Stress and verbal abuse in nursing: do burned out nurses eat their young?

Department of Health Services, Saint Joseph's University, Philadelphia, PA 19131, USA.
Journal of Nursing Management (Impact Factor: 1.14). 06/2005; 13(3):242-8. DOI: 10.1111/j.1365-2834.2004.00533.x
Source: PubMed

ABSTRACT The purpose of this study was to explore the types and frequency of verbal abuse of nurses by other nurses. Further, this study explored the components, characteristics, consequences and effects of abuse in an effort to better understand the dynamics of verbal abuse of nurses in the workplace. Nurses who experience occupational burnout are more likely to abuse other nurses.
It is believed that nurses have been historically subjected to verbal abuse by colleagues, something previously considered to be done primarily by doctors. The effects and consequences of verbal abuse can be devastating and long-lasting. Research that has focused on its consequences has found that it is both physiologically and psychologically damaging.
Participants completed an adapted survey, incorporating the Verbal Abuse Scale and the Verbal Abuse Survey and demographic questions developed by the researchers. Specifically, types of verbal aggression, the frequency and stressfulness of each type, emotional reaction to verbal aggression, cognitive appraisal of verbally aggressive encounters, and similarity and effectiveness of coping behaviours were explored. The long-term negative effects of verbal aggression, including absenteeism and errors in patient treatment, were also evaluated to determine if verbal aggression is a contributing factor.
Respondents reported that the most frequent source of abuse was nurses (27%), followed by patients' families (25%), doctors (22%), patients (17%), residents (4%), other (3%) and interns (2%). Of those who selected a nurse as the most frequent source, staff nurses were reported to be the most frequent nursing source (80%) followed by nurse managers (20%).
Verbal abuse in nursing is quite costly to the individual nurses, the hospitals and the patients. Nurses who regularly experience verbal abuse may be more stressed, may feel less satisfied with their jobs, may miss more work and may provide a substandard quality of care to patients.

1 Bookmark
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Verbal abuse is a most common form of workplace violence in the operating room settings. It affects operating room nurses personally and professionally. Such effects have a major implication for nursing profession in term of retention, satisfaction, and quality of care. So, the occurrence of verbal abuse depends on a great extent of coping behaviors among nurses working in the operating room environment. Thus this study aimed to determine the relationship between verbal abuse and coping behaviors directed at operating room nursing staff at university hospitals. This study was conducted in all operating room (n = 65) in five major governmental hospitals affiliated to University hospitals, Egypt. The subjects consisted of 206 operating room nursing staff categorized into operating room head nurses (n=16) and operating room nurses (n=190) working in the above mentioned settings. The participants completed a questionnaire includes the verbal abuse scale (VAS) , this questionnaire consisted of a five section related to frequency and stressfulness of incidence of verbal abuse , strength of feeling, similarity of thought, severity of long term negative effects, and coping behaviors. The finding of this study shows that 40% of operating room nursing staff reported that they had been abused by surgeons followed by another nurses 27.7%. The average number of reported incidents during the year was at least once a month or less episodes of verbal abuse. Judging and criticizing, abusive anger as well as blocking and diversity were the most frequent and stressful forms of verbal abuse. The most severe, long term effect of verbal abuse was reported to be its impacts on the physical health, relationship with other nurses as well as patient care outcomes. Threatened was the most intense of emotional reactions, indifferent and frustration. In addition the operating room nursing staff identified with a variety of adaptive and maladaptive coping behaviors and rated the similarity and effectiveness of these coping behaviors in responses to verbally abusive episodes. Conclusion, the need of nursing administrators for empowering operating room nurses to develop the formal protocols for adequately supported dealing with and prevent incidence of verbal abuse from surgeons against them. Also, training of nursing personnel is an essential element of effective verbal abuse prevention program.
  • Source
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Pre-hospital emergency care is a particularly vulnerable setting for workplace violence. However, there is no literature available to date on the psychological consequences of violence in pre-hospital emergency care. Objectives: To evaluate the psychological consequences of exposure to workplace violence from patients and those accompanying them in pre-hospital emergency care. Design: A retrospective cross-sectional study. Setting: 70 pre-hospital emergency care services located in Madrid region. Participants: A randomized sample of 441 health care workers (135 physicians, 127 nurses and 179 emergency care assistants). Methods: Data were collected from February to May 2012. The survey was divided into four sections: demographic/professional information, level of burnout determined by Maslach Burnout Inventory (MBI), mental health status using General Health Question- naire (GHQ-28) and frequency and type of violent behaviour experienced by staff members. Results: The health care professionals who had been exposed to physical and verbal violence presented a significantly higher percentage of anxiety, emotional exhaustion, depersonalization and burnout syndrome compared with those who had not been subjected to any aggression. Frequency of verbal violence (more than five times) was related to emotional exhaustion and depersonalization. Conclusion: Type of violence (i.e. physical aggression) is especially related to high anxiety levels and frequency of verbal aggression is associated with burnout (emotional exhaustion and depersonalization). Psychological counselling should be made available to professional staff who have been subjected to physical aggression or frequent verbal violence.
    International Journal of Nursing Studies 06/2014; · 2.25 Impact Factor