A Commentary on Workplace Bullying in Nursing: Psychological Safety, Speaking up, and Role of Leadership

Abstract

Workplace bullying remains a concern in nursing because its implications extend beyond individual nurses to professional communication, teamwork and the conditions supporting patient safety. Although bullying is sometimes regarded as an interpersonal issue, it is also associated with organisational culture, hierarchical relationships, leadership behaviour and the wider work environment. This commentary examines the relationship between workplace bullying, psychological safety and nurses’ willingness to speak up, with particular attention to the responsibilities of nurse leaders. Nurses frequently need to clarify clinical orders, report changes in patients’ conditions, question decisions and communicate potential risks. Experiences of humiliation, intimidation, exclusion or anticipated retaliation may discourage such communication. Psychological safety provides a useful framework for understanding how nurses can raise concerns, acknowledge uncertainty and engage in professional disagreement without fear of interpersonal punishment. The commentary distinguishes constructive feedback and legitimate accountability from repeated harmful behaviour, and considers the influence of colleagues, bystanders and leadership responses on safety-related communication. It also argues that individual resilience and communication training, although valuable, cannot substitute for organisational responsibility. A practical leadership approach is outlined through six commitments: Recognize, Listen, Protect, Respond, Follow Up and Prevent. Together, these commitments emphasise fair responses to concerns, protection from retaliation and sustained attention to workplace culture. Psychological safety should be supported as a condition that facilitates communication and learning, rather than treated as a guarantee of improved patient outcomes.