Influence of Workplace Bullying and Bystander Types on Speaking Up for Patient Safety Among Hospital Nurses: A Cross‐Sectional Study
Authors: Park Sunghee , Kim Kyoungja , Kim Sinhye , Jones Cheryl B. 
Published: January 2025

ABSTRACTAimsTo explore the influences of workplace bullying experiences, witnessing workplace bullying and bystander types on Speaking up for patient safety (SUPS) among hospital nurses.DesignCross‐sectional study.MethodsA 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.ResultsOne 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.ConclusionsFindings 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.Implications for the ProfessionNurse 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.Impact

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.Reporting MethodThis study adhered to STROBE guidelines.Patient or Public ContributionsNo Patient or Public Contribution.