Understanding the barriers to reporting bullying among nursing students in clinical settings: A systematic review

Workplace bullying in clinical settings undermines nursing students' learning, mental health, and professional development, posing significant challenges to nursing education and patient safety. Despite its high prevalence, underreporting due to systemic and cultural barriers hampers efforts to address the issue effectively.

This scoping review aims to identify and explore the barriers preventing nursing students from reporting bullying and to discuss the implications to decrease bullying and enhance the reporting process in nursing education and clinical practice.

Following the Arksey and O'Malley framework and PRISMA guidelines, a systematic search was conducted across nine databases for studies published between 2015 and 2024. Inclusion criteria encompassed peer-reviewed original research focusing on nursing students' experiences with bullying reporting barriers. Data were extracted, quality-assessed using the JBI tool, and synthesized narratively, emphasizing thematic analysis of identified challenges.

28 studies involving diverse global populations revealed nine key themes: fear of retaliation, distrust in reporting systems, normalization of bullying, feelings of shame and isolation, concerns over professional reputation, lack of awareness and education on reporting protocols, peer pressure, and fear of negative evaluations. These interconnected barriers foster a culture of silence, hindering effective intervention.

The findings highlight the urgent need for nursing education programs to implement strategies addressing these barriers. Creating supportive environments and improving awareness of reporting protocols are essential for promoting the mental health and professional growth of nursing students in clinical settings.