A fifth of nurses were bullied at work over a six-month period and over two-fifths had seen a colleague being tormented, research by Durham University suggests.
The study was based on a survey of 2,950 staff at seven NHS organisations, of which 23 per cent were nurses or midwives and 10 per cent were healthcare assistants.
Managers were the most common source of bullying-responsible for over half of reported incidents-but it was also done by peers. Many identified a 'bullying culture' at work.
The types of bullying most commonly reported were being given unmanageable workloads, not being given vital information that affects performance, being humiliated over work, being ignored and being shouted at.
Of the 500 registered nurses who took part in the study, 20 per cent said they had been bullied in the past six months, while 43 per cent had witnessed bullying of colleagues.
The authors say that recent NHS staff surveys indicate a 'sharp increase' in bullying in recent years.
Bullying is linked to increased distress, higher rates of sickness absence and an increased intention to leave, while 'constraints on the freedom of communication at the group level suggest that patient care may suffer as a result', they note.
'Cultures in which bullying behaviours are not challenged can send a powerful message to staff that such behaviours are acceptable or even condoned,' said lead author Dr Madeline Carter of Durham University's school of medicine.
'Bullied individuals are often advised to approach their manager with issues related to bullying and harassment; but, if their manager is the perpetrator, then it is important for staff to have access to advice and assistance from outside their work group. If managers are the primary perpetrators of bullying, then interventions should be targeted at managers as a priority.'
Unison's head of health, Christina McAnea, said: 'Bullying is often a symptom of people under pressure, and NHS staff are currently under serious pressure. The top-down re-organisation of the NHS, the pressure on budgets and on staff means that a more stressed out culture has hit the NHS.'