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The High Cost of Nurse Bullying

Analysis  |  By Jennifer Thew RN  
   January 23, 2019

Incivility is an issue in nursing and it harms more than just the victim.

Caring is the cornerstone of the nursing profession. Yet, nurses are often on the receiving end of uncaring behavior.  

Over 50% of 3,765 nurses and nursing students experienced ver­bal abuse in a 12-month period according to the 2014 American Nurses' Association Health Risk Appraisal survey.

And bullying causes harm to more than just the victim. A December study in the Journal of Occupational and Environmental Medicine found workplace bullying increases employees' psychological distress and intent to leave their job—even for workers who aren't personally being bullied.

More than 3,000 Japanese civil servants completed a questionnaire to assess bullying at work, rating the frequency of items such as "spreading of gossip and rumors" or "persistent criticism of your work." The researchers, including Kanami Tsuno, PhD, MPH, of Wakayama Medical University in Japan, gathered baseline and one-year follow-up responses from the participants.

At the one-year follow-up, individual reports of being bullied at work were linked to increased psychological distress such as depression. Bullied workers also had higher ratings on a scale assessing their intention to leave their job.

After the results were adjusted for bullying on the division and department levels, researchers found division-level bullying had a greater impact on both psychological distress and intention to leave, compared to individual exposure to bullying.

"[This] suggests that the presence of bullying in the workplace can be a strong indicator of mental health problems and intention to leave among work members, regardless of individual experiences or witnessing of bullying," Tsuno and coauthors write. "Bullying is not simply an interpersonal issue but is an organizational dynamic that impacts on all workers, even those who are not personally victimized."

A study published in the journal's February 2018 issue also found that bullying had far reaching effects in a work unit.  The researchers found that non-bullied coworkers in work units where bullying was reported, had 15% to 22% more long-term sickness absence than employees in work units without bullying.

For healthcare organizations, it would pay—literally—to stop tolerating bullying. Nurse absenteeism and turnover are costly. A 2013 Gallup-Healthways Well-Being Index survey found the annual cost of lost productivity because of nurse absenteeism was $3.6 billion. The cost of turnover for a bedside nurse is estimated between $38,000 to $61,100. This results in an estimated per-hospital cost of between $4.4 million and $7 million per year.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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