How does workplace bullying influence nurses' abilities to provide patient care? A nurse perspective

Mediating Effects of Emotional Exhaustion Between Lateral Violence in Nursing and Turnover Intentions: A Cross-Sectional Survey

AIM

This study aims to determine the mediating effect of emotional exhaustion on the relationship between lateral violence in nursing and turnover intentions.

DESIGN

A cross-sectional survey.

METHODS

This research project involved the enrollment of 314 nursing professionals from two tertiary medical facilities associated with academic institutions in Changsha, Hunan Province, China. To measure the variables, a series of self-administered questionnaires was used. The data were analysed using SPSS 25.

RESULTS

Lateral violence and emotional exhaustion were positively correlated with turnover intention. Emotional exhaustion partially mediated the relationship between lateral violence and turnover intention.

CONCLUSION

Emotional exhaustion serves as a partial mediator in the relationship between lateral violence and turnover intention. Reducing lateral violence and avoiding emotional exhaustion can help to reduce the turnover intention of nurses.

IMPLICATIONS FOR THE PROFESSION

When developing targeted programs or policies aimed at decreasing nurses' turnover intention, it is important to consider the issue of lateral violence among nurses, as well as their negative emotions.

IMPACT

The study provides us with a more fine-grained understanding of the relationship between lateral violence among nurses and turnover intention. Insights to enhance nurse retention are also provided, which can support the development of future relevant policies and guidelines.

REPORTING METHOD

The study adhered to the STROBE guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The Moderating Role of Person-Job Fit and Person-Organization Fit on the Relationship Between Workplace Spirituality and the Physical and Mental Health Among Nursing Staff

Background: The physical and mental health of nursing staff is crucial, affecting them personally and influencing the quality of medical care they provide. In this study, we used positive psychology to examine the effect of workplace spirituality on the physical and mental health of nursing staff. We also employed person-environment fit theory to identify the moderating effects of person-job and person-organization fit on the aforementioned relationship. Methods: Full-time nursing staff employed for more than 6 months at a medical center were recruited. Stratified random sampling was conducted together with a questionnaire survey, yielding 320 nursing staff participants and 255 valid questionnaire responses. Results: Workplace spirituality was found to have a positive effect on physical and mental health. Better person-organization fit was associated with better person-job fit and a stronger effect of workplace spirituality on physical health. In addition, more favorable person-job fit was associated with a stronger effect of workplace spirituality on mental health. Conclusions: This study emphasized the effect of workplace spirituality on the physical and mental health of nursing personnel. It also considered the moderating effects of person-organization fit and person-job fit. Managers should prioritize and support the cultivation of workplace spirituality, involve employees in shaping the culture of their organization, and ensure alignment between employee's job requirements and skills.

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.

Empowering nursing students: understanding and addressing bullying experiences in clinical training

INTRODUCTION

Bullying in educational environments, particularly among nursing students, is recognized as a significant challenge that can adversely affect their mental health and professional development. Therefore, this qualitative study aims to elucidate nursing students' experiences concerning the phenomenon of bullying during clinical training.

MATERIALS AND METHODS

This qualitative study employed a conventional content analysis approach. Sixteen nursing students were selected using purposive sampling. Semi-structured in-depth interviews were conducted to gather data. The collected data were analyzed using the method proposed by Lundman and Graneheim (2020). MAXQDA version 0.9.5 software was utilized for data management.

RESULTS

The mean age of the participants was 25.3 ± 3.9 years. Nursing students' experiences regarding bullying were articulated through five main themes, eleven categories, and twenty-two subcategories. The main themes included "contexts and agents of bullying," "type of bullying," "roots and causes of bullying," "characteristics of the bully," and "characteristics of the victims." The categories encompassed "educational settings," "healthcare environments," "administrative settings," "direct bullying," "indirect bullying," "clinical environment," "socio-economic factors," "psychological issues," "communication and emotional challenges," "individual challenges," and "educational challenges."

CONCLUSION

The findings indicate that nursing students encounter various forms of bullying from different individuals in educational, therapeutic, and clinical settings. This issue necessitates serious attention from educational institutions and healthcare organizations. Academic institutions should proactively enhance students' abilities to cope with this phenomenon. Additionally, healthcare organizations must take the initiative to develop anti-bullying policies to mitigate this challenge.

CLINICAL TRIAL NUMBER

Not applicable.

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 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.

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.

Exploring the Link Between Structural Empowerment, Workplace Bullying, and Continuance Commitment: The Role of Person-Related and Work-Related Bullying as Mediators and Serial Mediators

Employee empowerment as a management intervention promotes employee engagement: Psychological empowerment is found to influence employee engagement and organizational commitment, but the effect of structural empowerment (SE) is not explored much. SE increases employees' self-esteem, which can encourage a dissatisfied employee to look for other better work options, thus influencing their continuance commitment (CC). Workplace bullying is associated with higher turnover intentions and reduced commitment. This study investigates the mediating effects of person-related bullying (PB) and work-related bullying (WB) on the relationship between SE and CC. The study findings highlight the partial mediation effect of PB and serial mediation of WB and PB on the relationship between SE and CC. This study establishes that in comparison to WB, PB causes more damage to employee relationships with the organization. Moreover, the serial mediation effect of WB and PB is also noticed on the relationship between SE and CC. Organizations should regularly measure their employees' CC, as SE negatively affects CC. Organizations should take adequate measures to curb PB to preserve employee morale and confidence. This study uniquely reports a negative relationship between SE and CC.

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.

Impact of Workplace Bullying on Nursing Care Quality: A Comprehensive Review

Workplace bullying, commonly known as mobbing, persists as a significant problem across various industries, including the healthcare sector. To establish effective interventions and protocols for enhancing the well-being of healthcare workers and patients, it is vital to fully grasp the link between workplace bullying and the quality of nursing care. The analysis highlights the complex link between workplace bullying and nursing care quality, stressing the urgency of addressing this issue due to its wide-reaching impact on individuals and healthcare organizations, ultimately affecting patient safety. Emphasizing the significance of addressing workplace bullying across different professional settings is crucial for protecting the mental health and well-being of employees. The research identifies various forms of aggression and emphasizes the need to understand how these behaviors affect patient outcomes. Further investigation is needed to clarify nurses' responses to workplace violence, particularly in specialized settings like mental health facilities. The studies underscore the numerous challenges nurses encounter when trying to report incidents of workplace bullying. This insight is vital for developing effective reporting mechanisms and targeted interventions to combat bullying behaviors in medical environments. Ultimately, establishing a safer working environment for nurses is paramount. This article aims to review the associations between workplace bullying and the quality of nursing care.

Influencing factors of inter-nursing lateral violence: A qualitative systematic review

BACKGROUND

Lateral violence is a global social problem that has attracted considerable attention in the field of public health. This has seriously affected the quality of care, the safety of patients' lives and the career development of nurses.

OBJECTIVE

To systematically evaluate the factors influencing of nursing lateral violence and provide evidence for preventing and reducing inter-nursing lateral violence.

METHODS

A systematic review of qualitative study was performed in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. We collected qualitative studies on the factors influencing of inter-nursing lateral violence by searching PubMed, EMbase, The Cochrane Library, Web of Science, CINAHL, Science Direct, WanFang Data, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP) and Chinese Biomedical Literature Database (CBM). Data from inception to September 2023. Literature screening and data extraction were independently conducted by two reviewers. The Critical Appraisal Skills Program (CASP) scale was employed to assess the quality of the studies, including objectives, methodologies, designs, results and contributions.

RESULTS

A total of 25 studies involving 882 participants were included. The results of the thematic analysis indicated that inter-nursing lateral violence was influenced by hospital management, perpetrators, victims and sociodemographic factors.

CONCLUSION

Inter-nursing lateral violence was influenced by multidimensional factors. To reduce the occurrence of horizontal violence among nurses, hospitals need to explore the establishment and improvement of a horizontal violence resolution mechanism, and schools should pay attention to the joint support and education of nursing students, create a good working environment and harmonious nursing culture, and promote mutual respect among nurses.

RELEVANCE TO CLINICAL PRACTICE

This review emphasises the importance of the influencing factors of horizontal violence among nurses, analyses the importance of influencing factors from different perspectives, and proposes corresponding measures to reduce inter-nursing lateral violence.

NO PATIENT OR PUBLIC CONTRIBUTION

This study was mostly a literature review; neither patients nor pertinent staff were involved in either the design or conduct of the investigation.

Latent Classes of Personality Traits and Their Relationship with Workplace Bullying among Acute and Critical Care Nurses

Objective

To identify the latent classes of personality traits among nurses in acute and critical care departments, as well as the relationship between latent classes of different personality traits and workplace bullying.

Methods

A total of 245 nurses working in the acute and critical care department at a 3 A-grade hospital in Shandong Province, China, were recruited by convenient sampling. The Chinese Big Five Personality Inventory brief version was used to assess personality traits, and the Negative Acts Questionnaire was used to measure workplace bullying. Latent profile analysis was used to identify the latent classes of personality traits. Multiple linear regression analysis was used to examine the relationship between latent classes of personality traits and workplace bullying.

Results

Four latent classes of personality traits among acute and critical care nurses were identified, namely, the negative group (49.0%), flexible group (16.0%), neurotic group (18.1%), and stable group (16.9%), respectively. Compared with the neurotic group, the negative group (B = -6.227, P < 0.05), stable group (B = -16.562, P < 0.001), and flexible group (B = -19.208, P < 0.001) experienced less workplace bullying.

Conclusion

Our findings explore latent classes of personality traits among acute and critical care nurses, identify subgroups susceptible to workplace bullying, and suggest the development of appropriate interventions to reduce workplace bullying. Implications for Nursing Management. Hospital managers can identify nurses who are prone to workplace bullying based on their personality traits and provide them with psychological counseling services and psychological healing groups to help them establish good interpersonal relationships and maintain their mental and physical health.

A Descriptive Study Examining the Correlation of Emotional Intelligence and Leadership Styles to Conflict Management Styles of Nursing School Administrators

AIM

This study aimed to identify if a correlation exists among trait emotional intelligence (EI), leadership styles, and conflict management styles used by nurse education administrators.

BACKGROUND

Nursing is fraught with incivility, bullying, and increasing physical aggression. Conflict surrounds nurses at every level. EI and leadership styles in nursing have been addressed. Few studies were found that addressed conflict management by nurse education administrators.

METHOD

A quantitative nonexperimental correlational design using discriminant analysis was used in this study.

RESULTS

Trait EI factors of emotionality and sociability correlated with conflict management styles. Leadership styles and conflict management styles were situational; management styles of integrating and compromising were underused in conflict situations.

CONCLUSION

Nurse education administrators are in a position to become disruptive innovators in changing the nursing culture. The increased use of conflict management styles of integrating and compromising can help address incivility and bullying.

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.

Verbal violence and missed nursing care: A phenomenological study

AIM

To define the missed care experiences of nurses exposed to verbal violence from patients.

BACKGROUND

Verbal violence takes the first place among the types of violence that nurses face in healthcare settings. This can cause negative emotional and physical responses in nurses and issues in patient and nurse interaction. As a result, it may lead to missed nursing care, defined as skipped, postponed or incomplete care during the patient's care.

METHODS

This is a phenomenological study. The study sample included 16 nurses working in inpatient clinics who reported experiencing verbal violence at least once in Turkey. The study was conducted between January and February 2022 with institutional permission and ethics committee approval (09/12/2021-2021/357). A semi-structured interview method was used to collect data. The information gathered from the interviews underwent thematic analysis using an inductive approach. The 'Consolidated Criteria for Reporting Qualitative Research (COREQ)' was used to report this qualitative study based on a comprehensive protocol.

RESULTS

The types of verbal violence most frequently faced by nurses were determined as swearing, insulting, shouting and threats. Study findings were classified into three main themes: (i) response to verbal violence, (ii) missed nursing care experiences and (iii) suggestions to cope with verbal violence. The most felt emotions in the face of verbal violence were feeling sad, unsafe and worthless. Nurses common behaviours, in response to verbal abuse were ignoring, getting used to, and wishing to get away. The examples of missed care included using non-therapeutic communication, postponing care or withdrawing from care.

CONCLUSION

Verbal violence caused negative emotional and behavioural responses in nurses, which, in turn, negatively affected the nurse-patient interaction. These findings mean that verbal violence may pave the way for missed nursing care.

IMPLICATIONS FOR NURSING POLICY

According to these findings, an uninterrupted nursing care process needs to focus on preventive measures against verbal violence and increase the administrative and legal support offered to nurses.

What are the key factors influencing newly graduated nurses' preference for choosing their workplace? A best-worst scaling approach

INTRODUCTION

The literature cites many factors that influence a nurse's decision when choosing their workplace. However, it is unclear which attributes matter the most to newly graduated nurses. The study aimed to identify the relative importance of workplace preference attributes among newly graduated nurses.

DESIGN

A cross-sectional study.

METHODS

We conducted an online survey and data were collected in June 2022. A total of 1111 newly graduated nurses in South Korea participated. The study employed best-worst scaling to quantify the relative importance of nine workplace preferences and also included questions about participants' willingness to pay for each workplace preferences. The relationships between the relative importance of the workplace attribute and the willingness to pay were determined using a quadrant analysis.

RESULTS

The order according to the relative importance of workplace preferences is as follows: salary, working conditions, organizational climate, welfare program, hospital location, hospital level, hospital reputation, professional development, and the chance of promotion. The most important factor, salary, was 16.67 times more important than the least important factor, the chance of promotion, in terms of choosing workplace. In addition, working conditions and organizational climate were recognized as high economic value indicators.

CONCLUSION

Newly graduated nurses nominated better salaries, working conditions, and organizational climate as having a more important role in choosing their workplace.

CLINICAL RELEVANCE

The findings of this study have important implications for institutions and administrators in recruiting and retaining newly graduated nurses.

Bullying among nursing professionals in Brazil: validity and reliability of the Negative Acts Questionnaire-Revised

Introduction

Bullying in the nursing work environment has negative consequences for both professionals and institutions. The early identification of this behavior can contribute to a positive organizational climate and better quality of life.

Objectives

This study analyzed the validity and reliability of the Negative Acts Questionnaire-Revised with nursing professionals.

Methods

A total of 350 nursing professionals were included in this methodological study. Multivariate confirmatory factor analysis was based on 4 domains, as in the Portuguese version of the Negative Acts Questionnaire-Revised. The instrument consists of 22 items that address negative acts committed in the work environment without directly mentioning bullying. Respondents indicate, on a Likert-type scale, how often they experience these acts in their work routine.

Results

The adjusted model of the Brazilian version of the Negative Acts Questionnaire-Revised resulted in an instrument with 20 items and 4 distinct domains that presented satisfactory validity and reliability for identifying bullying behavior among nursing professionals.

Conclusions

The Brazilian version of the Negative Acts Questionnaire-Revised is a valid instrument for identifying acts of bullying among nursing professionals and can be used in efforts to prevent such behavior in health services.

Workplace Bullying among Healthcare Professionals: A Quanti-Qualitative Survey in a Sample of Women Working in an Italian Healthcare Setting

The main objective of this study was to analyze, in a sample of female healthcare workers in Italy, the training needs to improve positive relationships in the healthcare organization. To better understand these needs, perceived workplace bullying and its consequences in terms of professional commitment and well-being were analyzed from a descriptive and quantitative perspective (or mixed-methods analysis). A questionnaire was completed online in a healthcare facility in northwestern Italy. The participants were 231 female employees. The quantitative data showed that, on average, the sampled population perceived a low burden of WPB. The majority of the sample expressed moderate engagement at work and moderate perception of psychological well-being. It is interesting to note that one element seemed to be overarching in the responses to the open-ended questions: communication, which emerged as a problematic element that affects the entire organization. The research data provide useful evidence for intervention in favor of an environment that helps to recognize the phenomenon and intervene in time, offering the possibility of accepting the discomfort and fatigue of healthcare workers and offering useful interventions to the individual and the team.

Effectiveness of transition programs on new graduate nurses' clinical competence, job satisfaction and perceptions of support: A mixed-methods study

AIM

To assess the effectiveness of two graduate nurse programs on new graduate nurses' overall competence at 3, 6, 9 and 12 months. Secondary aims were to assess new nurses' job satisfaction at 12 months and explore their experiences of support.

BACKGROUND

Most clinical settings have implemented transition programs to help new nurses to adapt to their new environments and expand their competences. To this day, very few studies have assessed the effectiveness of these programs.

DESIGN

Longitudinal mixed-methods study.

METHODS

The study was conducted at two teaching hospitals in Australia. New nurses were recruited during orientation. Data were collected at baseline (T0; n = 88), 3 (T1; n = 29), 6 (T2; n = 15), 9 (T3; n = 11) and 12 months (T4; n = 9). At each time point, the questionnaire included demographic and the Nurse Competence Scale. At T4, the questionnaire also included the Nurse Satisfaction Scale. Semi-structured interviews were conducted from T1 to T4. This study conforms to the STROBE guidelines.

RESULTS

Competence increased significantly at T1, with participants stating that they learned by "getting out" of student mode. At T2, despite no significant difference in competence, participants expressed they were more confident and in control, because they felt supported. Again, at T3, there was no significant increase in competence. Finally, at T4, competence increased significantly, with participants acknowledging that they still had a lot to learn.

CONCLUSION

This study supports that 12-month transition programs are necessary for NGNs to expand their competence. One major factor influencing NGNs during their first year was how well they felt supported and encouraged to seek help when they needed it.

RELEVANCE

There is a need to understand how new NGNs enrolled in transition programs expand their competences. Their professional development depends on a supportive environment where NGNs feel confident in asking questions or for help.

Newly qualified graduate nurses' experiences of workplace incivility in healthcare settings: An integrative review

AIM

To explore, identify and integrate the existing knowledge to categorise the characteristics, likelihood, and consequences of workplace incivility among newly qualified graduate registered nurses. A particular focus of this review is on the experiences of new nurses related to these negative workplace behaviours and the strategies employed by these nurses and their organisations to manage workplace incivility.

BACKGROUND

Workplace incivility has been widely recognised as a global problem in healthcare settings and is known to affect nurses in all facets of their professional and personal life. This might be particularly harmful for newly qualified graduate nurses, as they are unprepared to deal with this uncivil culture.

DESIGN

An integrative review of the global literature, conducted according to the Whittemore and Knafl framework.

METHODS

Database searches (CINAHL, OVID Medline, PubMed, Scopus, Ovid Emcare and PsycINFO), and manual searching generated an aggregate of 1904 articles, which were further screened based on inclusion criteria and eligibility using the Mixed Methods Appraisal Tool (MMAT). Peer-reviewed empirical studies that explored the workplace incivility experiences of new graduate nurses were included in this review. Extracted data were grouped to develop themes and sub-themes.

RESULTS

This review included 14 studies in total with seven quantitative and seven qualitative studies. The data collected from these studies were categorised according to the research questions into a) expectations of civility, b) experiences and exposure to workplace incivility, c) forms and characteristics of incivility, d) sources of incivility, e) consequences of incivility, and f) managing and coping with incivility. Across studies, graduate nurses' views about the prestige and power of the nursing profession are conflicted due to experiences of incivility in clinical practice. New graduate nurses experienced a high but variable prevalence of incivility from their co-workers (25.6-87 %), with manifestations of incivility varying greatly, including eye rolling, yelling, exclusion and sexual harassment. Included studies primarily focused on professional and organisational effects and their outcomes relative to the physical and psychological effects on new nurses.

CONCLUSION

Findings from the literature demonstrate that incivility directed toward newly qualified graduate nurses is prevalent and can have significant negative impact on their self-esteem and confidence, which may ultimately impact on their workforce participation decisions and the quality of patient care. Supportive and empowering work environments are vital not only for improved nurse health and well-being, but also to retain new graduate nurses. The current nursing shortage emphasises the need for such conditions.

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.

Predictors of events of violence or aggression against nurses in the workplace: A scoping review

AIM

To identify predictors and consequences of violence or aggression events against nurses and nursing students in different work contexts.

BACKGROUND

Workplace violence against nurses and nursing students is a very common and widespread phenomenon. Actions to manage or prevent violent events could be implemented knowing the risk factors and consequences. However, there is a lack of systematic reviews that summarize knowledge on the predictors and consequences of workplace violence.

EVALUATION

A scoping review was conducted using electronic databases including APA PsycInfo, CINAHL, Cochrane, Ovid Medline, PubMed and Scopus.

KEY ISSUES

After full text analysis, 87 papers were included in the current scoping review. Risk factors of horizontal violence were grouped into 'personal' and 'Environmental and organizational', and for violence perpetrated by patients into 'personal', 'Environmental and organizational' and 'Characteristics of the perpetrators'.

CONCLUSIONS

The results of this scoping review uncover problems that often remain unaddressed, especially where these episodes are very frequent. Workplace violence prevention and management programmes are essential to counter it.

IMPLICATIONS FOR NURSING MANAGEMENT

The predictors and the consequents identified constitute the body of knowledge necessary for nurse managers to develop and implement policy and system actions to effectively manage or prevent violent events.

Conflicting Working Relationships Among Nurses: The Intersection of Should Nursing, Double Domination, and the Big Picture

Background

Research conducted on conflict between Registered Nurses (RNs) has established that it happens regularly within the hospital setting, that it adversely affects the health and well-being of RNs, impacts the effective functioning of the health care organization, and compromises quality patient care. In this article, the phrase conflicting working relationships (CWRs) is used to represent working relationships between RN peers that are non-collegial, uncaring, and non- supportive, and inclusive of the behaviours associated with incivility, horizontal violence, and bullying, among others.

Purpose

To examine how nursing, including nursing knowledge and practice, is socially organized within the hospital setting and how this organization is linked to CWRs between RN peers.

Methods

Interviews were conducted with 17 RNs, followed by text analysis and mapping guided by institutional ethnography (IE) as the research methodology.

Results

The intersections between should nursing, double domination, and the big picture threads shows work environments where RNs struggle to provide appropriate care and conflict has become institutionalized. The intersection between threads can be used as caution areas for RNs and individuals in leadership positions to reflect on nursing practice when conflict is being experienced.

Conclusions

The contextual variables surrounding professional nursing practice are very influential with respect to how RNs relate to each other. A new type of dialogue about the organization of nursing practice in the hospital setting is needed to support more relational practices between RNs.

Pathological narcissism, interpersonal cognitive distortions, and workplace bullying among nurses: A cross-sectional study

AIM

The aim of this work is to examine whether nurses' pathological narcissism and interpersonal cognitive distortions predict workplace bullying when controlling for organizational culture, work-related factors, and demographic variables.

BACKGROUND

To eradicate workplace bullying, a multifaceted holistic approach to identify potential predictors is needed. Nurses' narcissistic behaviours negatively affect collegial relationships and the organization. Furthermore, interpersonal cognitive distortions have been demonstrated to directly affect bullying and victimization.

METHODS

Responses from 236 nurses to an online survey were analysed. The Pathological Narcissism Inventory, Interpersonal Cognitive Distortions Scale, Positive Nursing Organizational Culture Measurement Tool, and The Negative Acts Questionnaire-Revised were used to measure the key variables.

RESULTS

A multiple regression analysis revealed that pathological narcissism (β = .33, p < .001) had the greatest effect on nurses' workplace bullying, followed by positive organizational culture (β = -.31, p < .001), interpersonal cognitive distortions (β = .17, p = .028), marital status (β = -.15, p = .020), and position (β = -.12, p = .047).

CONCLUSIONS

Although prejudice or stigma surrounding narcissistic personalities should be avoided, nurses should be aware of and manage such characteristics so that they do not become a factor in workplace bullying.

IMPLICATIONS FOR NURSING MANAGEMENT

There is a need to protect nurses from workplace bullying and create a positive organizational culture by recognizing narcissistic traits and preparing intervention strategies that support improvement.

Prevalence of lateral violence in nurse workplace: a systematic review and meta-analysis

BACKGROUND

The prevalence of inter-nurse lateral violence (LV) reported in current studies is inconsistent, ranging from 7% to 83%. The purpose of this study is to quantify the prevalence of LV in nurses' workplaces.

METHODS

Systematic review and meta-analysis. Cochrane, PubMed, Embase, CINAHL, CNKI and Wanfang databases were searched for relevant studies (up to 27 January 2021). We included cross-sectional, case-control or cohort studies in which both abusers and victims were nurses. Studies that did not provide specific data on abusers were excluded. Stata V.16.0 was used for statistical analysis. Fixed-effect or random-effect model was adopted according to heterogeneity, which was evaluated by Cochran's Q and I² values. The main indicator was LV prevalence. Sensitivity analysis, subgroup analysis and meta-regression were performed to investigate the sources of heterogeneity.

RESULTS

A total of 14 studies with 6124 nurses were included. Further, 13 articles with 5745 nurses were included in the meta-analysis, and the pooled prevalence of LV among nurses was 33.08% (95% CI: 23.41% to 42.75%, p<0.05; I²=99.0%). The remaining one study containing 370 samples reported that the prevalence of inter-nurse LV was 7.92%. Subgroup analysis showed that region, sample size, sampling, study's quality, response rate and publication time might not be the sources of heterogeneity. Meta-regression indicated that sample size had the main influence on model heterogeneity. Egger's test showed the existence of publication bias (p=0.03).

DISCUSSION

The prevalence of inter-nurse LV is high in nurse workplace. It is suggested that scholars pay more attention to the cultural differences of inter-nurse LV between regions in the future. This study has the following limitations: there is a lack of studies on LV prevalence in many countries; lack of standard assessment tools; no grey literature was searched.

Strengthening a Culture to Address Bullying and Incivility in the Care Environment

The safety of our patients and our workforce is paramount to elevating the health and wellness of the global communities we serve. The health and well-being of our frontline staff directly influences the environment of care, and it is our job as healthcare leaders to address workplace bullying, incivility, and lateral and horizontal violence. From patient to provider violence, to peer-peer bullying, these acts of incivility erode at the core of the care environment and impact an organization's culture of safety, influence nursing engagement scores, negatively impact patient outcomes, and decrease overall retention. Magnet® organizations help to elevate the practice of nursing and ensure world-class interprofessional care. Therefore, the Commission on Magnet has included new language in the 2023 Magnet Application Manual in the Organizational Overview (OO7), which directly addresses the organization's structure and processes aimed at addressing workplace violence, bullying, and incivility.

The parents are watching: Midwifery students' perceptions of how workplace bullying impacts mothers and babies

PROBLEM

Bullying in the midwifery profession has been documented and the problem is now known to extend to the poor treatment of midwifery students. In nursing, research has shown that bullying in the clinical workplace can adversely impact on quality of care. To date, no research has explored whether the bullying of midwifery students has secondary impacts on the experiences and care of mothers, babies, and their support persons.

AIM

To examine how midwifery students, who self-identify as having been bullied, perceive the repercussions on women and their families.

METHODS

This qualitative descriptive study explored 120 Australian and United Kingdom (UK) based midwifery students. Data were collected using an anonymous online qualitative survey and were thematically analysed.

FINDINGS

The findings suggest that the bullying of midwifery students impacts women and their families in a number of ways. Midwifery students perceive that mothers and babies are frequently implicated either directly or indirectly in the enactment of bullying. This can impact their safety, fractures relationships, and impairs the women's confidence in the student and the profession. Students additionally reported that women and/or their support persons can feel compelled to step in to defend and protect the student.

CONCLUSIONS

The bullying of midwifery students is perceived to place women at risk, in uncomfortable situations, damage rapport and undermines their confidence in students and the profession. This also impacts adversely on the student's ability to provide women centred care as they lose confidence in front of the woman and her family when they are bullied by registered midwives.

A qualitative systematic review on nurses' experiences of workplace bullying and implications for nursing practice

AIMS

To explore nurses' experiences of workplace bullying and ways to prevent such occurrences.

DESIGN

A qualitative systematic review was conducted.

DATA SOURCES

Five electronic databases were searched from each database's inception to December 2020.

REVIEW METHODS

Meta-summary and meta-synthesis were conducted using Sandelowski and Barroso's approach.

RESULTS

Twenty-seven studies were included in this review. The overarching theme, 'The Vicious Cycle of Bullying in Nursing', and four themes were synthesized: (a) different 'faces' of bullying, (b) the hidden drivers of bullying, (c) impact of being bullied and (d) responses to bullying.

CONCLUSION

The nursing code of ethics and anti-bullying policies should be consistently enforced by each organization's upper management. Nurses should be provided a safe space to voice their concerns on bullying within the organization.

The impact of horizontal violence on the individual nurse: A qualitative research study

AIM

Horizontal violence (HV) is a familiar term used in nursing. Certain populations of nurses are more susceptible to HV than others. Graduate nurses (nurses within their first 12 months of practice) are widely considered a vulnerable population in the profession and thus more at risk for HV. The purpose of this qualitative study was to explore how HV affects graduate nurses (GNs).

DESIGN

Inductive thematic analysis was used in the design of this study.

METHODS

Participants included eight Canadian GNs or Registered Nurses (RNs), all of whom had experience with HV in their first 12 months of practice. Data collection was done via one-on-one interviews.

RESULTS

Two main themes were revealed from the data collected - Toxic Nursing Culture and Fear. Several subthemes were also identified - cycle of violence, nurses eating their young, shame, drowning, isolation and vulnerability. The findings indicate that HV is prevalent in the first year of practice and is destructive to the mental health of the individual nurse. Horizontal violence poses a serious challenge for GNs entering nursing and is often touted as the reason new nurses leave the profession altogether.

CONCLUSION

This study highlighted the personal and professional challenges that are heightened for a GN when they experience HV in their first year of practice. These experiences emphasize the impact that HV can have on the mental health of nurses and their ability to deliver safe patient care.