Distinguished scholar Sally S. Cohen shares her insights.

As the 2014-2015 Distinguished Nurse Scholar-in-Residence at the Institute of Medicine (IOM) of the National Academies (now the National Academy of Medicine), Sally S. Cohen, PhD, RN, FAAN, focused on childhood bullying prevention and policy. (The scholarship is supported by the American Academy of Nursing, American Nurses Association [ANA], and American Nurses Foundation.) Cohen, who is an ANA-NY member, is a clinical professor at the New York University Rory Meyers College of Nursing.

What makes childhood bullying such a complicated problem to solve?

Solutions to bullying involve a complex interaction of many factors. Each child responds differently to bullying due to variations in genetic characteristics, individual temperament, resilience, and social support. Home environments and community factors also are important. Schools and educational institutions have been the focus of most bullying-prevention policies, but differences in how local education agencies and school personnel handle bullying can affect outcomes of bullying incidents.

How can nurses identify the effects of childhood bullying and what can they do to help prevent it?

Nurses first need to know what bullying is. The Centers for Disease Control and Prevention developed a uniform definition of bullying, which is important to have on hand.

Children who are bullied might not show any signs of bullying, but some possible warning signs include unexplained injuries, changes in eating or sleeping habits, frequent reports of feeling sick or feigning illness, a decrease in friends, reluctance to engage with peers or attend school, and loss of or damage to personal possessions. Nurses might inquire about behaviors that can, under some circumstances, be called bullying, such as pushing, shoving, and name calling. Nurses also can observe for signs of depression and poor self-esteem, which often accompany bullying, and be aware that children with certain chronic conditions or behavioral disabilities who might appear or behave differently than their peers are at high risk for being bullied.

Nurses also should be on the lookout for signs of a child who might bully others. Possible warning signs are increasing aggressiveness, engaging in physical or verbal fights, repeatedly being sent to the principal’s office or to detention, and having friends who bully.

Encourage children who are concerned about bullying to talk to an adult. A school nurse can be one of the most important resources, but not every school or district has a nurse on site. In that case, encourage students to talk to their teachers or guidance counselors. The Health and Human Services bullying prevention website is regularly updated and has many resources.

Bullying affects everyone in a family, so nurses who care for parents with school-age children or grandchildren can ask if they suspect bullying.

Our culture—especially as it exists on the internet and social media—seems to encourage bullying. How can nurses make a difference?

Nurses can make a difference by role modeling kind and humane behavior for children and adults. We also can engage children and adults in discussions about the potentially harmful effects of the internet and social media and gently probe about screen time. Encourage young people to engage in activities that will keep them healthy. Refer children, adults, and colleagues to the stopbullying.gov website.

How can public policy help address the issue?

No federal bullying prevention law exists. Education and public health, the two main policy areas that address bullying, are primarily state issues. Working with state and local education and public health policy stakeholders is the best way to address bullying among children and youth.

What else would you like nurses to know?

Nurses should think about how our experiences with bullying as children could affect our responses to bullying as adults. Bullying is a public health, community, and societal issue. Until we all participate in preventing it, children are at risk for its potentially harmful effects.