Exposure to such behavior is known to be a crippling

Exposure to such behavior is known to be a crippling source of stress in
the workplace (Einarsen, 2005). While healthcare workers, in general, seem to experience
5

Running Head: NURSES’ PERCEPTIONS OF TEAMS AND BULLYING
higher rates of bullying than those in other professions (Lim & Bernstein, 2014; Quine, 2001;
Zapf, Einarsen, Hoel, & Vartia, 2003), such behavior has long been considered a significant
problem affecting nurses worldwide (Cooper & Swanson, 2002; Koh, 2016; Rodwell, Demir, &
Theol, 2013). Prevalence rates range from 21% - 70% (Berry, Gillespie, Gates, & Schafer, 2012;
Roberts, 2015; Vessey, Darmaico, Gaffney, & Budin, 2009; Wilson, 2016). Bullying is contrary
not only to general civility and collegiality within the workplace, but to nurses’ code of ethics
(American Nurses’ Association, 2015; International Council for Nurses, 2012). Such behavior
may lead to feelings of helplessness, depression, and anxiety (Einarsen, 2005)
While various causes, scope, and influence of bullying on the provision of quality of care
is described in the literature (Croft & Cash, 2012; Luparell, 2011; Leiter, Price, & Laschinger,
2010; Murray, 2009; Smith, Andrusyszyn, & Laschinger, 2010), one important consequence is
the resulting high turnover in the nursing workforce worldwide (American Nurses’ Association,
2015; Koh, 2016; Olender ? , 2013; Rocker, 2008). This outcome is critical given the impact such
turnover can have on team functioning and, hence, patient care (Hayes et al., 2006). In addition,
nurses are often positioned toward the bottom of the healthcare hierarchy invoking a sense of
powerless and frustration that can engender aggressive behavior toward peers (Croft & Cash,
2012). Not only can these factors undermine important performance variables such as trust,
commitment, and motivation, nurses may lack the assertiveness or negotiation skills needed to
address disruptive behavior (Lachman, 2015).
Effective teamwork is one tool for addressing the prevalence and impact of bullying in
healthcare settings (Rocker, 2008). Indeed, understanding the role of teams and bullying within
healthcare is critical to identifying potential solutions to bullying in team contexts. Although
substantial attention has been given to both teamwork and to bullying, independently, a gap
exists regarding stakeholder perspectives regarding the teams they serve and their experiences of
6

Running Head: NURSES’ PERCEPTIONS OF TEAMS AND BULLYING
bullying on these teams. Hence, the purpose of this study was to explore the association between
nurses’ perceptions and attitudes of teamwork and workplace bullying. Understanding the link
between what nurses think about the teams on which they serve and the experience of bullying
on these teams can provide insight for nurse managers regarding concerns that limit teamwork.
A central hypothesis was that a negative association between perceptions and attitudes of
teamwork and workplace bullying would emerge. In short, nurses who had positive attitudes
about teamwork (a reflection of effectively performing teams) and who perceived the teams on
which they served as having effective characteristics , would report lower rates of bullying. In
short, bullying is less likely to occur within effective teams.