Impact of Workplace Bullying on Nursing Care Quality: A Comprehensive Review

Introduction

Workplace bullying has recently become a serious problem that requires attention [1]. Its prevalence and effects go beyond the immediate impacted parties and permeate the structure of organizations and the caliber of treatment they provide [1]. According to Rodwell and Demir [2], bullying is an ongoing situation where individuals perceive themselves to be subjected to negative actions and behaviors from others, which can be instigated by one or multiple individuals [2,3]. The individual being bullied often struggles to defend themselves against the abuse. Three key elements are typically associated with bullying: a detrimental impact resulting in feelings of abuse, intimidation, and stress; persistence over time; and the recipient’s perception of the behavior as bullying [3,4]. Carter et al [5] identified the prevalent bullying behaviors encountered by healthcare staff, which include: (1) disregard for opinions and perspectives; (2) withholding of information by colleagues affecting performance; (3) assigning tasks with unreasonable or unattainable targets or deadlines; (4) humiliation or ridicule in the workplace; (5) significant responsibilities being replaced with trivial or unpleasant tasks.

Nurses play a crucial part in patient care in healthcare settings, highlighting the importance of their well-being and job satisfaction in maintaining high-quality nursing services [6]. The foundation of the healthcare system is the nurse, and the standard of care they deliver is closely correlated with their job happiness and general well-being [7–9]. Burnout, stress, and trauma symptoms are just a few of the physical and psychological effects that workplace bullying can have on nurses [7–10]. These negative results threaten patient safety and the overall standard of nursing care, in addition to having an impact on nurses personally [10]. Understanding the complex interactions between workplace bullying and the standard of nursing care is of utmost importance to healthcare organizations, policymakers, and researchers [9].

Mobbing, or workplace bullying, has been a recurring issue in several different sectors, including healthcare [11,12]. The overt types of abuse were predominantly the focus of earlier studies [13]. Contemporary research, however, focuses on more subtle and covert manifestations of workplace hostility [11,12,14,15]. This change demonstrates the better understanding of bullying’s complex character, which spans a range of actions from overt harassment to covert psychological violence [11,12,14,15]. Workplace bullying in nursing refers to recurrent and pervasive unpleasant behaviors directed towards a person or group that cause distress or harm [14,15]. Verbal abuse, exclusion, intimidation, and manipulation are just a few examples of the behaviors that can be taken [14,15].

Additionally, factors that may mitigate or moderate the association between bullying experiences and the standard of treatment given are examined [16,17]. The knowledge of the nuanced relationship between workplace bullying and the standard of nursing care has improved as a result of numerous studies [17–19]. The most influential contributions to healthcare quality include those of Donabedian [20], who conceptualized quality as a fundamental attribute of healthcare, comprising technical and interpersonal aspects. The Institute of Medicine [21] defined quality of care as the extent to which health services contribute to desired health outcomes for individuals and populations, aligning with current professional knowledge. On the other hand, nurses defined the concept of quality of care as holistic patient care, which encompasses aspects such as addressing patient needs, demonstrating nursing competency and empathy, achieving optimal patient outcomes, and ensuring satisfaction [22]. According to research, adverse patient outcomes and exposure to bullying behaviors are frequently linked [17]. In addition, there is compelling evidence that workplace violence has a negative psychological impact on healthcare workers, particularly nurses [17–19]. Significant mediators in this association include burnout, trauma symptoms, and emotional tiredness [18,19]. This article aims to review the associations between workplace bullying and the quality of nursing care.

Workplace Bullying and Nursing Care

The corpus of knowledge on workplace bullying and its effects on the standard of nursing care has advanced significantly in recent years [18–68]. Numerous studies have examined this complicated issue, illuminated different facets and pointing out gaps in the literature and potential areas for future research [18–68].

Arnetz et al [25] have played a pivotal role in drawing attention to the alarming issue of nurse-reported bullying and its potential association with adverse patient events. This study has underscored the imperative need to address workplace bullying concerning patient safety and the overall quality of nursing care. Although their study has brought the issue to light, there still needs to be more knowledge regarding the processes through which workplace bullying results in unfavorable patient outcomes. An in-depth investigation of the causative pathways in future research may help to pinpoint specific mitigation strategies [25]. Expanding on this issue, Havaei et al [24] undertook a study examining workplace violence’s negative health effects on medical-surgical nurses. Their study emphasizes the part burnout and the work environment play in reducing the negative effects of bullying on nurses’ well-being and, as a result, on the standard of care they deliver. Future research should focus on the specific coping strategies nurses use when dealing with workplace violence. Interventions can be created to better support nurses by understanding how they deal with these difficulties [24].

The impact of occupational violence on the well-being of mental health nurses in Japan is examined in depth by Kobayashi et al [26] in their specific setting. Their research raises the possibility that burnout and workplace violence are related, which may impact the standard of care provided in mental health facilities. However, the assessment of the long-term effects of such burnout on patient outcomes and care quality is lacking in the literature [26]. Future research may take into account longitudinal methods to investigate the long-term effects. Brewer et al [27] have shed light on the incidence of workplace bullying among nurses and the responses of organizations to these instances.

Given that bullying behaviors directly impact the workplace and, as a result, the standard of nursing care, their work highlights the need for effective policies and treatments to address these behaviors. However, evaluating these policies and interventions’ efficacy in various healthcare settings is a growing field of research. Comparing their effects in different circumstances can provide helpful information for customizing techniques for maximum efficacy [19,24,28].

Zhou et al [28] offered an intriguing viewpoint by studying the connection between nursing innovation and workplace violence. The employee well-being was a mediating factor in this relationship, and exposure to bullying behaviors may limit nurses’ ability to use innovative techniques [28]. Future studies could explore the precise pathways through which workplace violence affects nurses’ capacity for creativity and problem-solving, eventually affecting the standard of care. In their contribution to the conversation, Li et al [23] demonstrated the correlation of bullying behaviors with decreased job satisfaction and greater intention to resign among emergency nurses. This draws attention to a potential problem with employee retention, which may impact the consistency and standard of nursing treatment in emergency settings [23]. Insights into retention techniques for experienced professionals can be gained through more research into the variables that can reduce or increase nurses’ intentions to leave the field after experiencing workplace violence [23].

To examine the effects of the work environment on workplace violence, exhaustion, and work attitudes for hospital nurses, Wu et al [19] used structural equation modeling. Their findings highlight the need for a supportive workplace environment to lessen the negative impacts of bullying on nurses’ well-being and the care they deliver by illuminating the intricate interplay between these variables. Exploring the specific components of a supportive workplace that work best to mitigate the negative effects of workplace violence is a subject for future research [19].

Havaei et al [24] offered a distinctive viewpoint by exploring the connection between a high nursing workload, patient/family complaints, and workplace violence. The human factors framework was used in this study to clarify the complex dynamics at work in healthcare settings [18,24]. This study broadened our understanding of the contextual elements contributing to bullying behaviors, ultimately compromising the quality of care by highlighting the impact of workload and outside complaints on workplace violence [18,24].

Workplace Bullying and Nurses’ Well-Being

A strong link was found between increased levels of emotional weariness and workplace violence experienced by nurses [29]. This finding raises serious concerns about its possible effects on patient safety as well as worries for the safety of nurses. It emphasizes how crucial it is to deal with and correct workplace bullying incidents in healthcare settings [29]. A clear inverse relationship between incidents of workplace bullying and registered nurses’ good mental health was observed by Harb et al [60]. This realization illuminates the significant impact that the workplace has on nurses’ psychological health. Such an environment can significantly impact the care they can give patients. As a result, it underlines how crucial it is to create a supportive workplace culture that puts nurse well-being and top-notch patient care first [60]. Also, there was a notable connection between workplace bullying and the trauma symptoms that healthcare workers experience [55]. This research emphasizes the severe psychological harm that persistent exposure to bullying practices can cause to healthcare workers. To protect the mental health and general well-being of healthcare professionals, it serves as a devastating reminder of the urgency with which workplace bullying must be addressed [55]. Additionally, Cho et al investigated how verbal abuse in the workplace affected patient safety outcomes and the standard of care reported by nurses [56]. Their findings shed light on a potential connection between poor treatment at work and subpar patient care. This emphasizes how important it is to deal with workplace bullying and highlights how it directly affects patient safety and the general standard of nursing care [56].

Kim et al first suggested the idea of psychological capital as a mediator in the relationship between job stress and burnout among Korean psychiatric nurses [57]. This innovative viewpoint offers insightful information about alternative coping strategies that can help nurses’ well-being by reducing the negative effects of working pressures. Healthcare companies can greatly improve the general well-being of their nursing staff by better understanding and cultivating psychological capital. The standard of treatment provided to patients is subsequently favorably impacted by this [57]. With a distinct geographic setting in mind, Song et al conducted a study in China to learn more about nurses’ challenges when reporting workplace violence [30]. Their findings highlight the many difficulties nurses have while attempting to report such instances. This knowledge is crucial for creating efficient reporting systems and focused interventions to stop bullying behaviors in medical settings. In the end, it is important to establish a safer working atmosphere for nurses [30].

Workplace bullying was examined in connection to burnout and resilience among perioperative nurses in Australia [31]. To counteract the detrimental impacts of workplace bullying on nurses’ well-being, the study highlights the crucial importance of resilience as a potential protective factor. This conclusion emphasizes the importance of encouraging resilience-building techniques among nurses to improve general well-being and patient care [31].

Findings Shi et al [32] poignantly highlight the mental weariness that healthcare workers who experience workplace violence experience. This underlines even more how crucial it is to put bullying in the workplace prevention and treatment interventions in healthcare settings. It is essential to provide a secure and supportive work environment to ensure the wellness of healthcare professionals and, as a result, the quality of treatment provided to patients [32]. The study by Buonomo et al provides important details regarding the broader context of workplace bullying and its potential impacts on employees’ productivity and well-being. The importance of dealing with workplace bullying in various professional contexts is highlighted to safeguard employees’ mental health and wellness [33].

The issue of workplace violence is widespread and cuts across all spheres of expertise and geography [34,63]. The investigation of Korean workers sheds light on the complex relationships between workplace violence, mental health, and physical well-being [63]. The study highlights the significant negative effects of workplace violence on workers’ general health, even if it covers a wider range of occupations [63]. This is especially true for nurses because their health is closely related to the caliber of their treatment. Kaur et al offer a moving look into the pattern of workplace violence against doctors in India and its ensuing effects on patient care [34]. The findings paint a grim view of the troubles faced by medical staff, demonstrating that violence on the job not merely imperils the psychological and physical well-being of physicians but additionally risks the caliber and security of care for patients. This understanding underscores the pressing necessity for all-encompassing efforts to tackle violence in healthcare environments [34]. Ying-Ying et al explored the factors contributing to workplace bullying and how they are intricately linked to depression, especially in female nurses [35]. This study emphasizes the need for focused interventions to protect the mental health of nursing professionals by highlighting the severe psychological toll that workplace bullying exacts. Such actions are essential for maintaining good standards of care as well as the well-being of nurses [35].

Daouda et al performed a multilevel examination of determinants influencing healthcare worker turnover in intensive care units, touching upon wider factors that subtly affect the standard of nursing care [36]. A less stable workforce and probable interruptions in the continuity of care can result from high turnover rates, frequently made worse by workplace violence. This demonstrates the complex interaction between workplace dynamics and patient outcomes [36].

The examination of the connection between workplace violence and burnout among mental health employees adds a crucial layer to the conversation [37]. Their research explores the particular difficulties experienced by mental health professionals and sheds light on how workplace violence exacerbates the tensions specific to this specialized area. The results emphasize the necessity for focused interventions and support systems adapted to mental health providers’ special requirements [37]. According to Samma et al, a positive work environment free of rudeness and exclusion promotes innovation and general employee well-being [38]. These findings have significance for healthcare organizations working to build environments that support both professional development and the delivery of high-quality care [38].

Although the corpus of knowledge on workplace bullying and its effects on the standard of nursing care has grown, there are still several glaring gaps in the field [24–26]. First and foremost, more research is required to determine the precise processes by which workplace bullying results in unfavorable patient outcomes. While research like Arnetz et al. has drawn attention to the problem, a thorough understanding of these causal pathways still needs to be improved [25]. Future studies should focus on determining measures to reduce this risk successfully. Furthermore, research by Havaei and MacPhee has shed light on the moderating effects of burnout and the workplace environment on the negative effects of bullying on nurses’ well-being [24]. However, there is a void in the literature about the precise coping strategies nurses use when confronted with workplace violence, a topic ripe for further investigation. Longitudinal studies exploring the long-term effects of burnout on patient outcomes and treatment quality, particularly in mental health settings, provide a promising direction for future study growth [26].

Additionally a crucial area for research is evaluating the efficacy of regulations and interventions in various healthcare settings [27]. This comparison method could offer insightful tips for adjusting strategies for maximum performance. Further research is needed to identify the precise components of a supportive work environment that are most helpful in reducing the detrimental effects of workplace violence [19].

Correlations Between Workplace Bullying and Healthcare Quality

According to Hampton et al research on nurse leaders’ experiences with workplace bullying offers a crucial window into understanding practical coping strategies [39]. Their study notably emphasizes the critical importance of leadership support and the application of measures for successfully handling bullying incidents. This highlights the possible moderating effect of leadership conduct in reducing the negative effects of such abuse on the standard of nursing care. Additionally, the study by Hampton et al highlights the requirement for thorough training programs that allow nursing leaders to identify, handle, and prevent workplace bullying [39]. This emphasizes the need for a proactive strategy to promote a climate of professionalism and respect in healthcare settings, which will eventually improve the general well-being of the nursing staff and the standard of patient care delivered [39].

A study by Laschinger et al reveals fascinating insights into the psychological resources that serve as protective variables in the context of workplace bullying [68]. Their findings imply that those with strong psychological resources may be more resilient in the face of abuse, potentially reducing its negative impact on the general standard of nursing care. Highlighting the mediating function played by unique psychological elements adds a fascinating dimension. Furthermore, the study by Spence Laschinger et al [68] emphasized the significance of developing these psychological assets within the work environment, highlighting the potential for focused interventions to increase resilience among staff members dealing with bullying scenarios. This demonstrates a proactive attitude to creating a safe environment that protects people from danger and improves the general well-being of the workplace [68].

The qualitative investigation by Tuna et al on the leadership experiences of Turkish nurse managers provides insightful viewpoints [61]. This study reveals potential tactics for fostering a more supportive workplace by acquiring a greater understanding of how managers react to and handle cases of workplace bullying. It is significant because it suggests that organizational policies and leadership style may mediate how abusive behavior and nursing care quality are related [61].

Birks et al highlighted the alarmingly high prevalence of bullying in the classroom in their study of nursing students in Australia [40]. The importance of early interventions and strong support networks to stop the normalization of abusive behaviors within the nursing profession is highlighted by this revelation. Bullying prevention at the educational level is revealed as a significant mediator in the larger campaign to improve nursing care quality [40].

Understanding workplace dynamics crucially depends on Blackstock et al’s examination of organizational factors influencing horizontal bullying and nurse turnover intentions [41]. Their research highlights the crucial part company culture and policy play in determining bullying occurrence. This knowledge provides a clear direction for actions meant to raise the standard of nursing care. The results of Blackstock et al further highlight the necessity of proactive actions inside healthcare organizations. In addition to preventing horizontal bullying, creating a supportive corporate culture and implementing strong anti-bullying rules will enhance nurses’ working conditions, ultimately improving patient outcomes and healthcare delivery [41].

The correlational study by Lang et al, which focused on perioperative nurses in Australia, increases our understanding of the complex connections between workplace bullying, burnout, and resilience [31]. Their findings suggest that resilience may serve as a buffer against the harmful effects of bullying, potentially altering the general standard of nursing care. The study also emphasizes the urgent need for specialized interventions and support systems within the healthcare system to increase perioperative nurses’ capacity for resilience. This focus on preventative measures encourages a healthier workplace and emphasizes the possibility of improving patient outcomes through an empowered and resilient nurse workforce [31].

The study by Seyrek et al examines how nurses perceive organizational justice and how that affects bullying behavior in the context of Turkish hospitals [42]. According to their research, encouraging a sense of justice inside the workplace may be a mediator in lowering workplace bullying incidences, consequently improving the standard of nursing care. In addition, Seyrek et al stress the critical role of leadership in advancing organizational justice, emphasizing that open and equitable policies discourage bullying behavior and foster a good workplace climate favorable to providing the best possible patient care [42]. This emphasizes how important it is for Turkish hospitals to have a clear framework for justice because doing so will eventually be advantageous for patients and medical staff.

Anusiewicz et al shed light on how workplace bullying affects nurses’ capacity to deliver patient care by offering a moving nurse’s perspective [58]. This study highlights the direct and palpable connection between bullying experiences and the standard of nursing care, highlighting the urgent need for focused interventions [58].

Al-Ghabeesh et al [43] first addressed workplace bullying and its significant effects on emergency department nursing, showing that it is important to carry out ethical research and highlights how important it is to produce reliable results. The study also highlighted the necessity of ongoing discussion and research into workplace bullying in emergency department nursing [43]. This episode highlights the need for open reporting, sound methodology, and wider reflection on researchers’ difficulties in this delicate domain. It also demonstrates the scientific community’s tenacity in correcting mistakes, ultimately advancing the field’s understanding of this important topic to a more thorough and dependable level [43].

Parallel to this, Peng et al’s thorough investigation seeks to understand the complex relationship between workplace bullying and the professional quality of life nurses experience, focusing on the crucial mediating function of resilience [44]. The results of this study deepen our understanding of how personal qualities like resilience might act as a fulcrum in mediating the relationship between being bullied and receiving high-quality nursing care. The ground-breaking work by Peng et al [44] also emphasizes the urgent need for focused interventions and support systems in healthcare settings and sheds light on resilience’s mediating role. This study opens the door for creating specialized programs to enhance resilience and foster a healthier, more supportive work environment by recognizing resilience as a critical element in reducing the negative effects of workplace bullying on nurses’ professional quality of life. Such efforts can improve both the general standard of patient care and the well-being of individual nurses, making a big step toward developing a more effective and compassionate healthcare system [44].

Focusing on the educational realm, Cerit et al’s ground-breaking work has greatly influenced the development of an evaluation tool designed to evaluate bullying behaviors within nursing education [65]. Despite not explicitly addressing bullying in nursing, this study is a priceless tool for understanding the prevalence and typology of bullying behaviors common in nursing education. As a result, it is important to consider how this will affect how equipped future nurses are to deal with bullying in the workplace. Furthermore, the study highlights the urgent requirement for educational institutions to put forward preventative measures to stop bullying in nursing schools [65]. Nursing students can build the knowledge and resiliency needed to deal with these difficulties in their future employment by identifying and addressing these behaviors as soon as they arise. This study also emphasizes the link between education and professional practice, highlighting how a positive learning environment can help develop future nurses’ compassion and empathy, ultimately improving patient care results [65].

Students’ Experiences of Bullying

Minton et al surveyed nursing students in New Zealand and conducted a cross-sectional investigation examining the experiences of bullying and harassment during clinical placements [45]. This study is of utmost importance because it reveals how bullying affects students’ knowledge and practical skills in the future, providing compelling evidence to start interventions to stop bullying at the educational moment. Minton, et al [45] research highlights the significance of maintaining a secure and supportive learning environment within nursing education and putting light on the negative consequences of bullying on students’ education and future practice. By focusing on the problem of bullying during clinical placements, this study not only promotes interventions but also emphasizes the need for educators and institutions to foster a culture of respect and inclusivity, ensuring that nursing students can acquire the knowledge and self-assurance they need to succeed in their future careers as compassionate and skilled healthcare professionals [45].

In the UK, Tee et al studied workplace violence experienced by nursing students, highlighting the critical need to understand the alterations faced by prospective nurses during their formative training years [46]. Their findings serve as a rallying cry to fight bullying not just among working nurses but also behind the revered walls of the educational system. The study also illuminate the long-term effects of such early exposure to workplace violence on nursing students’ mental and emotional health, potentially influencing their future practice [46]. This emphasizes how vital it is for institutions to put strong anti-bullying measures in place and offer extensive support networks to foster future nurses’ resilience and mental health. Their research offers a vital framework for reassessing and strengthening the educational system, ensuring it creates a culture of respect, empathy, and professionalism from the outset [46].

Workplace Bullying and Work Environment

The incisive investigation by Giorgi et al delves into the complex interactions between organizational atmosphere, burnout risk, and bullying of nurses [47]. Their study dives into the psychological effects of workplace bullying, illuminating how it could catalyze escalating nurse burnout and set off a negative shift in organizational cultures. Additionally, the exhaustive study by Giorgi et al [47] emphasizes the vital necessity for intervention techniques and a positive workplace culture to lessen these negative consequences. Their findings highlight the value of building an environment of respect, empathy, and open communication inside healthcare companies and provide a glimmer of hope for a nursing workforce that is healthier and more harmonious. The study urges stakeholders to emphasize nurses’ well-being and acknowledge its significant effects on individual healthcare providers and the system [47].

Fatima et al. across international borders to thoroughly investigate time theft, knowledge obfuscation, and workplace bullying in Pakistani healthcare institutions [48]. Even while bullying is not the study’s primary focus, it does shine a mirror on the broader effects of bullying on other aspects of healthcare delivery, such as knowledge transfer and operational effectiveness. Additionally, Fatima et al [48] are thorough investigation from 2021 highlights the urgent need for policies and treatments that foster a culture of respect and collaboration in healthcare settings, as the effects of workplace bullying go far beyond individual suffering. This report underscores how critical it is for governments and healthcare institutions to address these issues head-on in Pakistan and globally. They must comprehend the importance of a supportive workplace environment to deliver the greatest patient treatment and the healthcare systems’ overall performance [48].

In a study that focuses on the environment of Greek public hospitals, Karatza et al explore the perplexing world of workplace bullying and its far-reaching effects on the general health of nursing staff [49]. This study serves as a sobering reminder that workplace bullying is a global issue that affects nurses’ overall well-being on a widespread level, cutting beyond national lines. Hartin et al conducted a colossal examination of the growth of bullying within the nursing profession over 40 years to complete this thorough assessment [59]. This longitudinal perspective offers a singular chance to examine how bullying’s nature and appearance have changed and evolved, highlighting the need to stay alert and sensitive to these alterations to address the problem successfully. In their thorough investigation, Hartin et al [59] stress the significance of establishing a culture of support and inclusivity and understanding the changing patterns of bullying within the nursing profession. Their research highlights the requirement of taking precautionary steps, such as implementing rigorous anti-harassment rules and offering assets for preclusion and interference. Doing so permits medical institutions to cultivate environments that encourage respectful teamwork and collaboration, ultimately improving nursing workers’ wellness and the quality of individual care [59].

Oh et al did a rigorous descriptive study that looked into the numerous elements driving workplace bullying and lateral aggression among clinical nurses in Korea [66]. They were attempting an in-depth investigation of workplace bullying in the nursing profession. Their study shed light on the intricate interplay of factors and painstakingly identifying the contextual factors sustaining such harmful behaviors within the clinical setting [66]. This research underlines the urgent need for a thorough understanding of the various factors contributing to workplace bullying. It also highlights the importance of targeted treatments. This research examines the subtleties of workplace dynamics and establishes a solid framework for creating focused tactics to address these prevalent problems [66].

Furthermore, the important work by Wing et al vastly improves our understanding of the dramatic effects of empowerment and rudeness on the mental health of newly graduated nurses [50]. Their study highlights the crucial role empowerment plays in reducing the damaging impacts of workplace incivility through a thorough evaluation of these crucial elements. This priceless insight has important ramifications for creating a loving and supportive work atmosphere, especially for nurses starting in their professions. This research emphasizes the necessity of empowering nurses as a cornerstone in promoting their well-being and professional development by highlighting the transforming potential of empowerment [50].

On top of this foundation, Hosseini et al work explores the complex interactions between workplace bullying and Iranian nurses’ professional self-concept [51]. Their research thoroughly examines the psychological foundations of professional identity and the pervasive effects of workplace bullying on this important component of a nurse’s sense of value [51]. This research serves as a sad reminder of the far-reaching effects that workplace relationships can impose on a person’s sense of professional self-identity by painstakingly revealing the subtle link between these variables. This in-depth comprehension of the complex psychological foundations provides a crucial basis for creating interventions that uphold and protect nurses’ professional respect [51].

In their ground-breaking validation of a grounded theory of nurse bullying in emergency department settings, Wolf et al significantly contribute to this body of knowledge [52]. Their thorough analysis reveals the underlying mechanisms and contextual elements supporting bullying’s persistence in this healthcare setting. This research offers the groundwork for creating targeted policies and interventions to minimize such behavior by offering a thorough methodology [52]. Through their thorough investigation, the researchers provide a road map for healthcare organizations to prevent bullying in this crucial healthcare environment and aggressively address it. This will ultimately promote a safer and more favorable work environment for nursing staff [52].

By focusing on the psychological health of nurses, Hong et al’s cross-sectional study reveals the complex link between post-traumatic stress symptoms in nurses and their perceived experiences with bullying at work [53]. This study sheds light on the severe psychological harm that workplace bullying may do to nursing professionals, highlighting the need for a deliberate effort to offer assistance and services to those impacted. The study sheds light on the intricate relationship between psychological health and work environments, highlighting the need to provide mental health care for nurses as the priority because they may be especially susceptible to the negative consequences of bullying [53]. To increase the resilience and well-being of their nursing staff, healthcare organizations should implement comprehensive mental health services and support networks [53].

By analyzing the impact of workplace bullying on Turkish nurses’ psychological distress and their responses to such behavior, Bardakç and Günüşen add to this discussion [67]. Their study adds a crucial cross-cultural dimension by providing insights into how bullying expresses and affects nurses’ well-being in a particular cultural context. This research emphasizes the necessity for culturally appropriate approaches to address this prevalent issue by addressing Turkish nurses’ particular difficulties [67]. The results serve as a sobering reminder that interventions must be customized to the unique cultural and contextual variations within healthcare settings, acknowledging that the manifestations and effects of workplace bullying might vary dramatically across different cultural contexts [67].

Sarwar et al. explore the complicated relationships between bullying and nurses’ job instability and antisocial conduct while taking resilience and support into account as potential moderators [62]. Their work sheds important light on the complex interactions between workplace bullying, personal resiliency, and the ensuing emergence of unhealthy coping strategies. This emphasizes creating a nurturing workplace culture that increases nurses’ resilience in the face of difficulty. This study offers the framework for focused treatments aimed at reducing the negative impacts of workplace bullying and enhancing nurses’ capacity to deal with difficult situations by revealing the complex correlations between these variables [62]. The results of this study have important ramifications for healthcare organizations looking to establish a working climate that actively promotes the resilience and well-being of their nursing staff while actively discouraging bullying [62].

A poignant qualitative investigation of bullying in the clinical setting is also provided by Amoo et al who drew on the first-hand accounts of nursing students in Ghana’s Central Region [64]. This qualitative approach emphasizes the need for specific interventions that consider nursing students’ particular difficulties by bringing a rich, contextual perspective to the study of bullying. This research offers a crucial basis for understanding the specific dynamics of bullying within the educational context by amplifying the perspectives and experiences of nursing students [64]. The findings represent a call to action for educational institutions to have strong anti-bullying policies and offer nursing students support networks. Hence, they are prepared to handle the difficulties of their clinical assignments [64].

The extensive study on nurse bullying conducted by Sauer and McCoy explores its wide-ranging effects on nurses’ health [54]. Their work offers a comprehensive knowledge of the many mechanisms by which bullying exerts its effects, in addition to exhaustively documenting the physical and psychological harm bullying at work causes nurses. This study serves as a rallying cry for comprehensive interventions to protect the well-being of nursing professionals by highlighting how bullying affects nurses’ health. The results highlight how important it is to prioritize a safe and respected workplace as a pillar in improving the well-being and vitality of the nursing staff [54].

State of Knowledge on Workplace Bullying

The literature review conducted showed that bullying significantly negatively affects the physical and psychospiritual well-being of nurses, as well as has a negative impact on the quality of nursing care and the nurse-patient relationship. Moreover, this phenomenon creates a toxic work environment that can lead to increased stress, absenteeism, and turnover among nursing staff. In our study shown that workplace violence’s psychological effects on nurses [32]. Nielsen et al’s [69] thorough review and meta-analysis revealed a strong link between nurse sleep issues and workplace bullying. This stresses the wider health effects of being exposed to bullying behaviors and suggests a potential indirect strategy to affect the standard of nursing care. Future studies may examine how sleep disruptions affect nurses’ cognitive and emotional functioning, revealing implications for future therapies to protect patient care. Magnavita et al [70] provided a systematic review and meta-analysis to compile the body of knowledge on this important topic as part of their investigation into the link between sleep issues and workplace violence. This study sheds information on an indirect mechanism through which the standard of nursing care may be impacted and emphasizes the wider health implications of exposure to bullying behaviors [70]. Shorey and Wong conducted a qualitative systematic study that focused on nurses’ firsthand accounts of workplace bullying, using these results as a foundation [71]. Their research highlighted how ubiquitous this problem is in healthcare settings and confirmed the negative impact on nurses’ mental health as in our study. This qualitative insight serves as a valid reminder of the necessity to put in place thorough interventions and support systems that not only deal with workplace bullying but also foster a culture of respect and collaboration, ultimately protecting the well-being of nurses and the standard of patient care [71].

Our review also found that bullying creates a toxic work environment. This, in turn, can negatively impact team dynamics, morale, and overall job satisfaction [47,48]. To lessen the effects of bullying and violence on nurses at work, Yosep et. al focused their research on nursing interventions [72]. This proactive strategy represents an important first step in tackling workplace bullying and its possible repercussions. Healthcare organizations can build a culture of mutual respect and well-being for their nursing staff by implementing focused interventions that support and safeguard them. To reduce workplace violence, nursing management and leadership are essential [72]. A comprehensive integrative study of antagonism, incivility, and workplace violence between nurses is provided by Crawford et al [73]. For nursing leaders attempting to understand and manage the many types of workplace harassment, their work offers vital assistance. This in-depth analysis acts as a guide for fostering a secure and encouraging work environment, fostering a culture of respect and dignity. A systematic study of the efficacy of interventions intended to deescalate workplace violence towards nurses was provided by Somani et al [74]. Their findings offer practical information about evidence-based tactics that can be used to prevent and control workplace violence in healthcare settings. The study provides healthcare institutions with a path to strengthen their defenses against workplace violence, promoting an environment conducive to delivering high-quality care. This is done by methodically evaluating these interventions [74].

A meta-analysis by Galanis et al [75] found a moderate positive correlation between workplace bullying and job stress in 9 studies involving a total of 3730 nurses. Furthermore, a small negative correlation was observed between workplace bullying and compassion satisfaction. Additionally, the findings indicated moderate positive correlations between workplace bullying and both job burnout and secondary traumatic stress [75]. According to Botha et al [76], mindfulness-based programs have demonstrated promise as interventions for reducing stress among nurses. The program integrates mindfulness meditation, body awareness, and yoga to enhance mindfulness among participants. This practice aims to induce relaxation in the body and cultivate mental calmness through present-moment awareness. Demonstrated effectiveness includes stress reduction, enhanced quality of life, and increased self-compassion among healthcare professionals [76].

Future Directions

To effectively prevent and manage bullying in nursing, it is imperative to conduct research on the topic to have a comprehensive understanding of its prevalence, repercussions, and underlying causes such as organizational climate, healthcare professionals’ resilience, emotional intelligence, or workload. Healthcare organizations can improve the quality and safety of patient care while also fostering healthier work cultures that support nurses’ well-being by tackling bullying. It is essential to realize that tormenting influences more than simply the individual attendant; it also affects the workplace overall, patient well-being, and the passion and actual prosperity of human services workers. To make powerful mediations and guidelines to ensure the personal satisfaction of medical attendants and patients, it is crucial to thoroughly comprehend the connections between workplace tormenting and the nature of nursing consideration. Additionally, longitudinal studies are necessary to examine the enduring effects of emotional exhaustion on patient care, specifically in specialized settings like mental health facilities. Evaluating the effectiveness of policies and interventions across diverse healthcare contexts is essential, as it provides valuable insights for tailored strategies. Moreover, comprehending the aspects of a supportive work environment that alleviates the damaging consequences of violence in the workplace continues as an area ripe for exploration.

Conclusions

The impact of workplace bullying on the standard of nursing care is particularly concerning. This study underscores the intricate connection between workplace bullying and nursing care quality. The findings highlight the pressing need to address this issue, as it impacts individuals and resonates throughout healthcare organizations, ultimately affecting patient safety and well-being. The research details the various forms of workplace aggression, from overt harassment to covert psychological harm. It stresses comprehending the subtle ways aggression behaviors influence patient outcomes. While studies have recognized critical factors like emotional exhaustion and trauma symptoms, further investigation is needed to clarify exactly how nurses deal with workplace violence. In conclusion, this assessment underscores the need for proactive interventions, sturdy support systems, and a culture of respect and teamwork to safeguard the wellness of nurses and uphold the standard of patient care. Healthcare organizations, policymakers, and researchers must cooperate to address bullying at work to ensure the highest quality of nursing care and the well-being of healthcare professionals.