Workplace bullying and burnout among healthcare employees: The moderating effect of control‐related resources

Workplace bullying is a widespread and challenging problem in healthcare organizations, bearing negative consequences for individuals and organizations. Drawing on the job demands–resources theory, in this study, we examined the relationship between workplace bullying and burnout among healthcare employees, as well as the moderating role of job autonomy and occupational self‐efficacy in this relationship. Using a cross‐sectional design with anonymous questionnaires, data were collected from two samples of 309 healthcare employees in a mental health facility, and 105 nurses studying for their bachelor degree in health systems administration. The findings indicated that workplace bullying was positively related to burnout dimensions, and that this relationship was moderated by job autonomy and occupational self‐efficacy resources. Job autonomy interacted with workplace bullying in predicting emotional exhaustion and depersonalization; the interaction of bullying with occupational self‐efficacy significantly predicted depersonalization. These results underscore the importance of control‐related resources in mitigating the harmful effects of workplace bullying on employees. Implications for research and managerial practices are discussed.     

One-year prospective study on the effect of workplace bullying on long-term sickness absence

ortega a ., christensen k.b. , hogh a. , rugulies r. & borg v. (2011) Journal of Nursing Management 19, 752–759
One-year prospective study on the effect of workplace bullying on long-term sickness absence Aims To examine the effect of workplace bullying on long-term sickness absence using a prospective design. Background Although bullying has been identified as a serious problem in the health care sector, little attention has been given to the possible effect of workplace bullying on long-term sickness absence and its implications. Methods The sample consisted of 9949 employees (78.1% response rate) working in the elderly-care sector in 36 Danish municipalities. Long-term sickness absence was measured by linking a survey on work and health to the national register on social transfer payments. Results Among the 1171 employees that were bullied at work in the past 12 months, 1.8% were frequently bullied and 7.3% were occasionally bullied. The risk of long-term sickness absence was higher for those frequently bullied even after adjusting for psychosocial work characteristics [rate ratio (RR) = 1.92, confidence interval (CI): 1.29–2.84; P < 0.05]. Conclusion This is the first prospective study that explored the effect of both frequent and occasional bullying on long-term sickness absence among health care employees. The effect of frequent bullying on long-term sickness absence was independent of the psychosocial work characteristics. Implications for Nursing Management Workplace bullying might impact negatively the quality of care and patients safety.     

Overseas nurses' experiences of discrimination: a case of racist bullying?

Aim  We present three case studies of discrimination to illustrate how racist bullying as discriminatory practices operates in the workplace.
Background  Workplace bullying in the British health care sector is reported along with evidence of discrimination towards overseas-trained nurses recruited to work in the United Kingdom (UK).
Methods  The three interviews, which form the basis of the discussion in this paper, were selected purposively from a national study of overseas nurses because they present strong examples of the phenomenon of workplace bullying. The data on which this paper draws were collected through semi-structured, audio-recorded interviews and thematically re-analysed using nvivo V2.
Results  The national study showed how racism is entrenched in health workplaces. Our findings in this paper suggest that racism can be understood by the concept of racist bullying. There are four key findings which illustrate racist bullying in the workplace: abusive power relationships, communication difficulties, emotional reactions to racist bullying and responses to bullying.
Conclusions  We argue that the literature on workplace bullying adds a layer of analysis of discrimination at the individual and organizational levels which enables us to further delineate racist bullying. We conclude that racist bullying can be specifically identified as a form of bullying.
Implications for nursing managers  Our data may assist managers to challenge current workplace working practices and support bullied employees. The three interviews show different responses to racist bullying which allow us to explore some implications for management practice.     

The origin of workplace bullying: experiences from the perspective of bully victims in the public service sector

BACKGROUND: Workplace bullying has attracted increased attention during the last decade due to its severe consequences on health. However, the origin of bullying has, so far, been insufficiently described. AIM: This study investigates the manner in which bullying is initiated at workplaces in the public service sector. METHOD: Twenty-two bully victims were interviewed in-depth and data were analysed according to grounded theory methodology. RESULTS: The findings of this study demonstrated that bullying was preceded by a long-standing struggle for power. This power struggle emanated from conflicts of values caused by organizational conditions, leadership styles and the involved parties' work expectations. In particular, individuals who perceived themselves as strong and competent or as vulnerable and sensitive persons were targeted in these types of power struggles. CONCLUSIONS: In these cases, if values conflicts were solved, the power struggle ebbed. When values conflicts remained unsolved, the gap widened between the targeted individual and that person's opponents. Thereby, the conflict escalated and grew into one characterized by systematic and persistent bullying.     

Workplace bullying in nursing: towards a more critical organisational perspective

Workplace bullying is a significant issue confronting the nursing profession. Bullying in nursing is frequently described in terms of 'oppressed group' behaviour or 'horizontal violence'. It is proposed that the use of 'oppressed group' behaviour theory has fostered only a partial understanding of the phenomenon in nursing. It is suggested that the continued use of 'oppressed group' behaviour as the major means for understanding bullying in nursing places a flawed emphasis on bullying as a phenomenon that exists only among nurses, rather than considering it within the broader organisational context. The work of Foucault and the 'circuits of power' model proposed by Clegg are used to provide an alternative understanding of the operation of power within organisations and therefore another way to conceive bullying in the nursing workforce.     

Bullying and employee turnover among healthcare workers: a three-wave prospective study

hogh a., hoel h. & carneiro i.g. (2011) Journal of Nursing Management 19, 742–751
Bullying and employee turnover among healthcare workers: a three-wave prospective study Aim To investigate the risk of turnover among targets of bullying at work. Background Exposure to bullying seems to leave targets with intentions to leave their workplaces. However, it is uncertain to what extent they actually leave. Method Data were collected by questionnaires in a three-wave study among Danish healthcare workers at the time of graduation (T₁), 1 (T₂) and 2 years (T₃) later. We followed 2154 respondents who participated in all three waves. Results The first year after graduation, 9.2% reported being bullied at work, 1.8% frequently. Follow-up analyses showed a strong relationship between exposure to bullying at T₂ and turnover at T₃ [odds ratio (OR) for frequently bullied = 3.1]. The inclusion of push factors such as low social support and low sense of community, intention to leave and ill health did not change the relation between bullying and turnover significantly. Three reasons for quitting stood out among reasons given by the bullied respondents: poor leadership, being exposed to negative behaviour and health problems. Conclusion Bullying may be costly to an organization in terms of staff turnover and subsequent recruitment and training of replacements. Impact for Nursing Management Managers should regularly monitor the psychosocial work environment. To prevent bullying local policies and procedures should be developed, implemented and evaluated.     

Workplace Bullying in the OR: Results of a Descriptive Study

This study describes the incidence of workplace bullying among perioperative RNs, surgical technologists, and unlicensed perioperative personnel in two academic medical centers. The study sought to determine whether the demographic variables of gender, ethnicity, hospital, years of experience on the unit, years in the profession, and job title predict the experience of workplace bullying; whether a relationship exists between workplace bullying and emotional exhaustion; and whether bullying is associated with perceptions of patient safety in the OR. The cross-sectional design included perioperative nurses, surgical technologists, and unlicensed perioperative personnel (N = 167). Fifty-nine percent of the study participants reported witnessing coworker bullying weekly, and 34% reported at least two bullying acts weekly. Having one’s opinion ignored is the most common bullying act, with 28% of respondents experiencing being ignored. Differences in the experience of bullying can be found between hospitals and among ethnicities. Emotional exhaustion also was correlated with bullying. The participants did not perceive bullying as affecting patient safety.     

Interventions against bullying of prelicensure students and nursing professionals: An integrative review

The problem of bullying is of such significance, health care accreditation agencies such as The Joint Commission have reiterated that these behaviors compromise on patient safety. Researchers demonstrate that much is known about the existence of bullying behaviors in health care and its detrimental effects on the profession of nursing. Leaders in health care and nursing education are beginning to tackle this issue. Guided by the methodology of Whittemore and Knafl, the purpose of this integrative review was to analyze literature discussing the interventions against bullying directed towards prelicensure nursing students and professionals.