In a hospital, verbal abuse may be 'contagious'

Verbally abused nurses are more likely to leave their jobs, study finds

Topics: Employee Engagement, Workforce, Leadership, Recruitment and Retention, Nursing

August 22, 2013

About 50% of registered nurses (RNs) say they are verbally abused as often as five times a month—and most of that abuse comes from physicians, according to a new study in the journal Nursing Outlook.

The research was conducted as part of a multistate study of RN working environments—the RN Work Project—and funded by the Robert Wood Johnson Foundation. For the six-year study, University at Buffalo researchers surveyed more than 1,300 RNs, asking them to rate their level of verbal abuse at work based on how many verbally abusive incidents they experienced from doctors and other nurses in the preceding three months.

The study found that:

  • 5% of RNs experienced "high" levels of abuse (between six and 20 incidents per month);
  • 50% experienced "moderate" levels of abuse (between one and five incidents per month); and
  • 45% experienced no abuse.

The RNs who were most likely to experience verbal abuse were young, worked in hospitals, staffed the day shifts, and worked on units that were short-staffed.

"It also seems that verbal abuse is contagious. One potential explanation is that negative behavior exhibited by one member of a group spills over to other members of the group and hurts the group dynamic," says lead author Carol Brewer, adding, "We also see that in a stressful environment, including one in which there is physician to RN abuse, there is more likely to be RN to RN abuse, as well."

The researchers found that RNs reported experiencing "moderate" to "high" levels of abuse also reported lower intent to stay in their job, poor relationships with other staff members, poor teamwork, and more work-family conflicts than other RNs. Brewer notes that if "there's verbal abuse, there are probably bigger issues," such as inadequate staffing, mandatory overtime, and negligent leadership.

The researchers recommend that hospitals and other employers "actively work to remove incivility" by implementing preventive measures, including thorough orientation of new nurses, sensitivity training, counseling programs, and "zero tolerance" policies. "Leaders set the tone," Brewer said, adding, "A zero-tolerance policy has to come from leadership" (RWJF release, 8/6; McCullough, Philadelphia Inquirer, 8/20; UPI, 8/20).

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