Table 2.

Suggested strategies by domain and level of Social-Ecological Model

Domain	Individual level	Relationship level	Organizational level
Preventing Future Bullying Behavior	Taking a communication class Expressing confidence in my skills Adopting an open-minded attitude	Helping coworkers Ask others for help Interrupt bullying incident and give each nurse a chance to speak Remind others about need for professional, respectful exchanges Talk with staff nurses about stressors and attitudes Address nurses known for bullying behaviors Addressing bully after event Confront the bully Communicate how behavior makes one uncomfortable Speak directly to the aggressor instead of going to HR	Fostering positive, team-oriented work environment Team-focused work environment Supportive culture Increase presence on unit Using resources to prevent workplace bullying behavior Orient preceptors to new nurses’ abilities Mentorship programs Education on effective and professional communication Zero tolerance policy for bullying behaviors Investigate the issue Better staffing
Stopping Incidents of Bullying Behavior	Understanding with clarity the scope of practice and job description	Discussing incident and/or seek support from peers/manager Using de-escalation strategies Try to get on same page Adopt appropriate tone of voice Remind aggressor that you are still learning Try to defuse situation Upstanding activities Step in and mediate incident Encourage aggressor to understand others’ perspective Responding with aggression Talk over aggressor to redirect conversation Call out bullying behaviors as unacceptable	Re-establishing equilibrium Keep bully away from others Change in patient assignment Remove or fire bully from unit Engaging the system Report the aggressor and incident using workplace system Involve Human Resources and Management Investigate bullying behavior incident
Promoting Others to Act	None	Fostering relationships in the workplace Get to know coworkers better so you can identify when they are escalating Understand the role of other professions Better communication between professions	Creating a safe work culture Safe culture for confronting WPB Create policy about workplace behavior Supportive and respectful work environment Reporting will lead to change Have outlets for work stress Preventing bullying behaviors through administrative support and resources Increased staffing Have another level of command between management and staff Reporting system for bullying behaviors