Calling it bullying is only the beginning. What are we going to do about it?
My recent post about new nurses speaking up opened an important conversation. Nurses shared stories of being humiliated, criticized, excluded, and made afraid to ask questions.
One nurse remembered discussing this same problem as far back as 1988. Another shared that she spent five years studying why nurse-to-nurse bullying persists. Their perspectives reinforced a difficult truth: This is not a new problem, and awareness alone has not ended it.
Silence allows harmful behavior to become normalized. When nurses fear retaliation, embarrassment, or damage to their careers, they may stop reporting what is happening.
Awareness matters—but awareness without action will not change the culture.
Zero Tolerance Must Be More Than a Policy
Healthcare organizations need genuine zero-tolerance policies addressing bullying, intimidation, retaliation, verbal abuse, and deliberate exclusion. However, a policy cannot live only inside an employee handbook. It must be consistently reflected in everyday practice.
That means:
- Defining bullying clearly: Provide specific examples so employees understand the difference between constructive feedback, workplace conflict, incivility, and repeated harmful behavior.
- Creating safe reporting channels: Give employees confidential and impartial ways to report concerns.
- Protecting against retaliation: Safeguard nurses who raise concerns in good faith.
- Reviewing complaints promptly: Investigate concerns fairly, consistently, and without favoritism.
- Documenting behavioral patterns: Track repeated conduct instead of treating every complaint as an unrelated event.
- Enforcing accountability: Apply expectations regardless of seniority, popularity, experience, or position.
- Using appropriate interventions: Offer coaching and education when appropriate, with meaningful and proportionate consequences when harmful behavior continues.
- Closing the feedback loop: Follow up with the person who reported the concern rather than leaving them wondering whether anyone listened.
A zero-tolerance statement has little value when employees see that certain people are repeatedly excused because they are experienced, popular, difficult to replace, or closely connected to leadership.
Breaking the Silence: Structural Solutions
Policy establishes expectations, but changing a culture requires deliberate structural action.
Prepare Nurses to Respond
Nurses—especially students, new graduates, and newly hired staff—should receive communication and de-escalation training. Cognitive rehearsal can help nurses practice calm, professional responses before a difficult interaction occurs.
Examples include:
“I am open to constructive feedback, but I would like us to speak respectfully.”
“Can you clarify what you mean?”
“I am asking this question because I want to provide safe patient care.”
Practicing these responses can help nurses find their voices when they might otherwise freeze or remain silent.
Create an Objective Review Process
A bullying complaint should not depend entirely on the judgment of one manager, particularly when personal relationships or staffing pressures may influence the response.
Organizations should consider a consistent review process involving appropriate representatives from nursing leadership, human resources, professional practice, and employee relations. The purpose should be to examine facts, identify patterns, protect confidentiality, and ensure fairness to everyone involved.
Hold Leaders Accountable for Unit Culture
Leaders are frequently evaluated on budgets, staffing metrics, productivity, and patient outcomes. Psychological safety should also matter.
Anonymous employee feedback, turnover patterns, exit interviews, repeated transfers, absenteeism, and reports of incivility may reveal problems that operational numbers alone cannot show.
A unit with persistent fear, silence, and turnover should not automatically be described as having “difficult staff.” Leadership practices and organizational conditions must also be examined.
Make Precepting an Earned Responsibility
Precepting should not be assigned simply because someone is available or clinically experienced. Strong clinical skills do not automatically make someone a supportive teacher.
Preceptors should demonstrate patience, emotional intelligence, respectful communication, and a genuine willingness to teach. They should also receive preparation, support, and feedback.
New nurses deserve structured mentorship—not “preceptor roulette.”
Clarification Before Assumption
Accountability does not mean labeling every disagreement or uncomfortable interaction as bullying.
Nurses come from different cultures, backgrounds, generations, and communication styles. These differences can affect how we express ourselves, interpret tone, and understand one another’s intentions.
That is why open communication and clarification are essential. Before assuming disrespect or harmful intent, we should pause and ask:
“Can you help me understand what you meant?”
A respectful conversation may uncover a cultural difference, unclear wording, high stress, or a genuine misunderstanding. Clarification gives people an opportunity to explain themselves, repair the interaction, and learn from one another.
However, clarification must never become an excuse for repeated humiliation, intimidation, gossip, exclusion, sabotage, retaliation, or verbal abuse.
Cultural differences deserve understanding. Persistent harmful behavior requires accountability.
Silence Protects the Culture
Leaders must create opportunities to discuss bullying during orientation, staff meetings, huddles, preceptor development, and leadership training. Nurses must know what behavior is unacceptable, how to report it, and what will happen after they speak up.
New nurses must feel safe asking questions. Experienced nurses must feel safe raising concerns. Leaders must be willing to listen, investigate, clarify, and act.
A policy means little when the nurse reporting bullying becomes the problem.
Silence may protect the reputation of a unit or organization temporarily, but it does not protect nurses. It does not strengthen teamwork, improve retention, or keep patients safe.
Zero tolerance must mean zero excuses, consistent accountability, protection from retaliation, open communication, and a commitment to cultural change—not merely protection of the organization’s image.
Silence protects the culture.
Speaking openly, listening carefully, and acting consistently protect the nurse.
What practical steps has your workplace taken to prevent nurse-to-nurse bullying while encouraging respectful communication?
#NurseBullying #NursingCulture #PsychologicalSafety #HealthcareLeadership #PatientSafety #NurseMentorship #TheNursingLens
