1. Workplace Bullying
The High Cost of Caring
Over 75% of novice nurses experienced or
witnessed workplace bullying (WPB) behaviors
in their first job as a registered nurse.1
Nurses
continued to have high frequencies of WPB
behaviors from peers, nurse leaders, and physicians
18 months later, with 60% identifying themselves as
WPB targets.2
WPB behaviors create stressful environments for
nurses more vulnerable to that abuse. However,
we are all vulnerable to WPB stressors. As WPB
escalates, stress and anxiety symptoms increase, and
may lead to post traumatic stress symptoms.2
Self-Label as Target of Workplace Bullying
60
50
40
30
20
10
0
Never Yes, but rarely Yes, now & then Yes, several times a week
2010 51 20 8 1
2012 35 29 16 0

2. Organizational
Costs
Productivity is negatively impacted as
WPB behaviors increase on the unit.1
Intent to leave is positively correlated
to WPB with bullied nurses three
times more likely to express intent
to leave employment.3,4
Unaddressed interpersonal WPB
behaviors leading an employee to
terminate employment potentially
can cost health care organizations
$22,000 to $64,000 per replacement
posing a significant burden to the
financial viability of any health care
facility.5
If a large facility with 1,000 RN’s
lost 40% of its staff yearly to WPB
behaviors, estimated replacement
costs would be between $8.8 and
$25.6 million.
For those nurses who continue
to work in an organizational
culture that ignores, enables, or
rewards WPB behaviors, these
behaviors become normalized.6
After 18 months, 20% (n=9) of the
nurses who remained in the same
unit where they were bullied,
adopted WPB behaviors.2
The transition from novice to
competent nurse requires more
organizational support at hire and
extended mentoring.
1. Berry, P.A., Gillespie, G.L., Gates, D., & Schafer, J. (2012). Novice nurse productivity
following workplace bullying. Journal of Nursing Scholarship, 44(1), 80-87.
doi:10.1111/j.1547-5069.2011.01436.x
2. Berry, P.A., Gillespie, G.L., Fisher, G.S., Gormeley, D.K., & Haynes, J.A Path Analysis
for the Adoption of Workplace bullying Behaviors. Unpublished
Manuscript.
3. Simons, S. (2008). Workplace bullying experienced by Massachusetts registered
nurses and the relationship to intention to leave the organization.
Advance in Nursing Science, 32(2), E48-E59.
4. Johnson S.L,, & Rea, R.E. (2009). Workplace bullying: Concerns for nurse leaders.
The Journal of Nursing Administration, 39(2), 84-90.
5. Robert Wood Johnson Foundation (2009). Business case/cost of nurse turnover.
Retrieved from: http:// www.rwjf.org/en/research-publications/find-rwjf-
research/2009/07/wisdom-at-work-retaining-experienced-nurses/
business-case-cost-of-nurse-turnover.html
6. Hutchinson, M., Wilkes, L., Jackson, D., & Vickers, M.H. (2010). Integrating
individual, work group and organizational factors: Testing a
multidimensional model of bullying in the nursing workplace. Journal of
Nursing Management, 18, 173-181.
Workplace Bullying Exposure Levels
No WPB exposure (0-24)
50% (n=40)
Moderate WPB exposure (50-124)
25.5% (n=10)
Low WPB exposure (25-49)
18.8% (n=15)
Psychological Distress Symptoms
Post Traumatic
Stress Symptoms
Anxiety State
Perceived Stress
0 10 20 30 40 50 60
Perceived Stress Anxiety State Post Traumatic Symptoms
negative 41 40 52
Positive 39 40 28
High WPB exposure (125 or above)
18.8% (n=15)