Verbal abuse in the workplace has been referred to as incivility, bullying, lateral violence, or workplace violence and is extremely common in nursing.
A study1 examined the relationship between verbal abuse by nurses and the personal characteristics, work attitudes, and work settings of nurses who reported experiencing abuse.
Participants completed the Verbal Abuse Scale (VAS), which asked respondents to report how frequently they have experienced any verbal abuse from colleagues, excluding supervisors. Verbal abuse was described as yelling or raising of voices in an angry manner, swearing, obscene or insulting comments, or making humiliating or abusive comments. Almost half of the 1,400 RNs completing the survey reported some degree of verbal abuse, most commonly condescending comments.
RNs with less than one year of experience were more likely to be targets of the abuse. Other associated factors included working in a hospital setting, as in a non-magnet organization. The RNs reported a lack of supervisory or mentoring support with lower levels of work group cohesiveness and reduced staffing.
Bullying has been described as a learning process that new nurses may observe and then utilize just to fit in, which contributes to continuing bullying behaviors.2 I can recall, as a new ICU nurse, my reluctance to verbalize a difference of opinion with a particular nurse as she was part of a clique to which I aspired for acceptance. I observed her sarcastic and condescending comments with anyone who disagreed with her. Lewis has suggested that these cliques may become places where bullies gain support and use the organizational bureaucracy to their personal advantage. This bully’s behavior was finally addressed when a new manager arrived and addressed the inappropriate behaviors.
The literature has identified organizational, individual, and environmental factors that are associated with bullying behaviors:3
Strategies to address and eliminate workplace bullying include managing the associated factors. In spite of the fact that bullying is unacceptable and managers are expected to ensure a respectful work environment, bullying continues to be prevalent in nursing.
The manager must provide support for the individual nurse. The visible participation of nursing leadership in addressing bullying fosters commitment, participation, trust, and open communication with front-line workers. Steps to combat workplace bullying include:
- Staff education. An open discussion of what to do and not to do when confronted by a bully. Nurses must feel safe in reporting the behavior. Bullied nurses have commented that they secretly felt ashamed and noted that self-doubt stifled innovation and creativity.
- Training for managers. Provide skills, training, and knowledge about how to detect and manage bullying behaviors. Leaders must promote healthy work environments and avoid excessive workloads and lack of autonomy.
- Develop codes of acceptable behavior, including a zero-tolerance policy. The policy should target positive behavior and work toward creating a working climate that treats nurses with dignity, respect, and fairness. Implement strategies to prevent discrimination, exclusion, unfair treatment, and other demeaning behaviors. Staff must display open and constructive criticism and handle conflict with creativity.4
We as nurses cannot ignore the issue of nurse to nurse bullying. We need to look at ourselves and be sure that we are treating colleagues, especially new graduates, with respect.
Do your organizations have successful programs to address this behavior? Have you seen successful support programs for nurses? It would be most interesting to hear from our colleagues. Now is the time to act to eliminate this destructive behavior toward our colleagues.
- Budin, WC (2013) Verbal Abuse From Nurse Colleagues and Work Environment of Early Career Registered Nurses. Journal of Nursing Scholarship.
- Lewis MA (2006) Nurse Bullying: Organizational Considerations in the Maintenance and Perpetuation of Healthcare Bullying Cultures. Journal of Nursing Management; 14; 52-58.
- Cooper CL (2002) Workplace Violence in the Health Sector: State of the Art. International Labour Organization.
- Rocker, Carol (2008) Addressing Nurse to Nurse Bullying to Promote Nurse Retention. The Online Journal of Issues in Nursing. Vol. 13. No.3