When Nurses Hurt Nurses

“
All persons ought to endeavor to follow what is right, and not what is established.” Aristole

Several weeks ago, I came across a LinkedIn post by Aryana Rivera about bullying. In the post highlighted how someone had attempted to bully her online. Fortunately, Aryana called it out publicly, giving her followers a clear view of what it was and what it wasn’t. Her courage prompted an important conversation in the comments section.

Coming across that post took me back to a version of myself that existed years ago before I had grown into my professional and personal identity. Back then, I could not speak up. I could not speak out and this made me wonder: how many new nurses recognize bullying when it happens especially when it comes from colleagues? 

Bullying in nursing by nurses refers to repeated, harmful behaviours by one nurse or a group of nurses towards another. These actions may be verbal, physical, psychological, or professional in nature and typically occur over a prolonged period. Unfortunately, such behaviours are often cloaked as “tough love”a form of professional initiation but they are, in reality, a toxic culture that spreads like cancer through the lymphatic system of healthcare settings.

Bullying manifests in different forms. Based on who is involved, we can categorize it as:

Lateral Violence – bullying between peers at the same level.

Vertical Violence – bullying from a superior (e.g., a charge nurse to a staff nurse), or even from staff towards a manager.

In terms of presentation, bullying may be:

Covert – subtle actions like exclusion, silent treatment, eye-rolling.

Overt – open acts like yelling, mocking, or public insults.

Examples of bullying within nursing include:

• Undermining another nurse’s work or competence.
• Spreading rumours or gossip.
• Withholding essential information.
• Sabotaging assignments (e.g., mis-labelling charts.

Globally, the seriousness of bullying in healthcare is well acknowledged. The World Health Organization (WHO), American Nurses Association (ANA), and the International Council of Nurses (ICN) all recognize workplace violence including bullying as a public health concern. Should we be worried? Yes, we absolutely should be. Recent studies affirm this concern. A narrative review found that horizontal violence disproportionately affects new graduates and less-experienced nurses, who are especially vulnerable to repeated harm by their peers (Gaffney et al., 2021). Similarly, a meta-analysis conducted in Ethiopia between 2016 and 2024 showed that 39.4% of nurses had experienced workplace violence, including incivility and bullying. Some individual studies reported prevalence as high as 61.3% (Abate et al., 2024). Comparable data from Kenya, South Africa, the United States, and the United Kingdom consistently highlight high rates of bullying in high-stress units such as ICUs, emergency departments, and teaching hospitals (Park et al., 2022). 

Causes

Research shows that bullying is often rooted in stressful working environments with high workloads and inadequate support (Sellers et al., 2019). It thrives in hierarchical systems, where poor leadership and lack of accountability create loopholes for toxic behaviours to flourish (Kim, Y. et al., 2023). It is further sustained by burnout, unresolved trauma, and a workplace culture that normalises “toughening up” junior staff (Kim, S. C., & Kim, I. H., 2024).

Consequences

For the nurse being targeted, the consequences can be devastating: anxiety, depression, post-traumatic stress disorder (PTSD), burnout, and ultimately, withdrawal from the profession.

For patient care, bullying leads to communication breakdowns, reduced collaboration, and medical errors. Patients may feel the effects through poor care quality or increased complaints.

At the organizational level, bullying contributes to high turnover, low morale, and tarnished reputations—especially in institutions that train or mentor nurses (Chang et al., 2022).

Correcting it

As Individuals:

1. Keep detailed records of bullying incidents.
2. Seek mentorship or peer support.
3. Use assertive communication to set boundaries.
4. Report incidents through formal institutional channels.

At the Organisational Level:

1. Enforce clear anti-bullying policies.
2. Establish a zero-tolerance culture, modelled by leadership.
3. Introduce mandatory training on respectful communication.
4. Create support structures such as counselling and ombudsman services.
5. Encourage bystander intervention and safe reporting systems.

At the National/Policy Level:

1. Strengthen labour laws that address workplace harassment.
2. Include civility and professional ethics in nursing curricula.
3. Promote unions and professional associations that defend nurses’ rights.

In summary , by fostering a nursing culture where respect, compassion, and collaboration exist we can replace intimidation and silence. We must move from a culture of endurance to one of dignity because healing is not just for patients it starts with us.

References

Abate, B. B., Chekole, Y. A., Kassa, A. M., & Kassie, A. M. (2024). Prevalence of workplace violence and associated factors among nurses in Ethiopia: A systematic review and meta-analysis. BMC Nursing, 23(1), 105. https://doi.org/10.1186/s12912-024-02660-y

Chang, H. E., Hur, J., & Park, S. (2022). Impact of nurse–nurse collaboration and communication on patient safety and quality of care: A systematic review. International Journal of Environmental Research and Public Health, 19(17), 10855. https://doi.org/10.3390/ijerph191710855

Gaffney, D. A., DeMarco, R. F., Hofmeyer, A., Vessey, J. A., & Budin, W. C. (2021). An integrative review of nurse-to-nurse lateral violence and bullying in the United States. Nursing Forum, 56(1), 69–84. https://doi.org/10.1111/nuf.12512

Kim, S. C., & Kim, I. H. (2024). The effectiveness of cognitive rehearsal programs in reducing workplace bullying among clinical nurses: A meta-analysis. BMC Public Health, 24(1), 569. https://doi.org/10.1186/s12889-024-18969-x

Kim, Y., Lee, E., & Lee, H. (2023). Horizontal violence and turnover intention among registered nurses: A meta-analysis. Journal of Nursing Management, 31(1), 3–13. https://doi.org/10.1111/jonm.13746

Park, M., Cho, S. H., & Hong, H. J. (2022). Interventions for workplace bullying in healthcare: A scoping review. Journal of Advanced Nursing, 78(1), 18–29. https://doi.org/10.1111/jan.14990

Sellers, K., Millenbach, L., Ward, K., & Scribani, M. (2019). The degree of horizontal violence in RNs practicing in New York State. Journal of Nursing Administration, 49(3), 136–142. https://doi.org/10.1097/NNA.0000000000000724