Rude Colleagues Take a Measurable Toll on Nurses’ Health, Taiwanese Study Finds

Rudeness on the hospital ward is often dismissed as a minor friction of demanding work — a curt remark at the nurses’ station, a supervisor’s dismissive tone during a handover. A new study from Taiwan argues that this low-grade disrespect deserves to be treated as a genuine occupational health hazard. In a survey of 900 registered nurses at a large medical center in northern Taiwan, researchers found that nurses exposed to high levels of workplace incivility were markedly more likely to report poor mental health, high personal burnout, and poor self-rated physical health than colleagues who experienced little of it. Crucially, the association held after the authors statistically adjusted for the established psychosocial characteristics of nursing work — job control, psychological job demands, and workplace justice — suggesting that incivility is not merely a symptom of a high-pressure environment but a health risk with an effect of its own. The findings, published as an open-access research article in BMC Nursing, add a specific and modifiable target to the list of workplace conditions that shape whether nurses stay well or burn out.

The study was conducted between October and December 2022 at a single medical center in northern Taiwan. The researchers distributed a self-administered questionnaire to full-time registered nurses and received 900 valid responses, a response rate of 84.0 percent — unusually high for survey research among clinical staff, and one that strengthens the representativeness of the sample within the institution studied. The questionnaire covered a deliberately broad set of constructs. It measured workplace incivility separately for two sources, colleagues and supervisors, recognizing that rudeness from a peer and rudeness from a person with authority over one’s career may carry different weights. It also assessed personal burnout, mental health status, and self-rated health, alongside the psychosocial work characteristics that decades of occupational health research have identified as core stressors: how much control nurses have over their tasks, how demanding their psychological workload is, and how fairly they perceive themselves to be treated by the organization.

Workplace incivility occupies a specific niche in the taxonomy of occupational stress. It denotes low-intensity disrespectful behavior — rudeness, dismissiveness, condescension — that falls short of outright aggression or violence but accumulates into a corrosive ambient stressor. In nursing, where work is already organized around high psychological demands, time pressure, and emotional labor, the question is whether incivility does any harm that is not already accounted for by those better-studied factors. That gap motivated the study. As the authors note in their background, workplace incivility is increasingly recognized as a key occupational stressor in nursing, but few studies had explored its independent association with nurse health after adjustment for established psychosocial work characteristics. Without such adjustment, an observed link between rudeness and burnout could simply reflect that both are products of an under-staffed, high-demand ward. The Taiwanese team set out to isolate incivility’s own signal.

Methodologically, the researchers treated the data as a cross-sectional snapshot and analyzed it with standard tools. They used chi-square tests to examine raw associations between incivility exposure and each health outcome, and then multivariable logistic regression to model the odds of poor mental health, high personal burnout, and poor self-rated health while adjusting for demographic factors and the three psychosocial work characteristics. Logistic regression is well suited to this question because each outcome was dichotomized — for example, into high versus low burnout — and the model yields odds ratios with confidence intervals quantifying how much incivility raises the odds of each adverse outcome once other factors are held constant. The same models allowed the team to test, in parallel, whether job control, psychological job demands, and workplace justice showed their own independent associations with nurse health, a design that lets incivility be judged against the classic stressor framework rather than in isolation.

The raw differences between high- and low-incivility groups were substantial. Among nurses with high incivility exposure, 51.8 percent reported poor mental health, compared with 30.0 percent of those with low exposure — a gap of nearly 22 percentage points. High personal burnout was reported by 55.3 percent of the highly exposed group versus 40.1 percent of the low-exposure group. Poor self-rated health, a simple but well-validated global measure in which respondents judge their own health as poor rather than good, was reported by 20.4 percent of the high-incivility group against 11.9 percent of the low-incivility group. In every one of the three health outcomes the study examined, the more incivility nurses experienced, the worse their reported health. These are prevalence figures from a single institution, but their consistency across mental, psychological, and physical dimensions of health is the pattern that occupational health researchers look for when a stressor is plausibly doing broad harm.

The more consequential result is what survived the statistical adjustments. After accounting for psychosocial work characteristics and demographic factors, high workplace incivility remained significantly associated with poor mental health, high personal burnout, and poor self-rated health. In other words, the elevated risks were not explained away by the fact that rude workplaces also tend to be demanding or unjust ones; incivility carried predictive weight in its own right. The regression models also produced a second, independent finding: high psychological job demands were significantly associated with increased risks of personal burnout, poor mental health, and poor self-rated health. That parallel result matters for interpretation. It shows the models were capable of detecting the expected effects of the classic demand-side stressor, which lends credibility to the incivility estimates, and it confirms that in this workforce both the volume of psychological demand and the quality of everyday interpersonal treatment leave separate fingerprints on nurse health.

For the nursing profession, the implications cut against a long habit of normalizing incivility as an unfortunate by-product of stressful shifts. If rudeness from colleagues and supervisors predicts burnout and poor mental health even among nurses whose workload and organizational justice are otherwise comparable, then reducing incivility is not a soft cultural aspiration but a concrete health-and-safety intervention with a measurable expected payoff. The study’s impact statement frames it in exactly those terms: the findings highlight workplace incivility as a key occupational health problem in nursing, and strategies to address incivility and psychological job demands while promoting a healthier work environment may support nurses’ mental health and overall well-being. The authors position the work as guidance for nurse managers and policymakers developing organizational strategies to support workplace health and safety — a framing that shifts responsibility from individual nurses’ resilience to the conduct standards and climate that institutions enforce on the ward.

The study’s design also defines the boundaries of what can be concluded. As a cross-sectional survey, it captures one moment in time and cannot establish that incivility causes the poor health outcomes; it is possible, for instance, that nurses in poorer health perceive or report more incivility, or that unmeasured factors influence both. The sample comes from a single medical center in northern Taiwan surveyed in late 2022, and all measures were self-reported, so generalization to other health systems, cultures, and periods should be made with care. The published article reports the direction and statistical significance of the adjusted associations but the source material does not include the specific odds ratios or confidence intervals, so the magnitude of the independent effects cannot be quantified here. Within those limits, the study was conducted in accordance with the Declaration of Helsinki, approved by the Joint Institutional Review Board of Taipei Medical University under approval number N202209026, with the informed-consent requirement waived because the survey was anonymous, voluntary, and minimal-risk. The work received no external funding, and the authors declare no competing interests.

The article — authored by Chia-Hui Wang of Taipei Medical University, Yu-Hwei Tseng of National Cheng Kung University, Wan-Ju Cheng of the National Health Research Institutes and China Medical University Hospital, Fang-Chun Lee of Taipei City Hospital Songde Branch, and corresponding author Li-Chung Pien of National Cheng Kung University and Wan Fang Hospital — was received on 8 March 2026, accepted on 31 August 2026, and published on 2 September 2026 in BMC Nursing. Its arrival is timely. Health systems worldwide are wrestling with nursing shortages and attrition, and the evidence base increasingly points to workplace climate as a lever that administrators can actually pull. This study’s contribution is to show that the lever includes not only workload and fairness but the everyday civility of the people nurses work beside. Rudeness, the data suggest, is not the smallest of the hazards on a ward — it is one that shows up in nurses’ mental health, their burnout levels, and even how they rate their own physical health, and it persists as a risk factor even when the demands of the job are taken into account.

Subject of Research: Association of workplace incivility from colleagues and supervisors with burnout, mental health, and self-rated health among registered nurses in Taiwan

Article Title: Effect of workplace incivility on nurses’ health outcomes: a cross-sectional study

Article References: Wang, C.-H., Tseng, Y.-H., Cheng, W.-J., Lee, F.-C., & Pien, L.-C. (2026). Effect of workplace incivility on nurses’ health outcomes: a cross-sectional study. BMC Nursing. https://doi.org/10.1186/s12912-026-05330-3

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05330-3

Keywords: workplace incivility, nurses, burnout, mental health, self-rated health, occupational health, psychological job demands, workplace justice, job control, cross-sectional study, Taiwan, BMC Nursing