand what they were 'fighting against'.

Conclusion

It is essential to consider the impact of these phenomena on employees' well-being and their potential consequences for patient safety, quality of care and financial performance. A preventive approach by increasing nurse leaders' competence in observing everyday working realities and identifying strategies for addressing bullying is required. Further research on the construction and implementation of specific interventions is essential, aimed at preventing and addressing these phenomena comprehensively.

Defeating Nurse Workplace Bullying Through Political Activism

ABSTRACT

Workplace bullying is a social injustice with a detrimental impact on nurse retention, job satisfaction, self-esteem, and patient care. Nurses can engage in individual-, unit-, and policy-level activities aimed at promoting a healthier work environment. In the public sphere, political activism by nurses to promote the anti-bullying Healthy Workplace Bill can help improve the safety of healthcare work settings. Christian nurses' political advocacy enhances social justice as reflected in the Bible and can be seen as another avenue for godly service.

When Leaders and Followers Match: Unveiling the Nexus Between Despotic Leadership, Supervisor-Employee Value Congruence, and Organizational Deviance-Evidence From Egypt

Introduction

Leadership style and employee behavior has long been a topic of interest in organizational research.

Objectives

To explore levels of despotic leadership, supervisor-employee value congruence, and organizational deviance among the studied nurses. Furthermore, to explore the connection between the three variables.

Methods

The study employed a cross-sectional quantitative design. The researchers used three tools as follows: the despotic leadership survey, an organizational deviance scale, and a perceived supervisor-employee value congruence scale. The first of April 2023 to the first of July 2023 were the 3 months that were used to collect the data from 250 nurses. The data were analyzed using descriptive statistics, Spearman's correlation, Kruskal-Wallis test, and Mann-Whitney U test.

Results

Nurses perceived a moderate level of despotic leadership as mean ± SD, 16.80 ± 3.01, also a moderate level for organizational deviance (30.63 ± 4.65). The studied nurses perceived a moderate level of supervisor-employee value congruence (10.93 ± 1.32) Furthermore, there is a solid positive significant relationship between despotic leadership and organizational deviance where p = .001. There is a negative significant relationship between despotic leadership and supervisor-employee value congruence where p = .001. Also, there is a negative significant relationship between organizational deviance and supervisor-employee value congruence where p = .001.

Conclusion

Nurse managers need to retain leaders to inspire subordinates' uncluttered communication networks, stirring nurses' partaking in nursing committees' assemblies, and decision-making. Hospital administrators ought to focus more on the role that value congruence plays as a buffer for subordinates who exhibit organizational deviance and high levels of mistrust. Strategies should be employed to create and maintain value congruence and reinforce desired nondeviant behaviors to foster a positive work environment.

Workplace Violence Against Nurses: Challenges and Solutions for Europe

We report the results of a mapping exercise by the European Federation of Nurses (EFN) on challenges and solutions related to violence against nurses. This is an issue of growing international concern, with the problem accentuated during and following the COVID-19 pandemic. Following a cross-sectional observational design, an online questionnaire was distributed among 35 national nurses' associations across Europe in March 2021. Face validity was achieved through an expert panel. Descriptive statistics were used for data analysis, including counts, percentages, and tabulation. Qualitative data analysis followed thematic synthesis techniques. Three main findings are noted. First, violent incidents against nurses are under-reported due to fear of victimization, employer discouragement, and the perception that reporting will not make any difference. Second, perpetrators of violent acts extend beyond patients and families to include health professionals of different ranks. Third, violent incidences have a significant adverse effect on nurses' health and retention, leading to nurses reducing their working hours or opting for part-time work. Violence against nurses is an expression of a broader problem that is rooted in the failure to recognize and manage violence at the level of the healthcare organization, and the absence of appropriate legislation to maintain minimum standards of safe working environments. This is partly the result of inadequate European Union-wide legislation targeting workplace violence in the health professions. Nurses need more institutional support through dedicated funding aimed at targeted interventions, more legislative commitment to ratify policies against discrimination, and an opportunity to voice the needs to the appropriate policymakers with the ability to bring significant change to existing conditions. Given the severity of the situation, inaction could lead to irreplaceable damage to the nursing workforce, compounding pressures resulting from the COVID-19 pandemic. Ultimately, this situation can further drive existing nurses out of the profession, weakening health systems worldwide.

Post COVID-19 workplace ostracism and counterproductive behaviors: Moral leadership

BACKGROUND

The wide proliferation of Covid-19 has impacted billions of people all over the world. This catastrophic pandemic outbreak and ostracism at work have posed challenges for all healthcare professionals, especially for nurses, and have led to a significant increase in the workload, several physical and mental problems, and a change in behavior that is more negative and counterproductive. Therefore, leadership behaviors that are moral in nature serve as a trigger and lessen the adverse workplace effects on nurses' conduct.

AIM

this research is directed to explore the impact of post-COVID-19 workplace ostracism on nurses' counterproductive behavior and examine the role of moral leadership as a mediating factor in post-COVID-19 workplace ostracism and nurses' counterproductive behavior.

ETHICAL CONSIDERATION

Ethical review and approval Was received from Ethical Committee at the Faculty of Nursing, Alexandria University, Egypt.

METHODS

A cross-sectional and correlation study was implemented in all units of medical, surgical, critical and intensive care units by using three tools; moral leadership questionnaire, Workplace Ostracism Instrument (WOS), and Counterproductive Work Behaviors Questionnaire (CWBs). A convenient sample of 340 from 699 bedside nurses was granted.

RESULTS

This study revealed that nurses' perceived moderate mean percent (55.49 ± 3.46) of overall workplace ostracism and counterproductive behavior (74.69 ± 6.15). However, they perceived a low mean percentage of moral leadership. There was a significant positive correlation between workplace ostracism and counterproductive behavior. Otherwise, a significant negative correlation was found between moral leadership, workplace ostracism and counterproductive behavior. Also, this study proved the mediating effect of moral leadership in decreasing workplace ostracism by 79.3% and counterproductive behavior by 36.7%.

CONCLUSION

Hospital administrators need to be aware of the significance of moral leadership and apply integrity in the clinical setting to reduce the drawback of isolation on nurses' conduct and increase value for the organization as a whole and nurses in particular.

Impact of workplace bullying on work engagement among early career employees

This study aims to measure the impact of workplace bullying on work engagement in terms of employee silence and knowledge sharing. It also helps to explain how psychological contract breach moderates the bullying-silence relationship. For this study, data is collected from 384 early-career employees having experience up to three years from seven banks of Lahore, Pakistan. Findings of this study reveals that workplace bullying has a positive relationship with employee silence and negative relationship with work engagement. Results of all moderation and mediated variables are significantly related to each other. However, the results explain that a psychological contract breach slightly moderates the bullying-silence relationship. Survey-based questionnaire, cross-sectional research design, and convenience-based sampling technique are some of the limitations of this study. This is the first study that tried to investigate the bullying-engagement relationship among early-career employees in the banking sector of Lahore, Pakistan. This study may help practitioners and policymakers to develop anti-bullying laws that can support the management in overcoming the negative workplace environment. This study aims to promote an equal opportunity for all employees where they can raise their voices about misconduct. This is the first study that investigated the victimization of bullying behavior among early-career employees in a Pakistani cultural context.

Evaluation and improvement of workplace vertical violence of nursing interns based on the Importance-Performance Analysis method

PURPOSE

To analyze the key factors related to workplace vertical violence among nursing interns in China and to propose strategies to improve the nursing practice environment.

METHODS

A cross-sectional study was conducted using the Importance-Performance Analysis (IPA) method to analyze the key factors and significance of workplace vertical violence for nursing interns. The data were obtained by administering a workplace vertical violence survey, designed specifically for this study, to 120 nursing interns at a tertiary general hospital in Zhejiang Province, China.

RESULTS

The results demonstrated that the variables "I was ordered to do something beyond my ability and lacked guidance (C3)," "Errors in work have been repeatedly emphasized, spread, or exaggerated (C8)," "I was unjustly criticized (C9)," "I was withheld or blocked information purposefully (C1)," and "I was belittled at work (C2)" were the most crucial variables for determining the presence of workplace vertical violence of nursing interns. Moreover, they are priority improvement variables.

CONCLUSION

Managers must prioritize the use of relevant resources during internships to minimize false reinforcement and unfair criticism. Efforts should focus on improving information sharing, emphasizing the role of nursing interns in clinical work, providing better guidance when arranging for nursing interns to do work that exceeds their capacity, reducing workplace vertical violence, and improving nursing intern practice environments.

Lived Experience of Violence Perpetrated by Treated Patients and Their Visitors in Intensive Care Units: A Qualitative Study of Nurses

BACKGROUND

Patient and visitor violence (PVV) is a widespread problem for health professionals. Nurses working in intensive care units (ICUs) face a relatively high risk of experiencing PVV, which significantly impacts both the health of nurses and the institution as a whole. The subjective perceptions of ICU nurses regarding PVV are inadequately explored in the literature.

PURPOSE

The purpose of this study was to explore the perspectives, experiences, and perceptions of PVV in ICU nurses and to better understand the precipitating factors of violence.

METHODS

A phenomenological qualitative design and purposive sampling were used. A semistructured interview guide was used to conduct in-depth interviews with 12 ICU nurses with PVV experiences. Giorgi's method of analysis was used to discover and identify the essential categories of experience.

RESULTS

Five main experience categories were identified: family and patient factors as flashpoints, managing suppressed emotions by weathering the emotional storm, spiritual awakening after violence, and strategies for surviving further violence. The participants' experiences with PVV included a range of caring and mental health difficulties. In ICU settings, patient progress is often unpredictable, resulting in discrepancies between patient/family expectations and reality. Because feelings of frustration and powerlessness can eventually cause exhaustion in ICU nurses, implementing effective emotional management, stress adjustment, psychological counseling, team support, and violence intervention programs are crucial.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

This study provides new information on the process by which nurses can progress from inner trauma to self-recovery, moving from a negative affectivity disposition to a better understanding of threat appraisals and coping response options. Nurses should increase their awareness of the complexity of the phenomenon and of the interplay among the factors underlying PVV. The results of this study suggest that routine confusion and delirium assessments to rule out patients with ICU delirium in ICUs are important to preventing PVV. This study considers some of the implications of the research findings for nursing managers. Interventions, training programs, and/or management action should be used to ensure psychological and mental support is extended to all witnesses of PVV events and not only to those targeted by violence.

The experience of nurses moving into forensic mental health employment: A qualitative study

While forensic mental health has seen considerable growth over the last two decades, little is known about the experience of registered nurses working in these environments. This study used a qualitative descriptive approach and interviewed 11 registered nurses to explore the interpersonal experiences of transition into a forensic mental health hospital. The data revealed three themes. 'Observing what's safe' examined nurses' ability to maintain safety in the context of inconsistent practices among colleagues. 'Navigating cliques and divisions' focused on nurses' sense of belonging and adapting to professional and personal groups. Finally, 'gaining management support' reflected nurses' experiences of engagement with management. This study provides new insight into nurses' experience of adapting to employment in forensic mental health settings and highlights the importance of positive support strategies for workplace transition.

Bullying and burnout in critical care nurses: A cross-sectional descriptive study

BACKGROUND

Employee bullying and burnout are two crucial, prevalent and challenging concepts that adversely affect organizational staff behaviours. Also, adverse patient care is associated with nurse bullying and burnout.

AIM

This study aimed to assess the incidence and association between workplace bullying and occupational burnout among nurses in critical care units in Iran.

STUDY DESIGN

A cross-sectional descriptive study.

METHODS

The subjects were 184 nurses from critical care units in 6 teaching hospitals in Iran. Three questionnaires were distributed among the study population; (a) demographic characteristics questionnaire, (b) Maslach Burnout Inventory (MBI) and (c) bullying at Workplace Questionnaire. Descriptive statistics were used to present the workplace bullying and occupational burnout status among nurses. Linear and logistic regression analyses were conducted to estimate the relationship between workplace bullying with MBI and nurses' demographic characteristics, respectively.

RESULTS

62% of the nurses had moderate emotional exhaustion, 59.8% had moderate depersonalization and 46.2% had a moderate individual achievement. 75.5% faced workplace bullying. There was a positive and significant association between bullying scores and burnout in total (Pearson's r = 0.598, p < 0.001). Linear regression test showed a positive and significant relationship between bullying with MBI dimensions (R = 0.613, p < 0.001) for emotional exhaustion, (R = 0.679, p < 0.001) for depersonalization and (R = -0.417, p < 0.001) for individual achievement.

CONCLUSIONS

Among Iranian nurses, bullying is a prominent and substantial issue that significantly correlates with their negative performance by enhancing job burnout.

RELEVANCE TO CLINICAL PRACTICE

It is suggested that some measures are adopted to avoid workplace bullying and to reduce occupational burnout for nurses. Managers should create an environment that encourages nurses to voice their concerns - informing nurses about their rights and creating a positive atmosphere in the hospital.

Creating respectful workplaces for nurses in regional acute care settings: A quasi-experimental design

AIM

To examine self-reported exposure and experiences of negative workplace behaviour and ways of coping of nursing staff before and after educational workshops.

DESIGN

A Quasi-experimental design.

METHOD/SETTING/PARTICIPANTS

Data were collected pre- /postworkshops using a structured questionnaire. Nurses (N = 230) from 12 units in four regional acute care hospitals were invited to complete a pre-intervention survey. Educational workshops were then implemented by the organization at two of the hospitals, after which, follow-up surveys were undertaken.

RESULTS

There were 74 responses in the pre-intervention and 56 responses in the postintervention time period. There were 111 participants who attended the educational intervention, 20% (n = 22) completed the follow-up survey. Participants were more likely exposed to work-related bullying acts and they used problem-focused coping strategies and sought social support as a way of coping when exposed to the negative behaviours. Overall, there was a decrease in both bullying and incivility experienced by participants; however, our findings were unable to establish that a statistically significant difference was made due to the implementation of the intervention.

STUDY REGISTRATION

Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).

The relationships between organizational culture and thriving at work among nurses: The mediating role of affective commitment and work engagement

AIM

Guided by the social embeddedness model of thriving at work, this paper explores how nursing organizational culture, work engagement and affective commitment affect nurses' thriving at work.

BACKGROUND

Thriving at work has implications for better employee and organization outcomes. The antecedents of thriving at work among the nursing population needs to be expanded by analysing the cross-level impact of organizational and individual characteristics.

METHODS

A cross-sectional design was used to collect data from 1437 frontline nurses in a tertiary teaching hospital in China between April and May 2020 through an online survey about perceived nursing culture, work engagement, affective commitment and thriving at work. Data were analysed using SPSS, and a structural equation model was established using the PROCESS macro.

RESULTS

Our results showed that work engagement and affective commitment mediated the relationship between nurses' perceived nursing culture and their thriving at work. Among nurses, work engagement was positively correlated to affective commitment.

CONCLUSION

Our study confirmed the social embeddedness model of thriving at work by showing that both contextual and dispositional factors can influence nurses' thriving at work. Nurse leaders can foster nursing staff's thriving at work by building an inclusive work environment and by providing adequate resources to staff. Future research is needed to elaborate on employee and organizational outcomes associated with thriving at work.

IMPACT

Nurse leaders should be the advocate for nurses to improve their organizational identification, fostering their thriving at work. Individual nurses can also take an active role in developing work-related resources to sustain their thriving through self-adaption processes. Collective thriving in the nursing workforce is needed to overcome adversity and hardship in the ever-changing and increasingly demanding health care industry and to further contribute to the vitality of the broader social and public environments.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public.

Influence of the Clinical Nurse's Self-Acceptance and Experiential Acceptance on Leadership Versatility

Introduction

This study identifies how the self-acceptance and experiential acceptance of nurses working in hospitals influences leadership versatility to utilize the information as basic data for developing strategies for improving nursing quality through effective manpower management.

Objective

This study aims to identify the relationships of nurses' self-acceptance, experiential acceptance, and leadership versatility and verify the influence of experiential acceptance and self-acceptance on leadership versatility.

Methods

This study used a descriptive design. The convenience subjects were 100 nurses at the one territory hospital in Korea. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regressions.

Results

There were significant positive correlations between self-acceptance and leadership versatility (r = .39, p < .001). Among predictors, self-acceptance had statistically significant influences on leadership versatility (β = 0.35, p < .001). Self-acceptance indicated an explanation power of 24.0% of the total variance and was shown to be statistically significant (F = 6.89, p < .001).

Conclusions

Self-acceptance and experiential acceptance and factors according to nurses' clinical experience and position should be identified in depth, and subsequent studies on factors related to this should be conducted.

Workplace mobbing, group cohesion and intraindividual variables in nurses from a rural hospital in Northern Greece: A correlation study

BACKGROUND

High levels of mobbing are reported in Greek nurses, but the intraindividual and perceived group emotional correlates are little investigated.

OBJECTIVE

To determine the relationship between workplace mobbing (specifically in the nursing sector of a public rural hospital in Greece) and emotional correlates.

METHODS

Questionnaires measuring emotional aspects such as Negative Act Questionnaire - Revised (NAQ-R) for measuring perceived exposure to bullying and victimization at work, Maslach Burnout Inventory (MBI), Overall Job Satisfaction Scale (OJS), Job Affect Scale (JAS: positive and negative subscales), Perceived Cohesion Scale (PCS), Ethical Climate Questionnaire (ECQ), and Short General Health Questionnaire (GHQ-12) were administered. For the analysis of the data, descriptive and parametric tests were performed through the Pearson correlations and regression for the relationship between variables.

RESULTS

High mobbing levels were reported (M = 45.93) compared to already established cutoff scores. Statistically significant positive correlations were found for NAQ-R and MBI (Exhaustion subscale) (r = .569, p < .001), NAQ-R and JAS-negative affect (r = .610, p < .001), NAQ-R and GHQ-12 (r = .280, p = .002), and NAQ-R andeducational level (r = .196, p = .033). Statistically significant negative correlations were found for NAQ-R and ECQ (r = -.323, p < .001), NAQ-R and JAS-positive affect (r = -.556, p < .001), and NAQ-R and PCS (r = -.586, p < .001). Only burnout,negative affect, and perceived group cohesion predicted mobbing measured by NAQ- R.

CONCLUSION

As mobbing and its consequences are related to specific emotional variables, these perceived individual and group indices, could be targeted in future prevention initiatives.

Aggression and burnout in nurses during COVID-19: A cross-sectional study

Workplace violence against nurses, an ever-present problem in the healthcare workplace, has been increasing with COVID-19 and affects occupational health. This study analyzed the consequences of COVID-19 on violence against nurses, identifying its association with burnout, emphasizing the importance of work-related variables. A total of 1013 actively employed nurses in Spain with a mean age of 34.71 years filled out a computer-assisted web interviewing survey. Aggression as a consequence of their work was reported by 73.44% of the nurses. Those most affected were in primary care, and verbal aggression by patients and their families was the most frequent. Nurses who were attacked scored significantly higher in emotional exhaustion and depersonalization. Furthermore, 83.22% said that COVID-19 was an important factor in the increase in violence toward healthcare workers. Analysis showed that a perceived secure environment was a mediator between the belief that COVID-19 was an influential factor in the increase of violence and the depersonalization dimension of burnout. Increasing perceived security in the work environment among nurses can be effective in promoting well-being, work performance, and commitment to the profession.

A Qualitative Meta-Synthesis of Studies on Workplace Bullying among Nurses

This study aimed to further understand and compare the phenomenon of workplace bullying (WPB) among clinical nurses in various sociocultural contexts. The study sought to determine appropriate interventions, examining how said interventions should be delivered at individual, work-unit, and institutional levels. Qualitative meta-synthesis was chosen to achieve the study aims. Individual qualitative research findings were gathered, compared, and summarized using the thematic analysis suggested by Braun and Clark. Based on the predefined analytic points, the findings included the following themes: horizontal yet vertical violence, direct and indirect violence on victims, nurses feed on their own, accepting and condoning WPB embedded in ineffective work systems, and rippling over the entire organization. The results showed that the phenomenon of workplace bullying shares quite a few attributes across cultures in terms of the characteristics, types, perpetrators, subjects, and consequences. The findings suggest that interventions to change and improve organizational work culture must be developed and implemented.

Longitudinal relations between abusive supervision, subordinates' emotional exhaustion, and job neglect among Pakistani Nurses: The moderating role of self-compassion

The main purpose of this study was to investigate reciprocal relationships between abusive supervision, subordinates' emotional exhaustion, and job neglect, and to examine the mediating role of emotional exhaustion in the cross-lagged relationship between abusive supervision and job neglect. Besides, we tested the moderating role of self-compassion in the cross-lagged relationship between abusive supervision and emotional exhaustion. We applied a two-wave cross-lagged panel design with a time lag of six months. Participants were 331 staff nurses of public sector hospitals in Islamabad, Pakistan. Data were collected using a self-report questionnaire at two points in time. Longitudinal structural equation modeling (SEM) was used to compare nested models. Results of cross-lagged SEM analyses supported the posited reciprocal model, indicating that abusive supervision, emotional exhaustion, and job neglect are mutually related. Results of mediation analysis showed that emotional exhaustion partially mediates the cross-lagged relationship between abusive supervision and job neglect. Further, we found that self-compassion attenuates the positive cross-lagged effect of abusive supervision on emotional exhaustion, and the indirect effect of abusive supervision on job neglect was weaker at higher levels of self-compassion. Our findings suggest that subordinates may find themselves in abusive relationships, in part, because their own behavioral responses to abuse can reinforce abusive supervision. Moreover, we identified the stress-buffering effect of self-compassion on emotional exhaustion.

Nurse-to-nurse horizontal violence in Chinese hospitals and the protective role of head nurse's caring and nurses' group behaviour on it: A cross-sectional study

AIMS

This study aimed to analyse the prevalence of nurse-to-nurse horizontal violence in Chinese hospitals and examine the effects of head nurse's caring and nurse's group behaviour on horizontal violence.

BACKGROUND

Horizontal violence is a serious global problem affecting the nursing profession, but little is known of the issue in Chinese hospitals. Increasing evidence has showed that leadership and group factors are important in facilitating horizontal violence. Whether the head nurse's caring and group behaviour perceived by nurses has protective effects against horizontal violence remains unclear.

METHODS

A cross-sectional online-based questionnaire study was performed in seven general hospitals in Hubei Province, China. Data related to the demographic information, horizontal violence, head nurse's caring and group behaviour were collected. Descriptive analyses, chi-squared tests and logistic regression were used for data analysis.

RESULTS

In total, 1942 valid questionnaires were collected, with a 92.70% effective response rate (1942/2095). Of those, 59.1% (1148/1942) of respondents had experienced horizontal violence at least once in the previous 6 months. Covert negative behaviours were more frequently reported. Compared with the low level, moderate and high levels of the head nurse's caring showed a lower risk of horizontal violence (odds ratio [OR] = 0.400, p < .001; OR = 0.128, p < .001); moderate and high levels of group behaviour also showed a reduced risk (OR = 0.601, p < .001; OR = 0.221, p < .001).

CONCLUSION

Horizontal violence is common among Chinese nurses. The head nurse's caring and maintaining a good climate of nurses' group behaviours could serve as protective factors for preventing horizontal violence.

IMPLICATIONS FOR NURSING MANAGEMENT

This study helps nursing managers identify which specific negative behaviours occur frequently and require special attention. It suggests that nursing managers attach importance to improving their caring ability towards nurses and to creating an amicable climate of group behaviour to buffer against horizontal violence.

Factors influencing the behavior of bystanders to workplace bullying in healthcare—A qualitative descriptive interview study

Workplace bullying is a severe problem that affects individuals, organizations, and society. Although there is a growing research interest in bystanders of workplace bullying, the rationale underlying bystanders' behavior in healthcare settings requires further investigation. The aim of the current study is to explore factors that influence the behavior of bystanders to workplace bullying in the healthcare sector. Qualitative semistructured interviews were conducted with 32 staff members in the healthcare sector in Sweden. Data were collected between March 2019 and September 2020 and were analyzed with thematic analysis. The participants experienced that bystanders of bullying, both colleagues and managers, were in many situations acting in a passive way. Organizational factors such as dysfunctional organizational culture and deficiencies in management affected how actively the bystanders could intervene. Additionally, a fear of negative consequences, lack of awareness of what was going on, bullying behavior being excused, and the bystander not being a member of the dominant group were social factors contributing to bystanders' passive behavior. For bystander intervention to be successful, the organization must consider bullying as a serious issue, take action, and show support for both the target and the bystander.