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Journal Article


Hawkins N, Jeong S, Smith T. Int. J. Nurs. Stud. 2019; 93: 41-54.


Department of Rural Health, The University of Newcastle 69a High Street, Taree, NSW 2430, Australia. Electronic address:


(Copyright © 2019, Elsevier Publishing)






BACKGROUND: Negative workplace behaviour among nurses is a globally recognised problem and new graduate nurses are at high risk for exposure. Negative behaviour has detrimental effects on new graduate nurses, the nursing profession and patients.

OBJECTIVES: To synthesise evidence on negative workplace behaviour experienced by new graduate nurses in acute care setting and discuss implications for the nursing profession.

DESIGN: An integrative review guided by Whittemore and Knafl's (2005) framework. DATA SOURCES AND REVIEW METHODS: A search of evidence-based research from five electronic databases (CINAHL, MEDLINE, ProQuest, JBI and Scopus) was conducted for the period of 2007-2017. Eligible articles were critically appraised using the Mixed Methods Appraisal Tool.

RESULTS: Eight qualitative and eight quantitative studies were identified and reviewed. There was a variety of terms and definitions used to describe the disrespectful, unprofessional and uncivil targeted behaviour towards new graduate nurses. The incidence of negative workplace behaviour varied from 0.3% as a daily occurrence to 57.1% experiencing sporadic exposure. The precipitating factors included the new graduates' perceived lack of capability, magnifying power and hierarchy, leadership style and influence of management. The negative behaviour was identified as either a personal or professional attack, which left new graduates feeling emotional distress, anxiety or depression, which in turn impacted upon job satisfaction, cynicism, burnout, and intention to leave. The lack of a definitional consensus and the range of negative workplace behaviour make identification, seeking assistance and intervention difficult. Specific or ongoing organisational support to address negative behaviours towards new gradute nurses was not identified. Instead, the way they used to deal with these behaviours were personal.

CONCLUSION: Negative workplace behaviour towards new graduate nurses continues to be an international problem. Available studies are descriptive and exploratory in nature and there have been few effective strategies implemented in acute care setting to address towards new graduate nurses. Multi-level organisational interventions are warranted to influence the 'civility norms' of the nursing profession. With a new understanding of the theoretical underpinnings of negative workplace behaviours towards new graduate nurses and the identification of limited intervention studies being undertaken, the nursing profession is provided with new directions in their future endeavours.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Language: en


Acute care; Bullying; Hospital; Incivility; New graduate nurse; Nurses; Workforce


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