Impact of bullying and incivility on new graduate nurses

Profile of an outstanding post-master's DNP project

Vera Clinton

Clinical Issue/Practice Problem: Bullying and incivility are longstanding issues in the nursing profession. They can result in stress, anxiety and depression in addition to causing new graduate nurses to leave a position or the profession entirely. Bullying not only affects the emotional and physical well-being of victims, it can have a negative impact on safe, quality patient care and is costly to employers as it can result in higher staff turnover. The purpose of this initiative was to educate preceptors of nurses at a large, urban academic medical center to use evidence-based strategies to recognize and manage bullying and incivility in the workplace and its impact on new graduates.

Summary of Supporting Literature: Bullying decreases nursing job satisfaction, increases absenteeism and threatens patient safety. The American Nurses Association (2015a) Code of Ethics for Nurses states the nursing profession will not tolerate violence of any kind from any source and that all registered nurses and employers in all settings must collaborate to create a culture of respect free of incivility, bullying and workplace violence. Any nurse can be a victim of bullying or horizontal violence, however, the new graduate nurse is at higher risk because of their lack of confidence and social connectivity.

Project Implementation: An education initiative was developed based on the Civility Tool-kit: Resources to Empower Nurse Leaders to Identify, Intervene, and Prevent Workplace Bullying (Pacers, 2014). The education module was delivered to preceptors and staff nurses from three hospital medical units and one observation unit. The initiative focused on increasing recognition of incivility and using evidence-based strategies to decrease workplace bullying and incivility toward new graduate nurses.

Outcomes: A pre-and post-initiative survey was completed by nurse preceptors to assess changes in knowledge and response to the education. Data showed a statistically significant improvement in several measures. The preceptors had an increased level of comfort to approach and discuss issues of bullying and incivility with both peers and nursing leadership as well as in their efficacy to intervene using evidence-based strategies.

Implications for Practice and Next Steps: This education program can increase preceptor knowledge and awareness of bullying and incivility with an overarching goal of empowering them to become champions and advocates for civility in the workplace. Preceptors can be effective advocates for a respectful, civil, and safe environment in which new graduate nurses can flourish.