Stress and verbal abuse in nursing: Do burn out nurses eat their young?

Department of Health Services, Saint Joseph's University, Philadelphia, PA 19131, USA.
Journal of Nursing Management (Impact Factor: 1.5). 06/2005; 13(3):242-8. DOI: 10.1111/j.1365-2834.2004.00533.x
Source: PubMed


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.

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    • "Studies have reported that poor interactions , withholding support, lack of coordination, tension and intimidation are prevalent among nurses [5] [16]. This perceived hostility among nurses is largely due to more experienced nurses being thought of as ''bitchy and cliquey " , since most of the more inexperienced nurses have reported being verbally abused by the superior nurses [17] [18]. The conflicts among nurses may also result from organizational constraints, leadership style, inadequate interpersonal relationships and violence among social equals who consider themselves powerless [5,17e19]. "
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    • "Such strategies are attributed to positive emotional health and consequently workplace stress and pressure can be mitigated (Akerjordet & Severinsson, 2007; Billeter-Koponen & Freden, 2005; Georges, 2011; Glass, 2009). Furthermore, by utilising a 'professional face' nurses are afforded emotional self-protection in difficult and complex interactions (Janlöv, Hallberg, & Petersson, 2011; Rowe & Sherlock, 2005; Savage, 2004; Severinsson, 2003). Most notably, an indicator of a professional face is a physical demonstration of a socially and professionally accepted level of emotion during nurse—patient interactions and therefore, one that conceals emotional depth. "
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    ABSTRACT: Introduction: While interpersonal styles of nurse-patient communication have become more relaxed in recent years, nurses remain challenged in emotional engagement with patients and other health professionals. In order to preserve a professional distance in patient care delivery however slight, nurses need to be able to regulate their emotions. Aim: This research aimed to investigate nurses’ perceptions of emotional protection and regulation in patient care delivery. Methods: A qualitative approach was used for the study utilising in-depth semi-structured interviews and researcher reflective journalling. Participants were drawn from rural New South Wales. Following institutional ethics approval 5 nurses were interviewed and reflective journalling commenced. The interviews and the reflective journal were transcribed verbatim. Results: The results revealed that nurses’ emotional regulation demonstrated by a ‘professional face’ was an important strategy to enable delivery of quality care even though it resulted in emotional containment. Such regulation was a protective mechanism employed to look after self and was critical in situations of emotional dissonance. The results also found that nurses experience emotional dissonance in situations where they have unresolved personal emotional issues and the latter was a individual motivator to manage emotions in the workplace. Conclusion: Emotions play a pivotal role within nurse-patient relationships. The professional face can be recognised as contributing to emotional health and therefore maintaining the emotional health of nurses in practice. This study foregrounds the importance of regulating emotions and nurturing nurses’ emotional health in contemporary practice.
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    • "An Australian study showed much higher frequencies of aggressive behaviour towards nurses with 71% from physicians and 61% from nursing colleagues (n=380) (Deans, 2004a). One study reported similar frequencies of aggressive behaviour from physicians (74%) and other nurses (75%) towards clinical colleagues (Rowe and Sherlock, 2005). Interestingly, there are no significant differences between male and female nurses regarding frequency and severity related to collegial aggression (Oweis and Mousa Diabat, 2005). "
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