While many of us think of bullying as something that happens in school, for many workers bullying remains a persistent problem in the workplace. At NIOSH, researchers study how to prevent work-related bullying, particularly in the nursing profession. Now, a recent study by NIOSH and university partners, published in the Journal of Nursing Education and Practice, has found that an education program incorporated into nursing-school curricula could help prevent bullying among working nurses. We asked study co-author Paula Grubb, Ph.D., NIOSH research psychologist, to explain the study and its findings.

Q: What is work-related bullying among nurses and how big is the problem?

A: Unfortunately, bullying has plagued the nursing profession for years, with as many as one-third of nurses experiencing it, according to some studies. In fact, the first part of the paper’s title, “Nurses Eat Their Young,” is a widely known, decades-old idiom among nurses worldwide.

For our research, we defined bullying among nurses as negative behaviors related to work activities, as well as to personal and physical aspects. These negative behaviors include withholding information, ignoring coworkers, spreading rumors, and intimidating others. Early educational interventions—ideally, in nursing school—to raise awareness and teach effective preventive skills are critical to preventing bullying among practicing nurses.

Q: How did you do the study?

A: We developed a multicomponent educational program for nursing students in their junior and senior years. In earlier research, we found that role-playing is an effective way to teach nursing students how to recognize, handle, and prevent bullying situations, so one of the components is classroom-based role playing. Other components include presentations, both in the classroom and on-line, and classroom discussions based on students’ responses to a questionnaire about bullying. We then tested the program on five university campuses.

Q: What did you find?

A: In the pilot study, we found that this educational program comprising a range of teaching methods over 2 years could improve anti-bullying education and, subsequently, help reduce the incidence of bullying among practicing nurses. Since the program includes multiple components, it is important that nursing schools begin to incorporate them during the sophomore year.

Faculty reviewers at five university campuses liked the program, overall. In particular, they commended it for using multiple teaching approaches, encouraging discussion about the issue of workplace bullying, and increasing student awareness of their own risk for bullying.

Q: What are the next steps?

A: Now that we have tested the program and found that it helps reduce the occurrence of workplace bullying, additional studies are necessary to evaluate its long-term effects. In other words, we need to see if nursing students who complete the program adopt and use what they have learned to prevent bullying once they enter the nursing workforce. It is also important to study whether nursing schools can implement the program effectively on their own without undergoing special one-on-one training.

More information is available:

• “Nurses Eat Their Young”: A Novel Bullying Educational Program for Student Nurses
• Qualitative Evaluation of a Role-play Bullying Simulation
• Role-play Decreases Bullying among Nurses
• CDC-NIOSH Division of Applied Research and Technology