Park Sunghee, Kim Kyoungja, Kim Sinhye, Jones Cheryl B
Surgery Intensive Care Unit, Ajou University Hospital, Suwon, Republic of Korea.
College of Nursing, Inha University, Incheon, Republic of Korea.
J Adv Nurs. 2025 Jan 30. doi: 10.1111/jan.16788.
To explore the influences of workplace bullying experiences, witnessing workplace bullying and bystander types on Speaking up for patient safety (SUPS) among hospital nurses.
Cross-sectional study.
A survey was conducted in September 2021 using a structured questionnaire about workplace bullying experiences, witnessing workplace bullying, bystander types, and SUPS. The questionnaire was administered to 200 bedside nurses from two tertiary university hospitals in South Korea.
One hundred and ninety-nine responses were analysed. A hierarchical regression model, incorporating organisational factors, workplace bullying experiences, witnessing workplace bullying, and bystander types explained approximately 44.0% of the variance in nurses' SUPS. Witnessing workplace bullying and the perpetrator-facilitating bystander negatively influenced SUPS, whereas victim-defending bystander had a positive influence on SUPS.
Findings suggest that witnessing workplace bullying and the bystander types of nurses working on patient care units are more impactful on nurses' SUPS than individual experiences of bullying. Notably, the victim-defending and perpetrator-facilitating bystander types were identified as key factors influencing SUPS.
Nurse managers should understand the roles of witnesses and bystanders working on a patient care unit, and how these roles may extend beyond traditional views of perpetrators and victims. Developing strategies to support and effectively manage witnesses and bystanders working on patient care units may promote positive SUPS behaviours among clinical nurses.
What problem did the study address? Speaking up for patient safety (SUPS) in clinical settings is critical in maintaining and enhancing patient safety. However, a negative work environment, such as one that promotes workplace bullying may hinder nurses' willingness to engage in SUPS. Because many nurses involved in workplace bullying may be witnesses or bystanders rather than direct perpetrators or victims of such situations, this study explored the potential influences of workplace bullying, including the roles of witnesses and bystanders, on SUPS. What were the main findings? SUPS was influenced more by witnessing workplace bullying and specific bystander types, namely victim-defending and perpetrator-facilitating bystanders, than by workplace bullying experiences. Where and on whom will the research have an impact? These findings highlight the importance of addressing the roles of witnesses and bystanders in workplace bullying. Nurse managers should broaden their focus beyond perpetrators and victims to include the roles and views of all nursing staff within a department. By effectively managing witnesses and bystander types, they can foster an environment that enhances SUPS behaviours among nurses.
This study adhered to STROBE guidelines.
No Patient or Public Contribution.
探讨工作场所欺凌经历、目睹工作场所欺凌及旁观者类型对医院护士为患者安全发声（SUPS）的影响。
横断面研究。
2021年9月使用一份关于工作场所欺凌经历、目睹工作场所欺凌、旁观者类型和SUPS的结构化问卷进行了一项调查。该问卷被发放给韩国两所三级大学医院的200名床边护士。
分析了199份回复。一个纳入组织因素、工作场所欺凌经历、目睹工作场所欺凌和旁观者类型的分层回归模型解释了护士SUPS差异的约44.0%。目睹工作场所欺凌和协助欺凌者的旁观者对SUPS有负面影响，而保护受害者的旁观者对SUPS有正面影响。
研究结果表明，目睹工作场所欺凌以及在患者护理单元工作的护士的旁观者类型对护士的SUPS影响比个人欺凌经历更大。值得注意的是，保护受害者和协助欺凌者的旁观者类型被确定为影响SUPS的关键因素。
护士长应了解在患者护理单元工作的目击者和旁观者的角色，以及这些角色如何可能超越对欺凌者和受害者的传统看法。制定支持和有效管理在患者护理单元工作的目击者和旁观者的策略，可能会促进临床护士积极的SUPS行为。
该研究解决了什么问题？在临床环境中为患者安全发声（SUPS）对于维持和提高患者安全至关重要。然而，负面的工作环境，如助长工作场所欺凌的环境，可能会阻碍护士参与SUPS的意愿。由于许多参与工作场所欺凌的护士可能是目击者或旁观者，而不是这种情况的直接欺凌者或受害者，本研究探讨了工作场所欺凌，包括目击者和旁观者的角色，对SUPS的潜在影响。主要发现是什么？SUPS受目睹工作场所欺凌和特定旁观者类型（即保护受害者和协助欺凌者的旁观者）的影响比受工作场所欺凌经历的影响更大。该研究将对何处及何人产生影响？这些发现凸显了在工作场所欺凌中解决目击者和旁观者角色的重要性。护士长应将关注点从欺凌者和受害者扩大到包括部门内所有护理人员的角色和观点。通过有效管理目击者和旁观者类型，他们可以营造一个增强护士SUPS行为的环境。
本研究遵循STROBE指南。
无患者或公众贡献。
