Running Head: NURSING INCIVILITY

The Psychological Effects of Nursing Incivility on New and Experienced Nurses:

A Systematic Review of Literature

Candice Belus, Elizabeth Chang, Emily Corridon,

Rebecca Dennis, Sara Greco and Adrian Lambert

James Madison University

NURSING INCIVILITY

The Psychological Effects of Nursing Incivility on New and Experienced Nurses:

A Systematic Review of Literature

Nursing incivility refers to the bullying of nurses by other nurses in the workplace, and
is a significant concern in the field of nursing. While the incidence of nurse incivility may vary
from facility to facility, national surveys report that 27% to 85% of all staff nurses have
experienced being victimized by their coworkers at some point during their career (Harris &
Smith, 2014). The consequences of this harmful behavior cannot be underestimated, as it
threatens the wellbeing of individual nurses, their patients, and the profession as a whole.
Research shows that nurses bullied by co-workers report physical manifestations of stress such
as headaches, gastrointestinal problems, poor concentration, and fatigue. Even more disruptive to
bullied nurses health are psychological symptoms such as anxiety, depression, and feelings of
low self-worth. Victims of bullying may fear going to work or may require time off to address
their physical and psychological symptoms, resulting in absenteeism and a decreased patient to
nurse ratio. Even if a bullied nurse is present at work, she may be so burnt out that she is
emotionally unavailable to her patient or may be prone to making medical errors. Therefore,
patients suffer from these hostile dynamics between nurses, as well. Nursing incivility has
become so severe that it has led many nurses to leave the profession, which contributes to the
current nursing shortage that plagues Americas health care system and threatens the future of
nursing. New nurses are particularly vulnerable to being victims or nursing incivility because of
their lack of experience and reliance on elder nurses for guidance and support. Yet, few studies
have been conducted that specifically compare the psychological effects of bullying between
younger and older populations of nurses. In this systematic review of literature, current research

NURSING INCIVILITY

studies will be synthesized to determine if nurse incivility causes more anxiety and depression in
new nurses than experienced nurses within the hospital setting. In this study, new nurses were
defined as those who have been out of nursing school and in the nursing practice for five years or
less; experienced nurses were defined as those who have been graduated from nursing school
and practicing in the field for five years of longer.
Discussion
Study Similarities
Common conclusions found in the reviewed studies show that the majority of new nurses
reported bullying/incivility in their new workplace. This internal incivility led to an environment
of high stress and poor working conditions. Research by Laschinger, Wong, Regan, YoungRitchie, and Bushell (2013) found that all forms of nursing incivility reported were significantly
related to poor mental health and burnout. Many of the new nurses reported not feeling
comfortable at their new job and wanted to leave: Hostile work environments make the
transition experience of a new graduate nurse difficult and have the potential to leave their first
job (Laschinger et al., 2013). However, the issue is that nursing incivility may occur at any
hospital you go to. According to Smith, Poole, and Coverdale (2003), different locations of
nursing care had varying degrees of nursing incivility. For example, about 26% were practicing
in surgical wards, 30% were practicing in other inpatient services, but only 6% were practicing in
the community setting (Smith et al., 2003). Therefore, this is an issue with more emphasis on coworker incivility rather than workplace incivility. These articles are similar to one another
because they all support the concept that a stressful work environment can lead to
miscommunication between co-workers, which in turn can negatively impact patient outcomes.

NURSING INCIVILITY

Study Differences
The studies included in this systematic literature review had unique aspects to their
research methodology. Some studies focused on locations within a hospital in which nurses were
bullied most frequently, while other studies investigated the different forms of bullying reported
by nurses. The studies also had different sampling requirements, such as how participants were
selected, criteria for participant inclusion, and sample size. For example, some samples were
selected through volunteers while others were selected through mailing lists or an online survey.
There were also differences in the various eligibility requirements. For instance, some studies
required nurses to be newly graduated while other studies required nurses to be working 3 years
or less. Some studies required nurses to work only on the medical surgical floor. The differences
in these studies reveal different perspectives of nursing incivility from various nursing cohorts,
which ultimately provide more insight into the complexity of nursing incivility.
Study Limitations
The majority of studies used surveys/questionnaires that were delivered via mail. This
limits results to only those who turned in surveys and their written responses. As a result,
researchers are not able to pick up on nonverbal cues and ask further questions. Also, the articles
were focused on reports from new nurses, however failed to include perspectives of older nurses.
This might alter results on how the more experienced nurses handled the anxiety and depression
that nurses so often deal with.
Implications for Nursing Practice
Implications for the nursing practice are extremely important when speaking of nurse
incivility because it not only affects the nurse but it affects the care the nurse gives to the
patients. There are many options to use when it comes to nurse incivility and how to work on

NURSING INCIVILITY

preventing its occurrence in the hospital setting among nurses. It would be beneficial to have
new nurse graduate programs in the hospitals to help decrease the incidence of nursing
incivility/bullying by assisting new grads with entering the workplace. It would help them orient
themselves to this new phase in their life, the new unit, and the new faces that will be around
them during their shift. Working closely with a nurse preceptor helps to get to know and form
relationships with co-workers. In addition, implementing an anonymous system in which nurses
can report bullying/incivility and holding nurses accountable for their actions would be
beneficial in reducing nurse incivility. Before entering the workforce it might also be beneficial
instill good stress management and nursing practices early to help new nurses cope with
challenges they may face. This can be done by creating student-centered learning environments
that focus on caring, humanistic relationships in which the academic and clinical settings
supports the students ability to cope with the challenges and stressors inherent to their practice
discipline and educational experience.
Conclusion
In conclusion, incivility and bullying in any profession is damaging to cohesion in a
workplace. Specifically, workplace bullying in new graduate nurses poses a serious threat to
nurse burnout, stress, lack of communication, and poor mental and physical health outcomes.
These problems manifest themselves in nurse attrition, absences, patient safety, nurse safety, and
emotional outbursts. Incivility among nurses is extremely prevalent in hospital and healthcare
settings today because of the demand and increase for new young nurses entering the workforce.
These bullying occurrences should be addressed directly, and educated according to hospital
floor, nursing population, and prevalence among workers. Implications for the nursing profession
to address the incidence of incivility include assigning new nurses to nurse preceptors,

NURSING INCIVILITY

implementing new nurse orientation programs, improved manager oversight, education, and
stress management. Nursing incivility is a legitimate threat to the profession and requires
prevention and intervention strategies so that the wellbeing of nurses and patients can be
preserved.

NURSING INCIVILITY

7
References

Anthony, M., & Yastik, J. (2011). Nursing students' experiences with incivility in clinical
education. Journal of Nursing Education, 50(3), 140-144. doi: 10.3928/01484834-20110131-04
Berry, P. A., Gillespie, G. L., Gates, D., & Schafer, J. (2012). Novice nurse productivity
following workplace bullying. Journal Of Nursing Scholarship, 44(1), 80-87 8p.
doi:10.1111/j.1547-5069.2011.01436.x
Etienne, E. (2014). Exploring workplace bullying in nursing. Workplace Health Safety, 62(1), 611. doi: 10.1177/216507991406200102
Harris, H., & Smith, S. J. (2014). Workplace bullying in nursing: The causes, effects and
possible solutions for the ongoing problem of lateral violence among nurses. Retrieved from
http://nursing.advanceweb.com/Features/Articles/Workplace-Bullying-in-Nursing.aspx
Laschinger, H. K. S., Wong, C., Regan, S., Young-Ritchie, C., & Bushell, P. (2013). Workplace
incivility and new graduate nurses mental health. The Journal of Nursing Administration, 43(78): 415-421. doi: 10.1097/NNA.0b013e31829d61c6
Laschinger, H. K. S., Finegan, J., & Wilk, P. (2009). New graduate burnout: The impact of
professional practice environment, workplace civility, and empowerment. NURSING
ECONOMIC$, 27(6), 377-383
Laschinger, H. K. S., Grau A. L., Finegan J., & Wilk, P. (2010). New graduate nurses'
experiences of bullying and burnout in hospital settings. Journal of Advanced Nursing, 66 (12),
27322742.
Prato, D., Bankert, E., Grust, P., & Joseph, J. (2011). Transforming nursing education: A review
of stressors and strategies that support students professional socialization. Advances in Medical
Education and Practice, 2011(2), 109-116. doi: 10.2147/AMEP.S18359
Rowe, M. M., & Sherlock, H. (2005). Stress and verbal abuse in nursing: Do burned out nurses
eat their young? Journal of Nursing Management, 13 (3), 242248.
Rush, K. L., Adamack, M., Gordon, J., & Robert, J. (2014). New graduate nurse transition
programs: Relationships with bullying and access to support. Contemporary Nurse, 4(2), 219228, doi: 10.1080/10376178.2014.11081944
Smith, N. A., Poole, S. J., & Coverdale, J. H. (2003). Horizontal violence: Experiences of
registered nurses in their first year of practice. Journal of Advanced Nursing, 42(1), 9096 93

NURSING INCIVILITY

Wing, T., Regan, S., Spence, L., & Heather, K. (2015). The influence of empowerment and
incivility on the mental health of new graduate nurses. Journal of Nursing Management, 23(5),
632-43. doi: http://dx.doi.org/10.1111/jonm.12190 .
Younju, L., Mihyoung, L., & Kunsook, B. (2013). Effect of workplace bullying and job stress on
turnover intention in hospital nurses. Journal of Korean Academy of Psychiatric and Mental
Health Nursing, 22(2), 77-87. doi: 10.12934/jkpmhn.2013.22.2.77

Table of Evidence

NURSING INCIVILITY

Group 9: Candice Belus, Liz Chang, Emily Corridon, Rebecca Dennis, Sara Greco, Adrian
Lambert
Pico Statement: Within the hospital setting, does nurse bullying/incivility cause more anxiety and
depression in new nurses than in more experienced nurses?
Author
& Year

L Study Purpose
O
E

Sample
How was the
sample
selected?
Who was in
the sample?
How many
were in the
sample

Intervention

Instruments with
Validity and
Reliability

Results/Findings

-To study the

influence of
empowerment
and incivility
on the mental
health of new
graduate
nurses.

-sample was
selected
through
surveys
-394 new
graduate
nurses who
worked in
med-surg,
critical care,
maternal/child

-surveys were
mailed out
including a
letter of info
explaining
the study, a
questionnaire,
stamped and
addressed
envelope to
return it, and
a cvoucher
for a coffee
shop to show
appreciation

-CWEQ-II [The
Conditions for Work
Effectiveness
Questionnaire]
- WIS [The Workplace
Incivility Scale]
-The State of Mind
Subscale from the
Pressure Management
Subscale

-The findings suggest that

workplace incivility is
associated with a decreased
effect of empowering workplace
structures in lowering mental
health symptoms experienced by
new graduate nurses.Hostile
work environments make the
transition experience of a new
graduate nurse difficult and has
the potential to make them leave
their first job.

-To examine
relationships
between coworker,
physician, and
supervisor
workplace

-833 new
graduate
nurses
-sample was
selected
through
surveys

-Surveys
were sent out
consisting of
3
standardized
questionnaire
s

-Likert scales
-Cortinas General
Workplace Incivility
Scale [WIS],
-Luthans
Psychological Capital
Questionnaire

-The results suggest that

personal resiliency may offset
some of the negative effects of
workplace incivility. Still,
efforts should be made by
nursing management to
eliminate the negative behaviors

Travis
Wing,
Sandra
Regan,
Heather
K.
Spence
Laschin
ger.
2015

Heather
K.
Laschin
ger,
Carol
Wong,
Sandra

NURSING INCIVILITY
Regan,
Carol
YoungRitchie,
Pamela
Bushell.
2013

incivility and
new graduate
nurses mental
health and the
protective role
of personal
resiliency.

1
Peggy
A.
Berry,
Gordon
L.
Gillespi
e,
Donna
Gates,
John
Schafer,
2011

10

To determine
the prevalence
and effects of
workplace
bullying (WPB)
on the work
productivity of
novice nurses
(NNs).

-Mental Health
Inventory [MHI-5]

-samples
were
randomly
selected
through 3 RN
mailing lists
and 5,000
eligible
participants
were selected
and sent
invitations to
participate in
study.
-284
participants
but only 197
eligible
-samples were
RNs in
practice for
<3 years

Postcard
invitations
with the
studys URL
Internetbased
survey
collector
were mailed
with an offer
of a $10 gift
card for study
participation.
On entering
the website,
NNs were
asked to read
a letter of
information,
which
included the
ability to opt
out at any
time during
the survey.
Informed

-Healthcare
productivity survey
(measures changes in
work productivity)

that cause mental health

problems and to create a
respectful and supportive work
environment.
-There is more co-worker
incivility than workplace
incivility. Followed by physician
and supervisor incivility.
-All forms of incivility were
significantly related to poor
mental health.

- 21.3% of novice nurses are

exposed to daily to Work Place
Bullying ( WPB).
- nearly half of the novice
nurses self-identified as being a
- Negative acts
target of WPB (44.7%)
questionnaire
- 18.2% have self-identified as s
( measures perception
being bullied now and then or
of being targeted for
several times a week
WPB over a 6 month
- 26% reported rarely being
time frame)
reported rarely being bullied
- 55.3% experience no bullying
-Demographic variable - Over 75% of the sample was
(nurse characteristics of exposed to a WPB event within
educational attainment, the 30 days prior to the study.
health care facility
- The main perpetrators of WPB
currently employed
events were staff nurses (44%). race or ethnicity, age,
Nurses in leadership positions
and sex are captured)
(director of nursing, manager,
supervisor, charge nurse, nurse
preceptor, nurse educator)
accounted for 19% of nurse
perpetrators. Only 6% of the
bullying incidents were by
physicians.

NURSING INCIVILITY

11
consent was
implied when
participants
visited the
study site,
entered their
unique study
identification
number found
on the
postcard
invitation,
and clicked
Next on the
web-based
survey
collector.

Kathy
L Rush,
Monica
Adamac
k, Jason
Gordon,
Robert
Janike,
2014

The purpose of
this study was
to examine the
relationships
between access
to support,
workplace
bullying and
new graduate
nurse transition
experience
within the
context of new
graduate
transition
programs

-the sample
recruited
included all
new graduate
nurses
(graduating
class of 2010)
from the
seven health
authorities in
British
Columbia
who were
within 1 year
of
employment
in an acute
care setting
-Recruitment
of the sample
for the survey

Data was
collected
through
online survey,
which took
approximatel
y 15 minutes
to complete,
asked new
graduates
questions
about their
orientation
and transition
including
participation
in a new
graduate
transition
program.
Each eligible
new graduate

-Demographics
-Orientation to the
employer and to the
nursing unit
-General transition
-Participation in a
formal new graduate
nurse transition
program
-CaseyFink Graduate
Nurse Experience
Survey
(utilized to quantify a
new graduate nurses
transition experience)

-39% of new graduate

participants reported they
experienced bullying/
harassment
-Among the program
participants, 69% of the bullied
nurses were able to access
support when needed most or all
of the time

NURSING INCIVILITY

Naumai
A.
Smith,
Suzette
J.
Poole,
John H.
Coverda
le,
2003

-Determine the
prevalence of
various types of
interpersonal
conflict
experienced by
nurses in their
first year of
practice.
-Describe the
characteristics
of the most
distressing
incidents nurses
experienced.
-Measure the
psychological
impact of the
events.
-Determine
consequences
of experiencing
such events.
-Determine the
adequacy of
training
received to
limit horizontal
violence.

12

component
occurred by email using
mechanisms
internal to
each health
authority.
-245 samples

nurse was
sent at least
one follow-up
e-mail
reminder.
Participant
consent was
implied via
survey
completion.

-A target
population of
first year
graduates was
identified by
the Nursing
Council of
New Zealand
from their
national
register of all
practicing
nurses.
-The Council
was
contracted to
mail out an
information
letter and
anonymous
questionnaire
to all nurses
residing in
New Zealand
who had
registered
following the
State
Registration

-Information
letters and
questionnaire
s were mailed
out.
Modification
of the
questionnaire
format to
apply to
interpersonal
conflict
between
nurses was
guided by
descriptions
in the
literature as
to what
constitutes
horizontal
violence.
-Respondents
were asked to
rate the level
of distress
(none,
minimal,
moderate, or

-The Impact of Events

Scale was used to
measure the level of
distress experienced
over the 7 days
preceding completion
of the questionnaire.
-Ethical permission for
the study was obtained
by the Auckland
University of
Technology Ethics
Committee.
-Statistics were
analyzed using SPSS

-545 participants indicated their

age: 513 being female and 32
being male.
-114 (21%) were practicing in
medical wards.
-145 (26%) were practicing in
surgical wards.
-164 (30%) were practicing in
other inpatient services.
-68 (13%) were practicing in
mental health.
-30 (6%) were practicing in
community settings.
-22 (4%) of the participants did
not specify their area of work.
-34% of respondents
experienced statements that
were rude, abusive, humiliating,
or involved unjust criticism.
-5% experienced verbal sexual
harassment.
-4% experienced inappropriate
racial comments and gestures.
-3% experienced harassment
through formal complaint
process.
-3% experienced formal threats.
Of the most distressing
incidents: 41% (or 70 of the 170

NURSING INCIVILITY

1
Heather
K.
Spence
Laschin
ger,
Joan
Finegan
, Piotr
Wilk,
2009

-Determine
how supportive
practice
environments,
workplace
incivility,
empowerment,
and burnout
collectively
affected the
new graduate
nurse.

13

Examinations
in November
1999, March
2000, and
July 2000.
-1169
questionnaires
were mailed,
584 were
returned, and
33 were
blank.

severe)
caused by the
one incident
that had
caused the
most distress
and to
describe the
incident in
detail.
-Questions
were also
asked to see
if the incident
led to
absenteeism
or desire to
leave the
nursing
workforce.

-An analysis
of a subset of
crosssectional data
collected
from staff
nurses in
2006 in a
large Ontario
provincial
study.
-All
registered
nurses who
graduated
within the
past 2 years
and worked in
the inpatient

-Nurses
received a
questionnaire
through
hospital mail.
A reminder
letter was
sent 3 weeks
following the
initial survey
package, and
a second
survey was
sent 1 month
after the
reminder
letter.

participants) described rude,

abusive, or humiliating
comments.
-24% (or 40 of the 170) reported
being given too much
responsibility without
appropriate supervision.
-66% (112 participants) reported
the level of distress as moderate
or severe.

-The Practice
Environment Scale of
the Nursing Work
Index consists of 31
items rated on a 4 point
Likert scale. Items are
reversed scored to
create high scores
signifying a high level
of Magnet hospital
characteristics in the
work setting.
-Shortell, Rousseau,
Gillies, Devers, &
Simons ICU
questionnaire measured
new graduate
perception of
workplace civility.

-New graduates perceived their

new work environment to have
moderate levels of overall
Magnet Hospital characteristics
(mean= 2.60). Nursing as a
foundation of care was ranked
highest while adequate staffing
was lowest.
-New graduates felt that their
work environments were only
somewhat empowering
(M=3.30).
-High levels of emotional
exhaustion were reported (62%).
-Combination of supportive
practice environment, civil
working relations among
nursing colleagues, and an
overall sense of empowerment

NURSING INCIVILITY

14

units (roughly
247
participants).
-71% of
participants
were younger
than 30 years
old; had 1.5
years of
nursing
experience;
and 1.3 years
in their
current
nursing
position.
-94% of
participants
were female.
-65% of
participants
worked full
time.
1
Mauree
n
Anthon
y&
Joanne
Yastik,
2011

- qualitative
study aimed to
explore the
experiences of
nursing
students as
targets of
incivility in
clinical settings
- to describe
their
perceptions of
specific uncivil
and favorable
behaviors by
nurses

-study took
place at a
private
university
with a large
nursing
school
- purposive
sampling was
used to recruit
students who
thought they
had been the
targets of
incivility by
staff nurses

- Four focus
groups were
held
- purpose of
the study was
described and
participants
signed
consent to
participate
- completed a
short
demographic
questionnaire
containing
questions

-Overall perceptions of
empowerment were
measured by the 2-item
Global Empowerment
Scale.
-Emotional Exhaustion
(EE) subscale of the
Maslach Burnout
Inventory-General
Survey was used to
measure graduate
burnout.

in the workplace contributed to

lower levels of emotional
exhaustion among new grads,
explaining 28% of burnout.

- demographics
- A line-by-line method
of analysis (Miles &
Huberman, 1994) was
used to code,
categorize, and analyze
data
- Dedicated education
units (DEUs): provide a
learning environment in
which the staff nurses,
with support from
school of nursing
faculty, serve as clinical
instructors

- Behaviors perceived to be
uncivil fell in three themes:
exclusionary, hostile or rude,
and dismissive
- reported difficulty giving and
receiving report on patients;
troubling because The Joint
Commission (2008b) identified
a standardized approach to
patient hand-off communication
as National Patient Safety Goal

NURSING INCIVILITY

Darlene
Del
Prato,
Esther
Bankert
,
Patricia
Grust,
&
Joanne
Joseph
(2011)

15

-to examine
how nursing
students think
schools of
nursing should
address
incivility in
clinical settings

- Eighteen
female and
three male (21
total) nursing
students
participated

about age,
gender, race,
and
educational
level in the
program
- interview
questions
were then
used to
explore
students
experiences
of perceived
uncivil
treatment by
staff nurses in
the clinical
setting

-this article
reviews the
literature on
stress and its
effects on
nursing
students
-focuses on the
clinical
environment
and facultystudent
relationships as
major sources
of students
stress -offers
strategies for
mitigating
stress while
fostering

-stress in
nursing
students
-stress in
clinical
environment
-faculty
student
relationship
-faculty
behaviors
-faculty
incivility

-tips for
managing
stress
-peer and
staff
mentoring
and modeling
-caring
learning
environments
-faculty role
and behaviors
-proactive
learning
strategies
-empowering
nursing
students

-stress theory
-Watsons human
caring theory
-reflective learning
model

-this article reports the negative

effects of stress and
unsupportive relationships on
students learning environments
-it is a review of literature on
these topics

NURSING INCIVILITY

16

learning and
professional
socialization of
future nurses
Heather 1
K.
Spence
Laschin
ge,
Ashley
L. Grau,
John
Finegan
,&
Piotr
Wilk
(2010)

The aim of the

study was to
test a model
linking new
graduate
nurses
perceptions of
structural
empowerment
(access to
information,
resources,
support and
opportunities to
learn and grow)
to their
experiences of
workplace
bullying and
burnout in
Canadian
hospital work
settings.

A sample of
1400 nurses
was drawn
from the
registry list of
practicing
nurses in
Ontario.
546
completed
surveys were
returned (39%
response
rate).
However,
only 415 of
the
respondents
had met the
criteria of
new graduate
nurses
(defined by
<3 years in
nursing)

Nurses
received a
mailed
package that
included a
letter
explaining
the study, a
questionnaire,
and a
stamped
researcheraddressed
envelope to
return the
questionnaire.
A follow up
reminder
letter was
sent to all
potential
respondents 2
weeks after
the initial
mailing.
Six weeks
after the
initial
questionnaire
s were
mailed, a
replacement
questionnaire

Structural
empowerment was
measured using-the
Conditions for Work
Effectiveness
Questionnaire-II
(CWEQ-II)
Bullying behaviours
were measured using
the Negative Acts
Questionnaire-Revised
(NAQ-R)
New graduate burnout
was measured using the
Maslach Burnout
Inventory-General
Survey (MBI-GS)

Overall empowerment levels

were moderate, with access to
opportunities to learn and grow
rated the highest. Formal power
was rated lowest.

Participants reported relatively

high levels of emotional
exhaustion, with almost half
(48.9%) qualifying as severely
burned out.
One-third (33%) of the new
graduates in our sample were
classified as bullied
Empowerment was statistically
significantly related to all types
of workplace bullying,
particularly work-related
bullying. All aspects of bullying
were statistically significantly
related to burnout.

NURSING INCIVILITY

17
package was
sent to nonrespondents
only.
Data for this
study was
collected
from July to
November of
2009.

1
Michell
e Rowe
& Holly
Sherloc
k
(2005)

The purpose of
this study was
to explore the
types and
frequency of
verbal abuse of
nurses by other
nurses.
Additionally,
this study
explored the
components,
characteristics,
consequences
and effects of
abuse in an
effort to better
understand the
dynamics of
verbal abuse of
nurses in the
workplace.

The sample
for this
research study
was taken
from
Registered
Nurses and
Licensed
Practical
Nurses
employed at a
teaching
hospital in the
Philadelphia
area. 307
surveys were
distributed,
and 213 were
returned (69%
response
rate).
Participants
included
nurses from

Subjects
received an
introductory
cover letter
indicating
that
participation
was strictly
voluntary, the
survey packet
and a
collection
envelop.
Any nurse
who chose
not to
participate in
the study was
instructed to
return the
uncompleted
survey
packet in the
collection

Coxs (1987) Verbal

Abuse Survey and
Manderino
and Berkeys (1997)
Verbal Abuse Scale.

Respondents reported that the

most frequent source of abuse
was nurses (27%), followed by
patients families (25%), doctors
(22%), patients (17%), residents
(4%), other (3%) and interns
(2%). Of those who selected a
nurse as the most frequent
source, staff nurses were
reported to be the most frequent
nursing source (80%) followed
by nurse managers (20% ).

NURSING INCIVILITY

Etienne, 1
Emerald
, MSN,
BSN,
RNCOB,
2014

The purpose of
this project was
to assess
registered
nurses
perceived
exposure to
workplace
bullying

18

all shifts, as
well as male
and female
nurses, full
and part-time
nurses, nurses
of varying
education
(LPN Masters), and
nurses from a
wide range of
units.

envelope.

A
convenience
sample of a
Pacific
Northwest
state
professional
nurses
association
membership
was solicited
for this
descriptive
study.

RNs from
professional
nurses
association
were invited
to participate,
via the
associations
online
newsletter.
Participation
was voluntary
and all
information
collected was
strict- ly
confidential.
Informed
consent was
required.

Nurses who
chose to
participate in
the study
were
instructed to
complete the
survey, place
it in the
collection
envelop and
seal it, and
place the
envelope into
a centrally
located
collection
mailbox
Data was collected
using a convenience
sample which was a
descriptive survey in
order to generate
information on the
extent at which nurses
were experiencing
workplace bullying.
Used the: Negative
Acts QuestionnaireRevised (NAQ-R).

Forty-eight percent of
respondents admitted to being
bullied in the workplace during
the previous 6 months, with
respondents choosing being
ignored or excluded as the
most common negative
experience in the workplace.

NURSING INCIVILITY

Younju 1
Lee,
Mihyou
ng Lee,
and
Kunsoo
k
Bernstei
n, 2013

The purposes of
this study were
to explore
nurse' bullying
experiences
according to
demographic
characteristics
and to identify
effects of
workplace
bullying and
job stress on
turnover
intention in
hospital nurses.

One hundred
sixty-one
graduate
students
working as
nurses were
recruited.

19

The collected
data was
analyzed
using
descriptive
statistics, ttest, ANOVA,
Pearson
correlation
coefficient,
and Stepwise
multiple
regression
with PASW
18.0.

Questionnaires, tables,
and statistical testing
were used. Ethical
testing was used.
Graduate students were
surveyed.

Results show that 23.0% of the

nurses interviewed had
experienced bullying in the
workplace within the last six
months and 19.4% had been
bullied during the entire
employment period.
Job stress was therefore highly
related to workplace bullying as
well as job turnover.