Workplace bullying, personality traits and health among hospital nurses: The mediating effect of social support

AIMS AND OBJECTIVES

This study aimed to explore the status of nursing staff's workplace bullying, personality traits, social support and mental health, to find out the predictors of nursing staff's health, and to explore whether social support is a mediator to regulate the impact of workplace bullying on mental health.

BACKGROUND

Bullying could cause physical and psychological problems, and nursing workplace bullying causes not only health problems of nursing staff but also patient safety problems. "Workplace bullying" is a worthy topic to pay attention to. Only limited studies could be discovered about the mediating effects between workplace bullying and health.

METHODS

Cross-sectional and correlation designs were used. The STROBE was used as a checklist for this study.

RESULTS

The results showed that the frequency of poor sleep quality ≥3 days in recent 2 weeks (p < .001), external control personality traits (p = .016), workplace bullying (p < .001) and less social support (p = .001) were the main predictors of the health problems among nurses, and social support was the mediator between workplace bullying and health problems.

CONCLUSION

It is recommended that hospital managers should apply regular sleep-wake schedule by designing a biological clock-compliant shift in order to promote good sleep hygiene of the nurses. Providing educational programmes and building up policies to decrease workplace bullying and increase social supports are suggested.

RELEVANCE TO CLINICAL PRACTICE

Hospital managers should provide education and training related to the prevention of bullying and establish communication and consultation channels for the bullied. Nursing managers should also educate nurses to establish effective social networks with family, friends and colleagues to prevent health problems.

Which nurses are victims of bullying: the role of negative affect, core self-evaluations, role conflict and bullying in the nursing staff

Background

Bullying among nurses is a universally recognized problem that has important consequences for nurses, patients and health institutions. This research was conducted with the aim of studying the relationship between role conflict, negative affect and core self-evaluations with bullying in nurses.

Methods

In this cross-sectional study, 329 nurses were selected by census method. Data were collected using PANAS Scale (negative affect), role conflict questionnaire, Core Self-Evaluations Scale (CSES), and the Negative Acts Questionnaire-Revised (NAQ-R). Data were analyzed using t-test, one way analysis of variance, Pearson correlation coefficient and multiple regression analysis with SPSS software (v. 22).

Results

The results showed that there is a significant difference between the mean bullying scores in according to gender and ward of affiliation. The influence of other variables (marital status, education level, years of experience, age group and work position) was not meaningful. Pearson correlation analysis results indicated that there is a significant positive relationship between role conflict (r = 0.47) and negative affect (r = 0.56) with bullying. Also there is a significant negative relationship between core self-evaluations and bullying (r = − 0.39). Moreover, regression analysis results revealed that negative affect, role conflict and gender can predict 44% of bullying variance significantly.

Conclusions

Based on these findings, core self-evaluations, negative affect and role conflict are good factors in predicting bullying among nurses. Consequently, hiring nurses with low negative affect and high core self-evaluations, improving nurses’ self-esteem and self-efficacy and changing workplace conditions in order to reducing role conflict can be useful in reducing workplace bullying.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00578-3.

The Influence of Bullying on Nursing Practice Errors: A Systematic Review

Workplace bullying is an important nursing issue that can influence a nurse's propensity to commit practice errors. This systematic review examines the influence of bullying behaviors on nursing practice errors and includes articles from 2012 to 2017 that focus on bullying among nurses in multiple health care settings, including ORs, emergency departments, and acute inpatient and critical-care units. Analysis of 14 relevant articles revealed four themes: the influence of the work environment on nursing practice errors, individual-level connections between bullying and nursing practice errors, barriers to teamwork, and communication impairment. This review indicates that nurses perceive that bullying influences nursing practice errors and patient outcomes, although the mechanisms are unclear. Additional research is needed to elucidate the effects of bullying on nursing practice errors and patient outcomes.

Does incivility impact the quality of work-life and ethical climate of nurses?

Purpose

The purpose of this study is to assess the relationship between incivility and two organizational and personal attitudes, namely, perceived ethical climate and perceived quality of work-life of nurses, in the framework of organizational climate.

Design/methodology/approach

Quantitative data of 148 nurses working in a medium-sized hospital in Israel were collected. Furthermore, qualitative data were collected through semi-structured interviews with 12 nurses and 14 doctors from the same hospital, constructing a mixed-method approach.

Findings

Findings revealed that witnessing or experiencing incivility affected the nurses' perception of the ethical climate of their work unit and their perceived quality of their work-life. Additionally, we found that the relationship between incivility and nurses' perceived quality of work-life was partially mediated through their perceived ethical climate. The qualitative data supported some of the findings.

Originality/value

The article stretches the incivility theory beyond its dyadic boundaries, prominently showing the spillover effect of incivility as an organizational problem. Additionally, it offers some evidence-based support for the multidimensionality of incivility, strengthening the need for a construct cleanup.

Association between workplace bullying and burnout, professional quality of life, and turnover intention among clinical nurses

Workplace bullying experienced by clinical nurses is associated with burnout, a factor that threatens the quality of nursing care and patient safety. This study examined the association of workplace bullying with burnout, professional quality of life, and turnover intention among clinical nurses. A descriptive cross-sectional study was conducted using a structured questionnaire. Data were collected from 324 nurses and were analyzed using t-test, one-way analysis of variance, and multiple regression. Controlling for the general characteristics of the participants, workplace bullying had a significant association with emotional exhaustion (B = 0.29, p < 0.01) and depersonalization (B = 0.15, p < 0.01) among the subdomains of burnout, compassion fatigue among the components of professional quality of life (B = 0.15, p < 0.01), and turnover intention (B = 0.05, p < 0.01). Thus, preventing workplace bullying is important to reduce clinical nurses’ burnout and turnover. The role of nursing leadership is crucial to develop interventions that reduce workplace bullying and successfully create a professional, nurturing, and supportive work culture.

Bullying in the nursing work environment: integrative review

OBJECTIVE

To evaluate the studies that approach bullying in the nursing practice environment.

METHOD

Integrative review, conducted between April and December 2018, by combining the descriptors "bullying/bullying" AND "nursing/nursing/nurse" AND "workplace/workplace". We identified 224 studies of which 38 met the inclusion criteria.

RESULTS

The studies on nursing bullying presented three main approaches related to the prevalence in nursing practice, the repercussions for health and professional development, and the construction of theoretical models for bullying and nursing work environment variables.

CONCLUSION

Bullying is a negative behavior present in the nursing practice environment and has a direct impact on professional performance, impairing general health and professional performance. Despite being a behavior with recognized negative potential in the work environment, few studies propose effective actions to prevent or control this phenomenon in health institutions.

Where Do You Think You Are? A Grounded Theory Study of the Critical Factors Triggering the Existence and Fueling the Persistence of Incivility in Nursing

BACKGROUND

Incivility in health care settings was first identified in 1976. The Institute of Medicine has called for a safer health care environment, and the Joint Commission emphasizes that disruptive behavior compromises patient safety. Incivility in nursing is a topic of interest, yet it had not been explored as a social process.

AIM

The purpose of this study was to acquire an understanding and develop a theory to address incivility in nursing.

METHOD

Twenty-nine RNs were interviewed based on Charmaz's constructionist grounded theory.

RESULTS

Four categories emerged (neglecting, alienating, relinquishing, and finding oneself) that developed into the theory of self-positioning.

CONCLUSION

To understand incivility in nursing, one must, immersed within the institution, profession, and society, find and position the self. It is only then that we can address the health and well-being of RNs, provide quality care, and ensure patient safety.

Mental Health Expenditures: Association With Workplace Incivility and Bullying Among Hospital Patient Care Workers

OBJECTIVE

Bullied workers have poor self-reported mental health; monetary costs of bullying exposure are unknown. We tested associations between bullying and health plan claims for mental health diagnoses.

METHODS

We used data from 793 hospital workers who answered questions about bullying in a survey and subscribed to the group health plan. We used two-part models to test associations between types of incivility/bullying and mental health expenditures.

RESULTS

Workers experiencing incivility or bullying had greater odds of any mental health claims. Among claimants, unexposed workers spent $792, those experiencing one type of incivility or bullying spent $1557 (P for difference from unexposed = 0.016), those experiencing two types spent $928 (P = 0.503), and those experiencing three types spent $1446 (P = 0.040).

CONCLUSION

Workplace incivility and bullying may carry monetary costs to employers, which could be controlled through work environment modification.

Factors influencing nurses' perceptions of occupational safety

To determine nurses' perceptions of occupational safety and their work environment and examine the sociodemographic traits and job characteristics that influence their occupational safety, we studied a sample of 278 nurses. According to the nurses, the quality of their work environment is average, and occupational safety is insufficient. In the subdimensions of the work environment scale, it was determined that the nurses think "labor force and other resources" are insufficient. In the occupational safety subdimensions "occupational illnesses and complaints" and "administrative support and approaches," they considered occupational safety to be insufficient. "Doctor-nurse-colleague relationships," "exposure to violence," and "work unit" (eg, internal medicine, surgical, intensive care) are the main factors that affect occupational safety. This study determined that hospital administrations should develop and immediately implement plans to ameliorate communication and clinical precautions and to reduce exposure to violence.

Nurse Bullying: Impact on Nurses’ Health

Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses’ resilience had an impact on the effects of bullying on the nurse’s health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample ( N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores ( p = .002) and lower mental health scores ( p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses’ quality of life and impede their ability to deliver safe, effective patient care.

Experiences With and Perceptions of Workplace Bullying Among Athletic Trainers in the Secondary School Setting

CONTEXT

Workplace bullying (WPB) has recently received much attention in society. Research on WPB in athletic training practice settings is limited.

OBJECTIVE

To determine the prevalence of WPB in the secondary school setting and explore the factors related to it.

DESIGN

Mixed-methods study.

SETTING

Secondary school.

PATIENTS OR OTHER PARTICIPANTS

A total of 567 athletic trainers (women = 322 [56.8%], men = 245 [43.2%]), aged 36.5 ± 11.1 years with 11.9 ± 9.5 years of experience took part in phase I. Ten participants (7 women and 3 men), aged 39.3 ± 10.1 years with 14.3 ± 8.3 years of experience, took part in phase II.

DATA COLLECTION AND ANALYSIS

For the online survey, we used the previously validated and reliable (Cronbach α = .84) Athletic Training Workplace Environment Survey, which included the Negative Acts Questionnaire-Revised. The prevalence of WPB was measured with descriptive statistics, and χ² analyses were used to compare differences between groups (ie, females and males, perpetrators' titles). The interview data were examined using an inductive content analysis.

RESULTS

Of the participants, 44 (7.8%) were empirically identified as targets of bullying, though a higher percentage (12.4%, n = 70) self-identified as bullying targets. Men and women did not differ with respect to having experienced WPB, but more perpetrators were male (71.6%, n = 48) than female (28.4%, n = 19; χ²₁ = 12.55, P = <.001). We also observed a difference in perpetrators' titles, with the vast majority of bullies being coaches or administrators (χ²₆ = 33.82, P = <.001). Lack of administrator support and discrimination were antecedents of bullying. Stress, depression, and sleep disturbances were reported consequences. Participants coped with bullying by avoidance and role refocusing.

CONCLUSIONS

Bullying was experienced by a small percentage of athletic trainers in the secondary school setting, a contrast to the findings in the collegiate practice setting.

Nurse Bullying: A Review And A Proposed Solution

Nurse bullying is an extremely common phenomenon which has detrimental consequences to nurses, patients, health care institutions, and to the nursing profession itself. It has even been linked to increased patient mortality. This article demonstrates the critical need to resolve the issue of nurse bullying. It also shows that previous attempts of resolution have not been successful, which may be partly due to the fact that the problem is relatively unacknowledged outside the nursing profession. To resolve the problem of nurse bullying, we believe that the solution must include an incentive for institutions to implement the necessary interventions and to ensure that they are effective. We propose that a measurement pertaining to the level of nurse bullying be factored into the calculation of the value-based incentive payment in the Hospital Value-Based Purchasing program. To facilitate this, we propose that a survey be developed and implemented which is similar to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. However, whereas the HCAHPS survey measures patients' perspectives of hospital care, this survey would measure nurses' perspectives of workplace bullying.