Bullying and employee turnover among healthcare workers: a three-wave prospective study

J Nurs Manag. 2011 Sep;19(6):742-51. doi: 10.1111/j.1365-2834.2011.01264.x. Epub 2011 Jun 15.


Aim: To investigate the risk of turnover among targets of bullying at work.

Background: Exposure to bullying seems to leave targets with intentions to leave their workplaces. However, it is uncertain to what extent they actually leave.

Method: Data were collected by questionnaires in a three-wave study among Danish healthcare workers at the time of graduation (T₁ ), 1 (T₂ ) and 2 years (T₃ ) later. We followed 2154 respondents who participated in all three waves.

Results: The first year after graduation, 9.2% reported being bullied at work, 1.8% frequently. Follow-up analyses showed a strong relationship between exposure to bullying at T₂ and turnover at T₃ [odds ratio (OR) for frequently bullied = 3.1]. The inclusion of push factors such as low social support and low sense of community, intention to leave and ill health did not change the relation between bullying and turnover significantly. Three reasons for quitting stood out among reasons given by the bullied respondents: poor leadership, being exposed to negative behaviour and health problems.

Conclusion: Bullying may be costly to an organization in terms of staff turnover and subsequent recruitment and training of replacements. IMPACT FOR NURSING MANAGEMENT: Managers should regularly monitor the psychosocial work environment. To prevent bullying local policies and procedures should be developed, implemented and evaluated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bullying*
  • Denmark
  • Female
  • Follow-Up Studies
  • Health Personnel / psychology*
  • Humans
  • Male
  • Personnel Turnover / statistics & numerical data*
  • Prospective Studies
  • Workplace / psychology