Bullying in the Nursing Working Environment. A Challenge for the Directors of Nursing Services

Background: In modern society there appears to be a common understanding that incidents of violence and aggression are usual. Such behaviour is commonplace, also, in the nursing working environment. Over recent years incidents of workplace violence, aggression and harassment have been increasingly observed in the health care sector. Aim: The purpose of this review was to make known to nurses and the leaders of nursing organizations that bullying is a feature of the health care workplace, and to provide potential solutions for dealing with the phenomenon. Method: A retrospective study was made of the international literature for 1990–2009, using the key words: “physical bullying”, “verbal bullying”, “nursing management”, “nursing confrontation”. Results: For the time period 2003–2004 there was an increase of 13% in reported violent incidents in the UK compared to the previous year. Such incidents reduce the job satisfaction, morale and enthusiasm of the nurses, and are among the main reasons why workers do not desire to work and in many cases wish to leave their jobs. Conclusions: The literature search provided strong evidence that violent behaviour in the nursing environment is destructive and should never be allowed or accepted. The bullying phenomenon has been better acknowledged and is under investigation, but nursing managers need to be well-informed and skilled in the recognition of its occurrence in the nursing working environment, and in the techniques of prevention and confrontation. Nursing organizations must develop strategies for confronting and managing the phenomenon.