Workplace Bullying of General Surgery Residents by Nurses

• Published in: Journal of surgical education 2014-11, Vol.71 (6), p.e149-e154
• Main Authors: Schlitzkus, Lisa L., MD, Vogt, Kelly N., MD, Sullivan, Maura E., PhD, Schenarts, Kimberly D., PhD
• Format: Article
• Language: English
• Subjects: Adult; Bullying; Female; General Surgery - education; general surgery residents; Humans; Internship and Residency; Interpersonal and Communication Skills; Interprofessional Relations; Male; nurses; Nursing Staff, Hospital; Patient Care; Physicians - psychology; Professionalism; Surgery; Surveys and Questionnaires; United States; Workplace; workplace bullying
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2014.08.003

Abstract Objective Workplace bullying is at the forefront of social behavior research, garnering significant media attention. Most of the medical research has addressed bullying of nurses by physicians and demonstrates that patient care and outcomes may suffer. The intent of this study was to determine if general surgery residents are bullied by nurses. Design A survey instrument previously validated (Negative Acts Questionnaire—Revised) to evaluate for workplace bullying was modified to reflect the resident-nurse relationship. After institutional review board approval, the piloted online survey was sent to general surgery program directors to forward to general surgery residents. Demographic data are presented as percentages, and for negative acts, percentages of daily, weekly, and monthly frequencies are combined. Setting Allopathic general surgery residencies in the United States. Participants General surgery residents. Results The response rate was 22.1% ( n = 452). Most respondents were men (55%) and had a mean age of 29 years (standard deviation = 7). Although 27.0% of the respondents were interns, the remaining classes were equally represented (12%-18% of responses/class). The respondents were primarily from medium-sized residency programs (45%), in the Midwest (28%), training in university programs (72%), and rotating primarily in a combined private and county hospital that serves both insured and indigent patients (59%). The residents had experienced each of the 22 negative acts (11.5%-82.5%). Work-related bullying occurs more than person-related bullying and physical intimidation. Ignoring of recommendations or orders by nurses occurs on a daily, weekly, or monthly basis for 30.2% of residents (work-related bullying). The most frequent person-related bullying act is ignoring the resident when they approach or reacting in a hostile manner (18.0%), followed by ignoring or excluding the resident (17.1%). Conclusions Workplace bullying of general surgery residents by nurses is prominent. Future research is needed to determine the toll on the resident’s well-being and patient outcomes.