Workplace bullying in intensive care units: intern nurses’ experiences and responses

Abstract

This study explores how bullying negatively affects intern nurses’ assertiveness, performance, and the quality of patient care. It emphasizes the need for supportive, respectful clinical environments to enhance interns’ confidence, safety, and professional development. This study aims to explore the intern nurses’ responses to bullying in the ICU. A convergent mixed-methods design was used to gain a comprehensive understanding of bullying among intern nurses in the ICUs of Alexandria University Hospitals in Egypt. questionnaire. Of 610 invited interns, 200 completed the questionnaire, and 29 provided narrative responses; a pilot study with 10% of the sample tested feasibility before data collection. The quantitative data were collected using the Negative Act Questionnaire (NAQ-R), and the qualitative data were collected using three questions developed by the researcher. The study revealed that over half of the intern nurses (53%) experienced bullying and about half witnessed it (47%), mainly due to their limited experience, unfamiliarity with ICU routines, and hierarchical workplace stress. The overall mean bullying score was (2.17 ± 1.00), with work-related bullying observed to have the highest mean score at (2.37 ± 1.17), followed by physically intimidating behaviors (2.35 ± 1.25), and person-oriented bullying (2.01 ± 0.97). In addition, there were statistically significant associations between the three dimensions of bullying experience and intern nurses’ age (p < 0.001, p < 0.001, and p = 0.002). Professional and social vulnerability to workplace bullying, the emotional reactions to bullying and its effect on intern nurses’ professional conduct, coping with bullying, and intern nurses’ explicit messages and suggestions were the four main identified themes from the qualitative analysis. The study revealed a high prevalence of workplace bullying among intern nurses, mainly work-related and physically intimidating, emphasizing the need for institutional interventions and support systems. It calls for pre-internship training on coping strategies, faculty mentorship programs, and clear, confidential reporting procedures to prevent and address bullying effectively.