1. Lockhart, Lisa MHA, MSN, RN, NE-BC

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Q: As a profession known for caring and compassion, what can we do about the prevalence of bullying in nursing?

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A: Unfortunately, bullying has been referred to as nursing's secret, although it's so commonplace that it's often considered to be part of the job. Bullying takes on many forms: eye rolling, shunning new employees, refusing to assist, unfair assignments and/or scheduling, aggression, poor evaluations, sabotage, gossip, and more. Seasoned nurses sometimes refer to this as "eating our young," but it isn't just new nurses who are affected. According to the website, 90% of nursing students reported being bullied by their instructors; 73% of new nurses felt they had been bullied within the last month and 58% felt they were a direct target of a bully or bullies. However, 44% of experienced nurses felt they were bullied by a peer within the last year.


Despite the evidence of bullying in our profession, we're ill-equipped to manage it. There's little if any formal education or preparation for managers and frontline staff. Although the manager may be the bully, he or she may also be bullied or even afraid to address such issues. There may also be a lack of organizational support for promoting a healthy work environment.


So what are some effective tools to combat bullying? First and foremost, communication and empowerment! Individuals who feel that they have a voice in their work environment are more likely to speak up. Shared governance models, unit-based councils, and open forums for communication among multiple levels have proven to be successful. These strategies work because they empower every individual and place importance and value on what we feel, share, and observe.


The promotion of a just culture and the provision of an open-door policy are the most practical steps to support empowerment. By using the same principle as the concept of "stopping the line," employees are empowered to put a hard stop on what they feel is a bad behavior, just like they would a safety risk.


Communication and empowerment need to be accompanied by actual enforcement of zero-tolerance policies. Behavioral standards and codes of conduct must be taken seriously and problems addressed as they arise. If a toxic environment is allowed to flourish, it will affect every aspect of the organization, including patient and staff satisfaction, care quality, and recruitment and retention. Standing up for yourself-and your coworkers-is vital to the success of the organization and our profession.


I urge you to be a part of the zero-tolerance antibullying movement. Look to professional and government organizations for tips on developing a healthy work environment. We must make this investment in nursing's future.




American Nurses Association. Incivility, bullying, and workplace violence.


Sherman RO. When the nurse leader is the bully.


Stokowski LA. A matter of respect and dignity: bullying in the nursing profession.


Townsend T. Break the bullying cycle.