How to Address Disparities? End Bullying of Nurses in the Workplace.

Apr 27, 2014, 10:00 AM

To mark National Minority Health Month, the Human Capital Blog asked several Robert Wood Johnson Foundation (RWJF) scholars to respond to questions about improving health care for all. In this post, Donna M. Fountain, MA, MSN, APRN, PHCNS-BC, a former assistant professor and RN-to-BSN program coordinator at Kean University, responds to the question, “What does the country need to do to address disparities and build a culture of health that includes all people?” Fountain is an RWJF New Jersey Nursing Scholar graduate fellow in the PhD program, and a doctoral student at Rutgers, The State University of New Jersey, College of Nursing.


Minority communities are challenged with many health disparities, including limited access, increased cost, and reduced quality of health care. Over the last decade, New Jersey has experienced the closure of several hospitals and visiting nurse services, especially in minority communities, leaving minority patients at increased risk of poor health outcomes. Issues related to black-on-black crime due to psycho-social dilemmas have fostered a higher level of vulnerability, hostility, and violence. 

Bullying in nursing presents another health care service variable which may impede quality and patient care outcomes for the minority population. For that reason, it is important to address the impact workplace bullying has on patient care and organizational factors such as adequate staffing and quality nursing care. 

To reduce health disparities and foster high quality patient care requires a good working environment for the provision of such services. To sustain quality health care services for vulnerable populations, it is critical that the nursing workforce receives the necessary resources to improve the work environment for all health care professionals, inclusive of strategies to reduce workplace bullying.

The World Health Organization and Institute of Medicine recognize bullying as a widespread international public health dilemma. Globally, this issue has been documented in Australia, Canada, Japan, Iraq, Scandinavia, Turkey, United Kingdom, Africa and the United States. Research suggests that workplace bullying among nurses is at epidemic proportions within the United States and abroad. Research evidence reveals potential negative consequences to quality patient care, nurse’s attitudes about job satisfaction, and organizational outcomes if workplace bullying goes unresolved. Empirical evidence according to the Agency for Healthcare Research and Quality (AHRQ) 2012 quality health care report should guide care delivery to all patients in ways that are safe, timely, patient centered, efficient, and equitable.

Nonetheless, minority populations in America may be at risk of receiving substandard health care—care that is delayed, inadequate, and culturally incompetent. AHRQ has identified higher quality of diabetes care as a strategy for reducing health disparities. But there is still work to do. After adjustment, among adults ages 40-64 with diagnosed diabetes, non-Hispanic Blacks were less likely than non-Hispanic Whites to receive the four recommended services for diabetes.

Disparities occur for various reasons and we have much more work to do to end them. Workplace bullying in nursing should not get in the way.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.