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Sectoral and institutional context[s] are critical to understanding how workplace toxicity manifests and how it might best be addressed. The education sector, specifically higher education, is the focus of this study, drawing on qualitative data collected from Irish Higher Education Institutions [HEIs]. Underpinned by a multi-faceted conceptualisation of bullying, the study explores how it is experienced by university staff and how institutional or contextual factors impinge on that experience. The study employed a qualitative interpretive methodology involving one-to-one semi-structured interviews with self-selecting participants. Persons who currently work or have recently worked in higher education institutions were recruited into the study. A generic thematic approach resulted in five intersecting themes, converging on one overarching organising construct, i.e., bullying in higher education as a traumatic process. The data displayed relationality, institutionalisation and unethicality, which are underlying features of a multi-faceted conceptualisation of bullying. It was concluded that the processes and procedures in place to address bullying and provide redress do not appear to be sufficiently nuanced to accommodate the complex behaviours and power plays involved in bullying in Higher Education, assuming a rationality stripped of power dynamics, which risks aggravating the damage already inflicted by bullying. The findings suggest that the institutional response, or lack thereof, can sometimes be more traumatising than the bullying itself. Individual cases often reflect a wider organisational culture that tolerates bullying and victimisation. Institutional responses will need to tackle the entire HEI ecosystem, requiring and a more nuanced understanding of the power dynamics and organisational context.

Bullying remains a pervasive problem in healthcare, and evidence suggests systems in place are not utilised due to perceptions of ineffectiveness and inequity. This study examines bystander responses to bullying and factors that influence decisions to intervene. We explore relationships between bystanders' perceptions of psychological safety across three levels (organisation, supervisor and colleague) and reactions to witnessing bullying. We suggest psychological safety would be positively associated with the decision to intervene. Findings indicate the most pervasive reaction to witnessing incidents of bullying is to discuss with colleagues, a low-involvement reaction. We find perceptions of supervisory and organisational safety/support are positively related to high-involvement decisions such as formal reporting of the incidents, highlighting the importance of support from those in power. However, perceptions of collegial support may lead to low-involvement responses, which risk reinforcing and underpinning dysfunctional organisational dynamics by providing informal social and emotional responses that may substitute more formal organisational responses to this persistent problem. This study highlights the importance of support from individuals in power if bystanders are to feel comfortable making high-involvement interventions., (© 2017 John Wiley & Sons Ltd.)

Background: Research evidence suggests that a multidisciplinary team approach improves the outcomes of patients with breast cancer. However, limited attention has examined the extent to which the clinical nurse specialist's (CNS's) role can impact Irish patients' care, particularly given the novelty of this role in Ireland., Objective: The objective of this study was to examine the informational role of CNSs in supporting Irish patients during their breast cancer journey and the extent of its impact on their care., Methods: Three Irish breast cancer teams were investigated. A Picker questionnaire was administered to more than 100 patients per team who had completed treatment. Questions focused on the patients' journey from diagnosis through to treatment completion. Follow-up interviews with the teams' CNSs were conducted to achieve a deeper understanding of the care received., Results: While patients reported an overall positive impression of their care, they were least satisfied with the amount of information and emotional support they received during their chemotherapy. Clinical nurse specialists commented that there is insufficient staffing in medical oncology to address this need in part because the ill-defined job description makes it difficult to quantify the impact of this role., Conclusions: The informational role of the CNS is inadequately recognized and is thus not currently able to fully address patients' care needs., Implications for Practice: Clarification of the CNS's role description in oncology care in Ireland is needed as is sufficient CNS staffing to maintain the vital informational role of CNSs throughout the patients' breast cancer journey.