The Hidden Costs and Human Toll of Nurse Bullying

A summary of the paper published in Nursing Administration Quarterly, a peer-reviewed journal, co-authored by this Scrubs Magazine reporter and a noted nurse bullying expert.

If you were bullied as a child, you were probably reassured “it gets better.” But if you’re a nurse, you may be wondering when “better” will happen.

Forget low pay, long shifts, and heavy workloads. Many nurses consider bullying to be one of the worst part of the job.

As part of Scrubs Magazine’s ongoing anti-bullying initiative, I partnered with co-author Dr. Cole Edmonson, DNP, RN and Chief Clinical Officer of AMN Healthcare on “Our Own Worst Enemies: The Nurse Bullying Epidemic,” published in the July/September 2019 edition of Nursing Administration Quarterly, a peer-reviewed journal for nurse leaders.

You can access the full article here, but in the meantime, I’ve summarized a few of the key findings for Scrubs Magazine readers.

Healthcare staff at 700% greater risk for workplace bullying

Nurse bullying is often brushed off by those in power. It’s a rite of passage, some claim, younger nurses must pay their dues. Others believe it’s a natural outcome of female competition — instead of fighting over a man, nurses fight over status and respect.^[1]

The truth is, horizontal aggression happens at all levels, age groups, and genders. Wherever you find nurses, you’ll find bullying. Compared to the general workforce, healthcare staff are seven times more likely to experience bullying on the job.^[2]

Some of the bullying is overt, like the nurse who was shoved into a wall as she attempted to check on a patient. But more subtle forms fly under the radar. Nurses may spread rumors, play favorites, withhold necessary information, or repeatedly assign unfavored nurses the worst tasks or shifts.

Bullying can also take place outside the hospital. A nurse may “forget” to invite someone to a retirement lunch, or refuse to talk to them when they’re there. Nurses may make fun of their colleagues on social media or text messages. They might even set up a nurse to fail, which can harm patients as well as the nurse.

“Patients are dying, and we’re fighting over a pen?”

The nurse shortage is real and it’s only getting worse. Our population is aging, and by 2030, one in five Americans will be 65 or older,^[3] a time when many need nursing care. In the next 10-15 years, a third of today’s nurses will probably retire, including faculty at nursing schools, limiting the numbers of students the schools can manage.^[4]

At the same time, 34% of nurses^[5] permanently quit the profession, or consider quitting, because of bullying. Each time a bedside RN leaves a job, it costs the hospital $38,000 to $61,100, with the average institution losing $4.4 – $7 million annually to nurse turnover.^[6]  Over any given year, absenteeism, reduced productivity, legal costs and other bullying-related outcomes cost the average U.S. hospital almost $12,000 per nurse.^[7]

While healthcare organizations deal with rising costs, and worry how they’re going to cope with the influx of Baby Boomer patients, many still don’t take nurse bullying seriously. It’s not good-natured hazing, or an inevitable fact of female existence. Bullying is an insidious and utterly avoidable disease that’s eroding patient care, destroying human potential, and costing our health system billions of dollars.

^[1] https://www.beckershospitalreview.com/human-capital-and-risk/8-things-to-know-about-nurse-bullying.html

^[2] Waschgler K,E.. (2019). Vertical and lateral workplace bullying in nursing: development of the hospital aggressive behaviour scale. – PubMed – NCBI . Ncbi.nlm.nih.gov.

^[3] https://www.census.gov/prod/2010pubs/p25-1138.pdf

^[4]  McDonnell, S. (2017). America’s Nurses Are Aging – Allied Staffing Network. Allied Staffing Network. https://alliedstaffingnetwork.com/americas-nurses-are-aging/

^[5] King-Jones, M. (2011). Horizontal violence and the socialization of new nurses. Creative Nursing, 17(2), 80-86.

^[6] Annual change in hospital RN turnover, 2013-2017. 2018 National Health Care Retention & RN Staffing Report, NSI Nursing Solutions, Inc.

^[7] Laschinger, H. K. S., Wong, C. A., Cummings, G. G., & Grau, A. L. (2014). Resonant leadership and workplace empowerment: The value of positive organizational cultures in reducing workplace incivility. Nursing Economics, 32(1), 5-18.