 2003 AJN Table of Contents
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Health & Safety
American Journal of Nursing -
March, 2003 - Volume 103, Issue 3
Verbal Abuse in the Workplace
How to protect yourself and help solve the problem.
A few doctors at my facility verbally abuse the
nurses. As a result, some nurses suffer from stress-related illnesses and
find it difficult to come to work. How can we address this problem and
protect ourselves from more abuse?
Verbal abuse in the workplace must not be tolerated. Violence often
begins with verbal abuse and escalates to physical abuse. In surveys over
the past several years, nurses have said that patients, physicians, and
other health care workers yell, swear, intimidate, demean, publicly scold,
and sexually harass them. In addition, 82% to 90% of 1,000 nurses surveyed
in at least seven states included verbal abuse in their definition of
workplace violence.
Alan Rosenstein’s report on the
nurse–physician relationship (AJN, June 2002) indicated that daily interactions with
physicians strongly influenced nurses’ morale. Carol Farina, a Denver
psychiatric clinical specialist who has facilitated communication for
health care teams, states, “When nurses experience abusive treatment
by physicians and feel unsupported by administration . . . they are left
feeling powerless to respond appropriately. Staff members may harbor
resentments for being treated disrespectfully, which can manifest as any
one of a number of psychological symptoms, including anxiety and
depression, as well as somatic complaints such as GI symptoms and
headaches.”
Verbal abuse can lead to staff turnover. An analysis of
the first 1,200 responses from nurses, physicians, and hospital
administrators in the Rosenstein study indicated that all respondents
directly linked disruptive physician behavior and nurse satisfaction and
retention. Verbal abuse can also affect the quality of patient care.
Research since the 1980s has indicated that when collaboration between
nurses and physicians is promoted, patient care improves, often with fewer
costs.
What can you do? Try not to react emotionally to
arrogant, hostile, or condescending behavior. Remain courteous and
professional, and concentrate on the issue. One helpful question to ask is:
“If we were looking for a solution to this issue, what would we be
doing?”
Report the incident in writing as soon as possible to
your immediate supervisor. If the incident is not addressed satisfactorily,
consider filing a formal complaint with the peer review committee. In 2001
the ANA released its Bill of Rights for
Registered Nurses, which states: “Nurses
have the right to a work environment that is safe for themselves and their
patients.” Cite these rights when asking your
administrators to address the issue of verbal abuse. Ask them to offer
training in the management of aggressive behavior; institute a
conflict resolution program; and develop a disruptive conduct policy, which
should have a formalized peer review system and outline clear consequences
for unacceptable behavior. Consider eliminating “zero
tolerance,” which translates as arbitrary, unfair, and without the
opportunity for reasonable and careful decisions. Instead, consider posting
policies or “no violence” signs.
Nurses and physicians must be able to relate to each
other with respect and professionalism. To be part of the solution, nurses
must not excuse or tolerate abuse. Use these and other strategies to make
your workplace safer and healthier and to
enhance patient outcomes and professional
satisfaction.
Resources
See Issues Update on page 65 to learn how the ANA’s Commission on
Workplace Advocacy and nurses are addressing verbal abuse. To order the ANA
Bill of Rights for Registered Nurses poster and user guide, go to
www.nursesbooks.org or call
(800) 637-0323.
Vicki Carroll is a clinical instructor at the University of Northern Colorado School of Nursing, a consultant in the area of health care workplace violence, and a member of the Colorado Nurses Association and the ANA Commission on Workplace Advocacy.
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