Workplace gaslighting in nursing practice: a concept analysis

Gaslighting is a subtle and insidious form of psychological abuse in the workplace that operates through the distortion or denial of reality and the induction of cognitive doubt, ultimately undermining individuals' confidence in their perceptions and professional judgment. Although the concept has gained increasing attention in organizational and psychological literature, gaslighting remains theoretically underdeveloped and conceptually ambiguous within nursing practice. It is frequently conflated with related phenomena such as workplace bullying, psychological violence, or incivility, which limits accurate identification, measurement, and intervention. This study aimed to clarify the concept of gaslighting in nursing practice through a systematic concept analysis.

This study employed Walker and Avant's eight-step concept analysis method. A comprehensive review of English- and Persian-language literature was conducted using databases including PubMed, Scopus, CINAHL, PsycINFO, Web of Science, SID, and IranDoc. All uses of the concept of gaslighting relevant to nursing and healthcare contexts were examined. Data were analyzed to identify defining attributes, antecedents, consequences, model cases, and empirical referents of gaslighting in nursing practice.

The analysis revealed that gaslighting in nursing practice is a covert, processual, and power-based phenomenon. Its defining attributes include distortion or denial of reality, induction of cognitive doubt, persistent and patterned behavior, power imbalance, victim blaming, and a subtle, non-confrontational nature. Key antecedents were identified as hierarchical power structures, high workload and stressful clinical environments, and the absence of clear organizational policies and supportive reporting mechanisms. The consequences of gaslighting extend beyond individual psychological harm and include reduced professional self-confidence, burnout, organizational silence, decreased reporting of concerns, diminished quality of care, and potential threats to patient safety. Based on these findings, a conceptual model illustrating the relationships among antecedents, defining attributes, and consequences of gaslighting in nursing practice was developed.

This concept analysis provides a clear and structured understanding of gaslighting in nursing practice and differentiates it from other forms of workplace mistreatment. The proposed conceptual framework offers a foundation for future empirical research, development of measurement instruments, and the design of educational and organizational interventions aimed at preventing and addressing gaslighting in nursing environments.