Organizational determinants of bullying and work disengagement among hospital nurses.

Abstract

To identify organizational determinants of bullying and resulting work disengagement among hospital nurses. A cross-sectional, web-based, anonymous questionnaire study. The questionnaire was administered in 2017 to all Registered Nurses in a regional healthcare system in the United States (N=1,780), with 331 complete responses. Logistic regression was used to identify factors associated with personally experiencing and witnessing bullying, respectively. Linear regression was conducted to identify organizational factors associated with disengagement due to bullying. Psychological safety, a measure of team trust and respect, was inversely associated with being personally bullied and witnessing bullying. Being personally bullied, but not witnessing bullying, was associated with disengagement due to bullying. Psychological safety and competence development, a measure of opportunities to develop skills and knowledge at work, were both inversely associated with disengagement due to bullying. Hospital units characterized by trust and respect among nurses are less likely to have a culture of bullying. Both psychological safety and competence development have a protective effect on nurse disengagement from the workplace due to bullying. Interventions to mitigate and prevent bullying and work disengagement among nurses should encompass efforts to enhance psychological safety and opportunities for competence development. Bullying is a pervasive hazard in the nursing profession that contributes to unhealthy workplaces. Nurse managers and staff nurses should work together to establish psychologically safe environments where nurses dare to discuss tough issues like bullying. This research contributes to understanding the characteristics of work environments in which nurses can thrive and work effectively.