Aims: To identify organizational determinants of bullying and resulting work disengagement among hospital nurses.
Design: A cross-sectional, web-based, anonymous questionnaire study.
Methods: The questionnaire was administered in 2017 to all Registered Nurses in a regional healthcare system in the United States (N = 1,780), with 331 complete responses. Logistic regression was used to identify factors associated with personally experiencing and witnessing bullying, respectively. Linear regression was conducted to identify organizational factors associated with disengagement due to bullying.
Results: Psychological safety, a measure of team trust and respect, was inversely associated with being personally bullied and witnessing bullying. Being personally bullied, but not witnessing bullying, was associated with disengagement due to bullying. Psychological safety and competence development, a measure of opportunities to develop skills and knowledge at work, were both inversely associated with disengagement due to bullying.
Conclusion: Hospital units characterized by trust and respect among nurses are less likely to have a culture of bullying. Both psychological safety and competence development have a protective effect on nurse disengagement from the workplace due to bullying. Interventions to mitigate and prevent bullying and work disengagement among nurses should encompass efforts to enhance psychological safety and opportunities for competence development.
Impact: Bullying is a pervasive hazard in the nursing profession that contributes to unhealthy workplaces. Nurse managers and staff nurses should work together to establish psychologically safe environments where nurses dare to discuss tough issues like bullying. This research contributes to understanding the characteristics of work environments in which nurses can thrive and work effectively.
目的: 确定医院护士欺凌和由此导致的工作疏离的组织性决定因素。 设计: 一项基于网络的横断面匿名问卷研究。 方法: 采用问卷调查法,对美国某地区医疗保健系统的所有注册护士(N = 1,780)进行问卷调查,共有331人完整回答了问卷。与个人经历和目睹欺凌相关的因素由逻辑回归分别确定。与欺凌导致的工作疏离相关的组织性因素由线性回归分析确定。 结果: 作为团队信任和尊重的衡量标准,心理安全程度与被欺凌和目睹欺凌现象的频率呈负相关。被欺凌而不是目睹欺负与由此导致的工作疏离有关。 作为衡量工作中技能和知识发展机会的指标,心理安全感程度和能力发展前景都与欺凌导致的工作疏离有关。 结论: 护士之间信任并相互尊重的医院单位不太可能存在欺凌现象。心理安全和能力发展能保护护士免受欺负和疏离工作。减轻和防止护士欺凌和工作疏离的干预措施应包括努力提高心理安全和提供能力发展机会。 影响: 欺凌是护理行业普遍存在的危害,会导致工作场所不健康。护士长和护士应共同努力,建设具有心理安全的环境,让护士敢于讨论诸欺凌等棘手问题。本研究有助于了解促进护士成长和有效工作的环境的特点。.
Keywords: bullying; competence development; disengagement; nurse; psychological safety.
© 2018 John Wiley & Sons Ltd.