Negative workplace behaviours: an ethical dilemma for nurse

managers
CHERYL LINDY P h D, RN, B C, NE A- B C
1
and FLORENCE SCHAEFER MS , RN, ACNS - B C
2
1
Director of Nursing and Patient Education and Research and
2
Education Specialiist, St Lukes Epsicopal Hospital,
Houston, TX, USA
Introduction
Negative workplace behaviour has been studied
worldwide with most of the information available
coming from Europe and Australia (Simons 2006). The
focus of the research regarding this phenomenon has
been in the business and corporate realms rather than in
healthcare settings. As recently as 3 years ago, research
studies investigating negative workplace behaviour and
nursing practice in the United States were few in num-
ber (Simons 2006). Studies reporting nurse managers
perspectives regarding the occurrence of negative
workplace behaviours on their units, how it affects the
staff and teamwork and how they address these situa-
tions are absent from the literature. This realization led
us to complete this study.
Background
Researchers have used many different descriptors for
negative workplace behaviour. Common terms
researchers use to describe this phenomenon are aggres-
sion in the clinical setting (Farrell 1997), emotional abuse
(Einarsen 1999), interpersonal harassment (Thomas-
Correspondence
Cheryl Lindy
Director of Nursing & Patient
Education & Research
St Lukes Epsicopal Hospital
6720 Bertner Avenue
Houston
TX 77030
USA
E-mail: clindy@sleh.com
or
Florence Schaefer
Education Specialist
St Lukes Episcopal Hospital
6720 Bertner Avenue
Houston
TX 77030
USA
E-mail: fschaefer@sleh.com
LI NDY C. & S CHAEFER F. (2010) Journal of Nursing Management 18, 285292
Negative workplace behaviours: an ethical dilemma for nurse managers
Aims To discover nurse managers perception of negative workplace behaviours
(bullying) encountered by staff on their unit.
Background Negative workplace behaviour is a worldwide phenomenon happening
in all types of work settings. Absent from the literature were studies specic to the
nurse managers perception on this topic.
Methods A phenomenological qualitative research methodology was used to gain
insight into the perceptions of nurse managers about negative workplace behaviours
that they have observed or addressed.
Results Nurse Managers described their perceptions of, and experiences pertaining
to, instances of negative workplace behaviour. Six themes emerged from the data
analysis: thats just how she is, they just take it, a lot of things going on,
old baggage, three sides to a story and a management perspective.
Conclusion Nurse Managers had observed, experienced and/or had received reports
of negative workplace behaviours. While some felt comfortable addressing the
behaviour, others experienced ethical dilemmas when trying to treat all fairly.
Implications The results of the present study provide guidance for nurse managers
to address negative workplace behaviours occurring on their units.
Keywords: bullying, negative workplace behaviour, nurse manager, perception
Accepted for publication: 4 February 2010
Journal of Nursing Management, 2010, 18, 285292
DOI: 10.1111/j.1365-2834.2010.01080.x
2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd 285
Peter 1997), horizontal violence (Farrell 1997, Einarsen
1999, McKenna et al. 2003, Randle 2003, Rowell 2005,
Simons 2006), bullying (Farrell 1997, Einarsen 1999,
McKenna et al. 2003, Randle 2003, Rowell 2005,
Simons 2006) and mobbing (Einarsen 1999), with the
most recent being incivility (Einarsen et al. 2009). The
terms, bullying and negative workplace behaviour, will
be used interchangeable throughout the remainder of the
present study.
Staale Einarsen, associated with the University of
Bergen, Norway, is world renowned as a pioneer in
researching bullying behaviours. He denes bullying as
the
unwelcome repeated hostile aggressive behav-
iours (physical or non-physical) of one colleague
towards another (Einarsen 1999). Einarsen et al.
(2009) reported that bullying is a common prob-
lem affecting contemporary working life.
Bullying is not specic to nursing and can be found in
almost every profession and workplace. A study con-
ducted by the Workplace Bullying Institute and Zogby
International, found that 54 million people or 37% of
American workers reported being bullied at work. An
additional 17.5 million people have witnessed this
negative behaviour at work (Namie 2007).
Daniel (2006) described bullying as a repeated mis-
treatment including humiliation, and intimidation that
interferes with job performance. According to Longo
with the Center for American Nurses (2007), victims of
abuse may exhibit physical and psychological illness
and effects, decreased self-esteem and increased job-
related stress. Simons (2006) reports that bullying in
the workplace affects the way nurses feel about their
jobs, the ability to do their jobs and whether they stay in
their jobs. AbuAlRub (2004) stated that increased job-
related stress is shown to decrease job satisfaction.
Dissatisfaction with colleagues is ranked 4th as a source
of workplace difculties (Simons 2006).
There is a relationship between work stress and bul-
lying (Hauge et al. 2007). Studies have demonstrated
that those who are the victims of bullying have less job
satisfaction. Job dissatisfaction is widely regarded as the
primary contributor to turnover among nurses. In-
creased turnover exacerbates understafng, decreasing
productivity and compromises standards of patient
care. The nurses who are left feel increased pressure and
in response either leave themselves or exhibit decreased
participation in the organization (Simons 2006).
Up to 40% of nurses surveyed in hospitals in the
United States, responded that they were dissatised
with their jobs (Aiken et al. 2001). Factors contributing
to their dissatisfaction were inadequate stafng, in-
creased patient load, decreased quality of care and
verbal abuse (Murray 2002). Simons (2006) reports
that negative workplace behaviour is a job dissatiser
and it interferes with positive workplace relationships.
Murray (2002) states that one in three nurses
<30 years old plan to change jobs within a year. Some
nurses indicated that their bullying incident was dis-
tressing enough for them to consider leaving nursing
(McKenna et al. 2003).
When incidences of bullying occur, staff do not report
those incidences to their managers (McKenna et al.
2003). Some researchers report that those who have
experienced bullying suggested that their managers
tolerated the bullying behaviour (Einarsen 1999, Lief-
ooghe & Olafsson 1999, Farrell 2001, Namie 2007,
2008). Other researchers have found that some orga-
nizations foster the bullying behaviour through inaction
(Speedy 2006). Yet no studies were located during the
literature review that investigated the perception of the
nurse manager regarding the occurrence of negative
workplace behaviours or bullying on their units.
Bullying has a profound negative effect on individuals
and the organization (Einarsen et al. 2009). Workplace
bullying contributed to increase workers compensa-
tion, decreased morale and engagement and diminished
customer satisfaction (Yamada 2008). Direct costs
related to bullying are increased turnover, decreased
quality of work and increased absenteeism (Yamada
2008). Indirect costs include decreased employee com-
mitment and loss of productivity. Simons (2006) esti-
mated that the cost for each victim of bullying can range
from $30 000 to $100 000.
Theoretical framework
The philosophy of Maurice Merleau-Ponty provided the
philosophical underpinnings for this phenomenological
study of experiences. Merleau-Ponty was a 20th century
phenomenological philosopher whose focus was on
existence and perceptions of experiences (Davidson
2000). The individuals perception of lived experiences
is an essential tenet of his philosophy (Thomas 2005). It
is not thinking but rather perception that gives meaning
to experiences (Davidson 2000).
Intentionally or the interconnectedness between peo-
ple and their world is another tenet of Merleau-Pontys
philosophy (Thomas 2005). Intentionally occurs
through an individuals lived experiences and not dis-
covered through an intellectual process (Davidson
2000). To understand the meaning of an experience, the
persons worldview must be described. A third tenet of
C. Lindy and F. Schaefer
286 2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 18, 285292
the philosophy is embodiment meaning the body is vital
for perception, thought and interaction with the world
(Thomas 2005). Time is another tenet of the philosophy
with a focus on the present (Thomas 2005). Subjective
experiences make one aware of time.
Merleau-Ponty viewed the human experience as
sacred (Thomas 2005). This directs the investigator be a
learner with interest in understanding the human
experience when approaching a study participant. The
investigator seeks to understand the complex relation-
ship between the body and the world. The philosophy
of Merleau-Ponty guided the investigators as they
explored the nurse managers experiences and percep-
tions of negative workplace behaviours experienced by
nursing personnel.
Methods
Setting and sample
Nurse managers of a tertiary hospital in South Central
United States of America employing approximately
4500 people were recruited as study participants. An
e-mail was sent to nurse managers inviting them to
participate in this study. There were approximately 40
nurse managers who supervise approximately 1400
registered nurses and 600 unlicensed assistive person-
nel. Of those, 20 participated in the study.
Instruments
A demographic information form was developed to
collect data regarding participant age, education level,
years as a registered nurse, years as a nurse manager,
years in current position, ethnicity and clinical area of
practice. The investigators developed semi-structured
interview questions. Each participant was asked to
describe what they have experienced or observed as
related to negative workplace behaviours using the
following questions:
How would you describe the characteristics of hori-
zontal violence, workplace bullying or mobbing?
Have you observed or experienced horizontal vio-
lence?
Have staff reported incidences to you?
What were the factors contributing to the horizontal
violence (people, situation, communication and
environment)?
Describe the communication involved in the incident.
How would you describe the bully?
How would you describe the victim?
What have been the effects of workplace bullying?
How are incidences handled?
What do you see your role is in managing horizontal
violence?
In the literature and the study conducted here, staff
indicated the manager ignores workplace violence.
What is your response to this?
What support do you need to address horizontal
violence in your unit(s)?
Data collection
Prior to data collection, approval was granted by the
organizations Investigational Review Board. An e-mail
communication was sent out to the 40 nurse managers
employed by the organization. Twenty nurse managers
agreed to participate in the study. One-on-one inter-
views were held with the participants.
A private setting was used to conduct the personal
interview. The interview began with the investigator
providing information regarding the study. Each par-
ticipant signed an informed consent to participate in the
study. After signing the consent form, the participant
was asked the demographic and interview questions. All
interviews were audio taped. Each audio tape was
transcribed verbatim that resulted in over 250 pages of
text. The investigator recorded written eld notes of
observations made during the interview. Some of these
notes were made during the interview, but most nota-
tions were made immediately after the interviews.
Data analysis
The recordings were transcribed verbatim of the
interview. The phenomenological analytic method
described by Colaizzi (1978) was used for data anal-
ysis. This method requires seven steps of the investi-
gator. The rst step is to read each transcript to begin
to understand the meaning. The second step is to re-
turn to each transcript and extract signicant sen-
tences or statements that are reective of the
phenomenon being studied. Each transcript was re-
viewed to identify statements participants used to
depict their experiences with negative workplace
behaviours. In the third step, the investigators began
to formulate a meaning for each statement identied.
Similar statements by participants were grouped to-
gether into themes or common experiences between
the participants as the fourth step (Morse 1994). The
investigators carefully re-examined the data to assure
data were not excluded or erroneously aligned with a
theme. In the fth step, an exhaustive description of
the phenomenon is prepared. To assure clarity,
Negative workplace behaviours
2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 18, 285292 287
an unequivocal description of the phenomenon is
developed in the sixth step of the method. The seventh
step is to take actions to demonstrate the trustwor-
thiness of the data. The themes identied were vali-
dated with the participants. This ensured that the
themes were consistent with their experience and
helped to establish credibility of the ndings (Colaizzi
1978, Polit & Beck 2008).
To assure conrmability, records and eld notes were
retained. Notes were made that describe the analysis of
the data and the development of the themes. Comments
made during the validation review by the participants
were documented. No changes were made to the iden-
tied themes based on the validation.
Results
Interviews were conducted with 20 participants, 18
females and two males. Demographic characteristics
of the sample are provided in Table 1. The average
age of the study participants was 46.9 years. Forty-
ve per cent held masters degrees in nursing and an
additional 35% were prepared at the baccalaureate
level. The average number of years of experience as a
manager was 14.8 years, with 8.5 years in the current
position.
Although all nurse managers reported observing
bullying behaviours when they were staff nurses, few
reported observing negative workplace behaviours in
their manager role. All managers indicated staff
reported situations to them.
Open-ended questions enabled the participants to
share their experiences when confronted with bullying
behaviours. Six common themes emerged from the data
provided by the nurse managers.
Themes
Just how she is
Each participant described verbal and non-verbal acts
of the bully that were attributed to the personality of
the individual. One manager stated, Its just how she is
(interview 1, Manager 7 years). Descriptions of the
bully included being loud and inappropriate with a
tendency to snap at people, be abrupt, demanding and
self-centered. Although the bullying nurses demon-
strated negative behaviours, they were viewed as good
clinicians. Several managers indicated the staff nurses
with negative behaviours were good clinicians with
many years of experience.
Another participant with 10 years management
experience described the bully on the unit as:
The best nurse in the world, having the best skills
you know hands on, but when it comes to inter-
personal skills, she doesnt have it. She is respected
by her peers for her nursing skills, her nursing
judgment, and her critical thinking skills. She
shows up to work on time every time (interview
13).
They just take it
The characteristics of the victim were described as
accommodating and passive. The victims tended not to
react to the behaviour, but rather tolerated it. Often the
victims looked to others to help or provide support to
them. One manager with 14 years of management
experience responded:
Theyre trying to stay professional. They try to
appease her (the bully). They want professional
courtesy, peace, and respect. They dont want to
confront and deal with all of that (Interview 19).
A lot of things going on
Participants explained one of the triggers resulting in
bullying behaviour was related to the personality of the
individual or that the individual is very stressed.
Increased bullying is observed when the census is high
or critical events are occurring on the unit.
There are a lot of things going on and people
(bully) expect people (victim) to just jump in
(Interview14, Manager 25 years).
Table 1
Demographic characteristics of sample (n = 20)
Gender
Male n (%) 2 (10%)
Female n (%) 18 (90%)
Age range (mean) 3458 years (46.9 years)
Years as RN range (mean) 1135 years (23.5 years)
Years as Manger range (mean) 2.529 years (14.8 years)
Years in Current Position
range (mean)
0.527 years (8.5 years)
Race n (%)
Asian 1 (5%)
African American 5 (25%)
Hispanic 1 (5%)
White 13 (65%)
Education n (%)
Diploma/Associate 4 (10%)
Baccalaureate 7 (35%)
Masters 9 (45%)
Clinical area n (%)
Acute care 9 (45%)
Critical care 5 (25%)
Other areas 6 (30%)
C. Lindy and F. Schaefer
288 2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 18, 285292
When shes very busy and behind in her work, she
cant tolerate a lot and says things that she should
not have (Interview 10, Manager 27 years).
Some managers attributed the negative behaviours to
generational differences, personality differences or
work ethic differences.
Generational differences, personality differences,
or work ethic differences contribute to bullying. If
you are a strong person and you dont like
anybody pointing out your mistakes, you hide the
behaviour by bullying other people (Interview 15,
Manager 7 years).
Old baggage
Participants described the decreased teamwork as one
of the long-term effects of bullying. This was attributed
to the inability of the individuals involved to resolve
conict.
People carry a lot of old baggage and sometimes
because they carry those feelings. Theres ani-
mosity. It does interfere with their working rela-
tionship (Interview 12, Manager 5 years).
Managers reported an increased turnover and
absenteeism among the victims of negative workplace
behaviour.
Turnover is high. Thats the biggest impact of
bullying. If youre not happy at work or a part of
the team, you dont want to come to work
(Interview 2, Manager 14 years).
Three sides to a story
Managers explained the actions they take to investigate
and address the negative work behaviours. All the
managers reported they will meet with the individuals
involved to determine what happened.
I tell the staff there are always three sides to the
storyyour story, their story, and somewhere in
between lays the truth. You sit them down and
talk about whatever happened, give each one time
to sort it out and talk it out (Interview 17,
Manager 15 years).
Managers indicated that when they became aware of
bullying, they had the obligation to address the
behaviour and correct the inappropriate behaviour
using the organizations established processes.
I think people dont want to report it (bullying),
but when they do, you have to act on it (Interview
5, Manager 25 years).
A management perspective
Participants described ethical dilemmas they experi-
enced when they addressed negative workplace behav-
iours. One new manager discussed how her point of
view regarding the behaviour had changed:
The perception is that the person might be able to
get away with more stuff because they know a lot
and they seem like an asset to the unit. As a staff
nurse, I was How could that person get away
with that? But from a management perspective, I
see it differently now (Interview 11, Manager
3 years).
Another ethical dilemma for managers often is that
the bully is an expert clinician with several years
experience. This nurse is often viewed as the informal
leader of the staff. The managers question if the
behaviour is actually bullying or if the nurse has con-
fronted someone for not doing something correctly.
Shes an excellent clinician. Other staff say thats
just the way she is and we cant do that just
because thats the way she wants it done (inter-
view 10, Manager 27 years).
When responding to the question regarding managers
ignoring negative behaviours, managers described
frustration with staff perceptions that the manager is
aware of the negative behaviour of other staff members.
It was noted that managers may ignore the behaviour in
some cases because its human nature not to want to
have conict with people. However, staff will not know
if the manager has addressed the issue.
We dont announce corrective action. We dont
have public oggings (Interview 10, Manager
27 years).
Managers indicated it was important to have support
from their immediate supervisor and the Human
Resources Department when addressing negative
behaviour.
In a previous position, I didnt have support that
I needed to address the behaviour and staff may
have thought the behaviour was being ignored
(Interview 13, Manager 9 years).
All managers reported that when they were made
aware of the negative behaviour, they addressed the
behaviour. However, new managers expressed frustra-
tion when questioned by peers regarding the decision to
address the bullying. Their perception was that the
bullying had been happening for some time and no one
had attempted to correct it. Managers reported that
Negative workplace behaviours
2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 18, 285292 289
victims have requested them not to talk to the bully
because they were fearful of retaliation.
Managers indicated that once they address the issue,
they are not always aware if the behaviour continues.
When people (victims) report it (bullying behav-
iour) to the manager, the manager has to follow
up with the staff. Please let me know if the
behaviour continues. You cant assume just
because you did corrective action that it has
changed (Interview 2, Manager 14 years).
Discussion
Incidences of verbal and non-verbal bullying behaviours
described by the nurse managers in this study were
consistent with behaviours described in the literature.
According to Einarsen (1999), verbal abuse is the most
common form of negative acts. Of the 551 participants
in a study conducted by McKenna et al. (2003), 34% of
the participants experienced verbal attacks. Namie
(2007) found non-verbal negative acts were experienced
by 53% (n = 7740) of participants. Farrell (1999) found
that 72% of respondents (n = 270) had experienced
coworkers refusal to help and 68% experienced
intimidating behaviours. Nurse Managers in this study
identied the bully as being clinically competent and
often the best nurse on the unit. No evidence in the
literature was found regarding the clinical competency
of the bully.
The victim in this study was described as being pas-
sive and willing to tolerate the negative workplace
behaviours of the bully. No descriptions of the victim
were found in the literature. In reporting the reaction of
victims, McKenna et al. (2003) found 50% (n = 1169)
of the victims would take no action and Namie (2007)
reported 40% (n = 7740) of the victims would not
report the incident. This may be viewed as being passive
and tolerant.
The participants in this study identied bullying
triggers that were related to increased workload which
is consistent with the literature (Hauge et al. 2007).
However, unlike ndings from this study, in the previ-
ous literature, the triggers are attributed to the per-
sonality of the bully (Farrell 1997, Einarsen 1999).
Namie (2007) reported 56% (n = 7740) of bullying was
due to the personality of the bully and only 14%
(n = 7740) was related to the work environment.
Rowell (2005) described the long-term effects of
negative workplace behaviours on the victim including
diagnosable mental illness such as depression, anxiety
and Post Traumatic Stress Syndrome. In addition,
physical impacts described included hypertension,
weight gain/loss, cardiac palpitations and irritable bo-
wel. None of these long-term effects were reported by
the participants in this study.
In the present study, nurse manager participants re-
ported decreased teamwork, increased turnover and
increased absenteeism. This is consistent with previous
research ndings (McKenna et al. 2003, Simons 2006,
Yamada 2008).
Nurse managers are reported to have tolerated bul-
lying behaviours (Einarsen 1999, Liefooghe & Olafsson
1999, Farrell 2001, Namie 2007), suggested the
behaviours (Namie 2007) or approved the behaviours
(Einarsen 1999). In this study, participants indicated
that when they were made aware of the behaviour, they
took action. However, managers indicated staff were
not informed about when or what action was taken to
address the bullying behaviours. This may contribute to
the perception that the behaviour was ignored or tol-
erated.
As the nurse managers revealed during their inter-
views, there are instances when they had experienced
ethical dilemmas in the management of bullying
behaviours. Respect for individual dignity is funda-
mental in nursing practice. As stated in the American
Nurses Association(ANA) (2001) Code of Ethics, nur-
ses must take into account the needs and values of all
persons in all professional relationships. Yamada
(2008) writes that the right to be left alone goes to the
very core of individual dignity. There are times when
the nurse manager is not aware of the bullying behav-
iours that occur on their units. They reported that they
have not witnessed the behaviour and unless it is
brought to their attention, they remain unaware. In one
such report of bullying to the nurse manager a staff
member said, How can you not see it?
While resolving conict, the Code of Ethics (2001)
states that this must be done in a manner that preserves
a nurses professional integrity. When an incident of
bullying is reported to the nurse manager, the involved
staff will be interviewed individually and then together
if warranted. All conversation is kept condential. At
times staff have asked the manager for the outcomes of
the disciplinary action. The manager is bound by con-
dentiality and again placed in a situation where the
staff at times feel they (the manager) have not addressed
the issue adequately.
The Code of Ethics (2001) states that the viewpoint
of one person should not be considered the truth over
that of another. Some of the nurse managers described
the person who is frequently reported to be the bully as
one of their best clinicians. The nurse mangers listen to
C. Lindy and F. Schaefer
290 2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 18, 285292
all involved prior to deciding which course of action
should be taken to rectify the problem. Nursing
administration is responsible for ensuring that the out-
come of similar situations is consistent and that all
personal are treated fairly.
One of the limitations of this study was that the
sample of 20 nurse managers was limited to one study
site. Another limitation was that the participants in the
study self-selected to participate.
Implications for nursing management
The ANA (2001) Code of Ethics for Nurses should be
enforced and utilized as a guide for the type of workplace
behaviour that is acceptable. The ANA is a professional
organization that represents the interests of the 2.9 mil-
lion nurses in the United States. The organizations
responsibilities include developing standards of practice,
promoting nurses rights, safeguarding the portrayal of
nursing in media and working with the government
and agencies on issues affecting nurses and the public.
The Code of Ethics (2001) was developed to serve as
a statement of the ethical obligations and duties of
every individual who enters the nursing profession and
is an expression of nursings own understanding of
its commitment to society. The Code of Ethics pro-
vides guidelines for nurses to provide the best care for
the patients and the community while supporting each
other.
Individual institutions should develop and enforce
Standards of Behaviour for all staff (Longo 2007).
Staff should know which behaviours at work are
acceptable and which are not. They need to be aware
of the consequences of behaviour that violates the
standards. Then there are no surprises when the staff
are held responsible for bullying behaviour. The
institution has an obligation to put into place clear
expectations regarding communication, teamwork,
professionalism, respect and responsiveness to requests
(Rowell 2005, Randle 2007). The nurse managers need
to have the support of Human Resources, Employee
Relations and upper management as they enforce these
standards when dealing with a bullying situation
(Longo 2007).
To better prepare staff to deal with bullying behav-
iour and to help decrease the incidents of bullying, it is
recommended to offer the staff training (McKenna et al.
2003, Rowell 2005). Assertiveness training will aid staff
to better defend themselves against, and diffuse, bully-
ing behaviours. Workshops geared towards team
building will foster a sense of camaraderie which in turn
may decrease the bullying behaviour (Randle 2007).
Implications for further research
This research opens the eld for further research. Studies
to further understand the causes and effects of negative
workplace behaviour will provide additional insight into
the phenomenon. Studies of negative workplace behav-
iour, specic to nursing, will help determine how we can
better manage this phenomenon. Replicating this study
in another facility with similar demographics will help to
determine if other nurse managers have similar experi-
ences. Further research focusing on nurse managers
perceptions of interventions to decrease bullying will
help provide direction for the nurse manager as they
continue to address this matter with their staff. Longo
(2007) and Randle (2007) report that effective manag-
ing of bullying will lead to a decrease of its negative
effects on the patients, staff and organization.
Conclusion
All nurse managers reported that they observed, had the
phenomenon reported to them and/or personally expe-
rienced bullying workplace behaviours. While some felt
comfortable in addressing the behaviour, others expe-
rienced an ethical dilemma in trying to treat all indi-
viduals involved fairly. Bullying is a universal issue and
there are resources available for nurse managers to use
as guidelines in dealing with these occurrences. It is
important for senior leadership and front-line managers
to promote a healthy work environment, one that does
not tolerate workplace bullying by having enforceable
employee policies. In addition to providing education
to nurse managers on addressing negative behaviours,
all personnel need training and guidance to recognize
and diffuse bullying behaviours.
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