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Usefulness of Current Approaches to Preventing and Managing Bullying in Hospitals

Mary Kenui
Kapiolani Community College


Usefulness of Current Approaches to Preventing and Managing Bullying in Hospitals

It is the American Nurses Association (ANA) position that all nursing personnel
have the right to work in healthy work environments free of abusive behavior (ANA,
2014). They state that bullying, hostility, lateral and horizontal abuse, verbal abuse,
violence, sexual harassment, and intimidation are all abusive behaviors. It needs to be
noted that bullying is an act perpetrated by an individual with higher authority
(management) against a subordinate, and lateral violence applies to acts between
colleagues of equal power or peer-to-peer (Johnston, Phanhtharath, & Jackson, 2010).
The ANA reports that between 18 and 31% of nurses have experienced bullying behavior
at work (ANA, 2012). The repercussions of bullying are significant. According to the
ANA (2012), nurses who are victims of bullying may experience physical symptoms
such as loss of sleep as well as psychological symptoms ranging from frustration to fear
and depression. This can directly affect patient care and patient safety, as well as may
cause the bullied nurse to leave the profession, which is why the usefulness of current
approaches to preventing and managing bullying in hospitals is significant in the practice
of nursing.
Preventing and Managing Bullying
Educating Staff
Bullying is considered disruptive behavior and is a violation of the first provision
of the Code of Ethics for Nurses (Cherry, 2014). It is a huge issue in hospitals and
education is key to preventing and managing bullying in the work environment.
Personnel need to be made aware of what constitutes bullying. They must understand
which behaviors are acceptable and which are not.


Supervisors Role
A study done by Laschinger, Wong, and Grau (2012) found that authentic
leadership had a direct negative effect on bullying. Their findings demonstrate the
significant role supervisors play in the battle against bullying. Managers and those in
supervisory positions are responsible for encouraging the reporting of incidents of
bullying and ensuring that bullying policies are adhered to. Consequences of breaking
these policies need to be stressed to help deter bullying from occurring. Per Cleary, Hunt,
and Horsfall (2010), many workplaces have established occupational health and safety
codes to prevent bullying, such as a zero tolerance policy (p.333), due to its increasing
When managers or supervisors are the ones perpetrating the bullying, or they do
not offer appropriate support to bullied nurses, the likelihood of bullying behavior
continuing in the workplace are high. Particularly since the bullying policies in place are
not being enforced, so they are rendered useless. The nurse respondents in the study
performed by Gaffney, DeMarco, Hofmeyer, Vessey, and Budin (2012) regarding
workplace bullying reported that they did not receive sufficient support from supervisors.
The study found that staff nurses frequently brought concerns of bullying to nurse
managers. Per Gaffney et al. (2012) the accounts from the nurses revealed, problems
were deflected back with little or no assistance nor response from administration (p.7).
The nurse managers acted indifferent to the allegations of bullying, leaving the staff
nurses frustrated. Going up the chain of command at this point would be an appropriate
action to address the nurse supervisors indifference and lack of assistance on the bullying
issue. Monthly or quarterly surveys pertaining to bullying could shed light on whether


bullying is a problem in the hospital setting. The first step in any resolution is recognizing
the problem, and then addressing it. Eradicating bullying from the workplace is a lofty
goal and zero tolerance policies, while sound, may not be beneficial if its not enforced.
Respectful Work

Cultivating a

positive work environment by those in leadership roles is an approach that can reduce
bullying incidents (Cleary, Hunt, & Horsfall, 2010). This can be done by providing
encouragement to the staff and recognizing that every staff member is important. The
value of teamwork needs to be emphasized and that no one individual is more valuable
than another (Cleary et al., 2010).

Individuals Role

Langlois (2012) asserts five steps can be taken to ensure that an individual isnt an
agent of bullying in the workplace. The first step is to address people by their name, and
if appropriate, title. Langlois proclaims that neglecting to use someones name when you
know it is often the first sign of contempt (para.2). Another step is to give help when
asked. According to Langlois, bullying comes in many forms and refusing to provide
assistance is a form of bullying. Accepting your fair share of the workload is the third
step. Not talking about other people behind their backs is step four. The last step is to not
stand idly by if one witnesses bullying or other abusive behavior. Langlois declares that
witnessing bullying and not speaking up about it acknowledges that bullying is
acceptable behavior and it is not. Each individual is responsible for his or her own
actions, and each nurse in the workplace can facilitate anti-bullying measures by
following the steps indicated by Langlois.


Nurses need to be aware of bullying policies in their workplace and what

constitutes bullying. A record of all incidents needs to be made and any witnesses to the
incident(s) needs to be noted (Cleary et al., 2010). It is essential that bullying policies are
adhered to in the workplace in order for them to be useful, and any allegations of bullying
needs to be treated with due seriousness by the supervisor. Human resources can assist if
supervisors or managers arent providing adequate or proper support regarding bullying.
Additional research into different strategies that can break bullying behavior in
the healthcare workplace is needed. Research shows that the efficacy of current
approaches to preventing and managing bullying in hospitals is dependent on those in
leadership roles executing bullying policies and promoting a supportive work
environment. It is necessary for nurses to follow the Code of Ethics for Nurses and treat
each other with respect and dignity. Patient care, patient safety, and professional retention
is affected by bullying, and nurses need to keep in mind that providing exceptional
patient care is the main goal of every nurse.



American Nurses Association. (2012). Bullying in the workplace: Reversing a culture.

Silver Springs, MD:
American Nurses Association. (2014). Bullying and workplace violence.
Cherry, B. (2014). Contemporary nursing - issues, trends & management (6th ed.). St
Louis: Elsevier Mosby.
Cleary, M., Hunt, G., & Horsfall, J. (2010). Identifying and addressing bullying in
nursing. Issues in Mental Health Nursing, 31(5), 331-335.
Gaffney, D. A., DeMarco, R. F., Hofmeyer, A., Vessey, J. A., & Budin, W. C. (2012).
Making things right: Nurses' experiences with workplace bullyingA grounded
theory. Nursing research and practice, 12. doi:10.1155/2012/243210
Johnston, M., Phanhtharath, P., & Jackson, B. (2010). The bullying aspect of workplace
violence in nursing. JONAs Healthcare Law, Ethics, & Regulation, 12(2): 36-42.
Langlois, B. (2012). Five steps to reduce bullying. Nursing Critical Care, 7(1): 48.
Laschinger, H., Wong, C., & Grau, A. (2012). The influence of authentic leadership on
newly graduated nurses experiences of workplace bullying, burnout and retention
outcomes: A cross-sectional study. International journal of nursing studies,
49(10), 1266-1276. doi:10.1016/j.ijnurstu.2012.05.012
NURS 211 Issue Paper Rubric FALL 2014

Exceeds Expectations

Meets Expectations

Needs Improvement


Choice of topic

Research (20%)

Scholarly sources

___ Approved topic

___ Not an approved topic

___ sufficient, relevant

At least 3 from nursing
___ recent, appropriate

___ sufficient sources;

some irrelevant

___ few or no scholarly


___ recent but some

inappropriate sources;
none within last 2 yrs.

___ none within last 5


Use of sources

___ data and arguments

from sources are
appropriately and

___ statements are

factually accurate but
irrelevant to the topic

___ misrepresents some

sources' data or


___ comprehensive and

accurate; key elements of
assignment covered

___ generalized


___ Major points supported

by specific examples and

___ most statements are

accurate; missing one of
the key elements of the
___ statements are


___ entire paper is very

clear and organized

Transitions from one

idea to the next

___ excellent section


Introduction and

Recent scholarly sources

Subject Matter (40%)

Organization (20%)

Mechanics (20%)

___ statements are made

without providing

___ paper is clear and

organized for the most
___ adequate section

___ entire paper lacks

clarity and structure

___ introduction provides

sufficient background on
the topic and conclusion
follow logically from the
body of the paper.

___ clear and concise

intro and conclusion

___ no clear intro and/or


Sentence structure
grammar, spelling,
sentence structure,

___ excellent mechanics

___ a few errors, minimal


___ not paraphrased.

Sources are
mined for facts but the
provides style and

___ paraphrase: the other

source is identifiable as
the origin of the style
and structure

___ many errors.

Mechanics interfere with
reader's understanding of
___ close paraphrase:
presentation of the
information is clearly the
work of someone else.
This is unacceptable.

Use of APA format

___ cover page, headers,

running head, subheaders,
in-text citation, reference
page correctly formatted

___ few errors in

formatting cover page,
headers, in-text citation,
and/or reference page

___ lack of section


___ cover page, headers,

in-text citation, reference
page formatted