Bullying on the Oncology Unit: Nurses Are at Risk

Bullying is an unfortunate occurrence that happens in many workplaces across the nation. However, nurses—and oncology nurses in particular—may be more likely to encounter the issue throughout their career, making it a pressing issue for nursing leaders to address, according to a recent study published in the Journal of Nursing Management.

Bullying Affects Nurses and Patients

A web-based survey was used to examine the prevalence of 2 issues in a comprehensive cancer center teaching hospital in South Florida: horizontal violence, described as, “violence or intimidating behavior toward a colleague at the same employment level American Nurses Association; and bullying, which the authors described as, “intimidating and disruptive behavior with the intent to abuse power.” A total of 241 nurses participated.

“[Horizontal violence] can be a particular problem for nurses who already experience highly stressful work environments, such as oncology nurses, who are expected to provide care to patients at different stages of health and to additionally remain current on advancements in treatments, medications, and management of care, which then increases the risk for job stress,” the authors wrote.

The researchers looked at 4 horizontal violence subscales: emotional, physical, verbal, and defiant behavior. All were positively related to bullying, with verbal and emotional violence displaying the strongest correlations.

These unpleasant environments not only have a major effect on the nurses working in them, but also on the patients being treated, too, since culturally safe environments tend to have improved patient safety and reduced nurse call-ins.

“Fostering such environments is therefore crucial because nursing personnel are continuously placed in high-stakes, high-stress situations in which clinical performance and positive patient outcomes are expected,” the authors wrote.

Not to mention, horizontal violence and workplace bullying can also lead to higher nursing turnover rates, especially when oncology nurses are already stressed with high workloads and the everyday demands of caring for people with cancer. This can be outlined by the fact that 78% of the participants in the study reported working on their current unit for 5 years or less.

Improving the Problem

“While these findings linking negative characteristics to bullying are not unique to this study, they strongly support the continued need for hospital and nursing leadership to improve the work environment,” the authors wrote.

The authors emphasized the need for support to recognize and then eliminate horizontal bullying. This should come from leaders at all administrative levels, as well as in schools of nursing.

It is crucial that nursing leaders do not engage in negative behaviors, such as insults, rumors, and “gang-like negative behavior,” and instead opt to set good examples through positivity— both in their words and their body language—eye contact, and punctual electronic communication.

Additionally, hospitals should adapt “zero-tolerance” policies that may include counseling sessions for bullying offenders.

“To reinforce knowledge learned about [horizontal violence] zero tolerance, offenders could be required to participate in the educational presentations delivered to future policy offenders,” the authors wrote.

Finally, the unique needs of new nurses should be taken into account when hospital and nursing leadership are crafting anti-bullying policies, since recent nursing school graduates may be particularly vulnerable to workplace violence, according to the researchers.

“The mixed demographic data reflect the need for oncology and outpatient clinics to have a heightened awareness of the impact of violence and bullying behaviors among employees who are providing care to vulnerable oncology clients,” the authors wrote. “Based on the current study, future studies should examine the effect of bullying on turnover of NLRNs, nurses in the force less than 5 years, and seasoned nurses.”