Breaking the Cycle of Bullying in Nursing Workplaces

There have been literally hundreds, if not thousands, of papers published on bullying in nursing. In the International Journal of Mental Health Nursing alone, a quick search suggests more than 80 papers have been published in the past 5 years that have in some way addressed bullying in nursing. A search of other nursing journals also reveals similarly high numbers of publications on bullying in the nursing literature. These publications represent the investment of the many thousands of hours of academic and clinical labour that have gone into researching the phenomenon. When we add to that the work that has been done on other workplace wrongdoing, such as horizontal violence, mobbing and workplace incivility, the extent of concern about bullying and workplace wrongdoing in nursing becomes clear. Yet, meaningful change remains elusive, and these behaviours continue to cause concern (Lessi et al. 2025).

Writing in 2015, Hutchinson and Jackson noted that ‘healthcare and public sector institutions are high-risk settings for workplace bullying’ (Hutchinson and Jackson 2015, 13). Ten years later, work-based conflict in nursing continues to be a persistent and corrosive force, and one that takes a significant toll on individuals, teams and systems. Bullying has been identified as a factor contributing to poor mental health in nurses (Yang et al. 2024). It affects multiple aspects of nursing and health care and even influences behaviour, such as speaking up for patient safety, and so therefore, potentially, bullying potentially influences patient outcomes (Park et al. 2025).

Unfortunately, workplace conflict, such as bullying, incivility and interpersonal hostility, is not a rare disruption; rather, it is an everyday reality for too many nurses and is associated with a range of negative outcomes for those experiencing it, including distress, trauma, burnout, absenteeism, reduced levels of job satisfaction, intention to leave and attrition (Alharbi et al. 2023; Fernández-Gutiérrez and Mosteiro-Díaz 2021; Lessi et al. 2025; Mohr et al. 2025). Mental health nurses are not exempt from workplace bullying, and bullying from both colleagues and managers has been identified as a significant workplace challenge for mental health nurses (Cranage and Foster 2022). The human cost of this insidious problem is significant, but so too is the economic cost, with lost productivity (Cullinan et al. 2020) and considerable resources expended on investigating and managing complaints, mediating disputes and replacing staff lost to bullying (Ballard and Bozin 2023).

Bullying in nursing has most often been framed as an interpersonal issue, a conflict between people who are positioned either as victims or perpetrators. This framing restricts our understanding and response, drawing attention away from the structural and cultural conditions that contribute to such behaviours and allow them to persist, sometimes for very long periods (Hutchinson et al. 2006). It is now almost two decades since Hutchinson et al. (2006) drew attention to the need to move beyond individualised understandings of bullying in nursing and instead recognise it as a symptom of deeper organisational dysfunction, and one that is shaped by power relations, toxic workplace cultures and managerial practices that may both enable and obscure harmful behaviours (Hutchinson et al. 2010). Though organisational cultures have been shown to be associated with workplace bullying (Peng et al. 2024), this association is still not necessarily considered when workplace bullying occurs. This is likely because it is far easier for organisations to blame individuals rather than critique the organisational cultures, leadership practices and systemic stressors that often contribute to workplace bullying.

Persistent exposure to bullying has the potential to render the workplace psychologically unsafe and dysfunctional (Zhang et al. 2025). In this editorial, we will reflect on bullying, how understandings of bullying have developed over time, the toll of bullying on individuals and the workplace, and consider ways that there could be a future for nursing that is free of workplace bullying.

The concept of bullying has attracted considerable attention from nurse researchers over the years, and understandings of what bullying is and why it occurs have continued to change and develop. Over time, the conceptualisation of workplace bullying has evolved from being viewed as isolated interpersonal conflicts or manifestations of oppressed group behaviour to recognising it as a complex phenomenon influenced by organisational structures and power dynamics (Hutchinson and Jackson 2015). As conceptual understandings have developed, so too have understandings of the importance of examining systemic factors and institutional cultures that perpetuate bullying, moving beyond individualistic explanations to more comprehensive, critical perspectives (Hutchinson and Jackson 2015).

To be considered workplace bullying, behaviour does not refer to an isolated event. Bullying is characterised by repeated and persistent behaviours, such as incivility, social exclusion and verbal or emotional aggression, that takes place and continues over time and acts to create a hostile work environment (Arnetz et al. 2019). When considered individually, the acts may be considered trivial and minor, but when viewed in the context of duration and multiplicity of events, they are able to be recognised as a pattern of bullying. Bullying behaviours are designed to isolate, humiliate and punish a person, and over time a pattern of bullying can gradually undermine the confidence and well-being of the targeted individual, and this can result in the targeted person feeling isolated, vulnerable and powerless.

Arnetz et al. (2019, 1230) provided a concise and succinct definition: ‘Bullying is deliberate, persistent, negative actions (harassing, coercing, intimidating, dominating, oppressing, persecuting, tormenting) on the part of one person or a group of persons toward a particular individual’. While there is no universally agreed list of actions that constitute workplace bullying, it often includes behaviours such as yelling, speaking rudely, gossiping, belittling others, deliberately undermining someone's work or creating unnecessary stress and pressure (Hurley et al. 2016). These authors also describe more targeted and harmful actions like persistent surveillance, online shaming, attacks on a person's reputation or career opportunities and deliberate social exclusion. In some cases, formal systems, job responsibilities or organisational procedures are manipulated to cause harm, giving rise to forms of bullying that are deeply embedded within workplace power structures and institutional practices (Hurley et al. 2016).

People affected by bullying experience emotional and mental health consequences (Hurley et al. 2016; Fernández-Gutiérrez and Mosteiro-Díaz 2021). In a large Australian study of public sector employees, respondents described workplace bullying as having severe mental health consequences, with respondents reporting symptoms, such as anxiety, depression and suicidal thoughts (Hurley et al. 2016). Some respondents reported experiencing panic and distress when entering the workplace, while others required stress or sick leave to cope with the psychological impact of workplace bullying.

While attention is rightly given to the experiences of those who are bullied, it is also important to acknowledge that being accused of bullying, particularly when the claims are unfounded, can be equally traumatising, particularly where there is a sense that procedural fairness has not occurred (Jenkins et al. 2011). The ripple effects of bullying can extend past the individuals directly involved. Teams can become damaged and fractured, and even though people involved in such situations are asked to maintain confidentiality, gossip and speculation can proliferate. Leaders can also be caught in the crossfire, and sometimes they themselves may feel unsupported. Staff who witness conflict may withdraw emotionally, disengage or begin to mistrust both colleagues and organisational processes. Real distress can result, especially when people feel unable to intervene or feel that complaints are mismanaged or not taken seriously or that the complaints process is being misused.

Despite decades of anti-bullying policies, the problem of workplace bullying in nursing remains concerning. This is not necessarily because the policies are flawed; generally, they are likely well-intentioned. However, policy on its own cannot meaningfully change cultures. Workplace culture is both shaped and reflected in the day-to-day interactions and dealings between those within the culture, in what is tolerated or not tolerated, and in how power and voice are distributed, heard and move through the organisation.

In order to meaningfully reduce the incidence and impact of work-based conflict and the damage it causes, there is a need to move beyond simple policy compliance into workplace transformation. Achieving this will require strong and emotionally intelligent leadership at every level of an organisation. We cannot assume that all leaders have the skills to achieve meaningful change, and so leaders must be supported and trained in relational approaches to performance management, courageous conversations and trauma-informed conflict resolution.

Effective management of bullying complaints is essential as the workplace can be seriously damaged when complaints are mismanaged. It really is important that the people and the systems charged with responding to bullying allegations are fair, transparent and timely. It is crucial that those investigating bullying allegations adopt a neutral position and not make assumptions based on one unsubstantiated version of events. When triaging complaints, it is also crucial to distinguish between bullying and other forms of interpersonal conflict and be able to differentiate between spurious complaints and genuine bullying. All parties involved need to be provided with immediate support once allegations are made, not just the complainant, and not only after an investigation has concluded.

Nurse researchers have provided the profession with many insights into bullying, including how and why it occurs and ways to recognise and respond to bullying, as well as ways to eradicate it. If we are serious about improving the health and emotional safety of our profession, we need more than policies and zero-tolerance statements. We need to take the lessons from the literature and use them to guide us through a process of cultural transformation that is grounded in relational ethics, strong and principled leadership and cultures of respect.

There is a need to move beyond performative (and often ineffective) policies toward authentic, compassionate relationship-centred cultures of care. Real and meaningful change is not just about reducing complaints or improving retention statistics. Real change is about honouring the humanity of nurses, who do some of the most important and emotionally demanding work in healthcare.

Nurses deserve workplaces where respect, fairness, compassion and justice are not aspirational, but foundational. Creating kinder, more compassionate workplaces and investing in emotionally intelligent leadership, team-based conflict resolution, ensuring adequate resources and manageable workloads offers a path forward. It is time to stop normalising dysfunction and start cultivating workplaces where nurses can thrive, not just survive.

The authors declare no conflicts of interest.