Factors Affecting Workplace Bullying Among Intensive Care Unit Nurses and Their Needs for Improving Organizational Culture: A Mixed-Methods Study.

Purpose: We identified factors influencing workplace bullying (WPB)-personality traits and organizational culture-among nurses working in adult ICUs at a tertiary hospital in South Korea. Additionally, supplementary questions and in-depth interviews were used to explore nurses' organizational culture improvement needs. Background: Nurses, under pressure to provide high-quality care, are frequently exposed to WPB and experience higher peer bullying rates than other professions. As WPB increases turnover and negatively affects organizations, addressing this issue is imperative. Methods: This mixed-methods study involved nurses working in intensive care units of a tertiary hospital. Quantitative self-reported data were collected from 161 nurses between June 29 and July 14, 2022, covering pathological narcissism, perfectionism, dark personality traits, and WPB experiences. Qualitative in-depth interviews were conducted with 21 nurses (10 with less than 5 years' experience and 11 with 5 or more) and analyzed phenomenologically. Results: Multiple linear regression analysis revealed that WPB experiences were significantly influenced by positive organizational culture, pathological narcissism, and dark personality traits. Qualitative data analysis identified three key theme clusters: "discomfort between novice and experienced nurses," "demand for strong sanctions against WPB," and "appeal to improve human infrastructure and the work environment." Conclusion: Lower levels of positive organizational culture, higher levels of pathological narcissism, and more pronounced dark personality traits were associated with more severe WPB experiences. Considering individual personality traits and the lack of a culture of mutual consideration and respect as causes of WPB, it is evident that both individual and organizational efforts are necessary to improve the situation. Implications for Nursing Management: Understanding the WPB challenges faced by novice and experienced nurses is crucial. Addressing their specific needs requires concrete and tailored interventions. As advocated by nurses, strong WPB eradication policies must be established, alongside improvements in working conditions to alleviate nurses' workload.