Check Up: Survey of nurses finds ‘moderate’ verbal abuse

By Marie McCullough for

Anyone who has been in the work world for a while knows that now and then, tempers flare and civility suffers.

But what if you were subjected to nastiness – insults, yelling, cursing, condescension, humiliating jokes, the cold shoulder – on a constant basis?

Assessing the frequency and impact of verbal abuse in nurses’ workplaces was one of the aims of the RN Work Project, a 10-year, multistate study of registered nurses’ work life, funded by the Robert Wood Johnson Foundation in Princeton.

The study was launched in 2006 to better understand and avert nursing shortages, a periodic problem that reflects not only supply and demand, but also social, economic, and technological trends.

The somewhat good news: The project’s fourth survey, conducted in 2011, found that “high” levels of verbal abuse were not common. About five percent of nurses reported six to more than 20 incidents of abuse by doctors or other nurses in the preceding three months.

Not good news: About half the 1,300 nurses surveyed reported “moderate” verbal abuse from doctors and other nurses, defined as up to five incidents in the preceding three months.

The article analyzing nurses’ verbal abuse was published in April in the Journal of Nursing Scholarship, and the physician verbal-abuse article appears online this month in Nursing Outlook.

The researchers found, as expected, that the more the nurses felt abused, the lower their job satisfaction and the weaker their loyalty to their jobs and organizations.

Previously, the researchers found that 17 percent of newly licensed RNs changed jobs within a year, and more than half did so within 6.5 years.

“When working conditions are bad, you get more abuse, both nurse-to-nurse and physician-to-nurse,” said Carol S. Brewer, a professor at the University at Buffalo School of Nursing and a leader of the research project. “If there’s verbal abuse, there are probably bigger issues,” such as inadequate training and staffing, high turnover, mandatory overtime, and lax leadership.

For the last five years, the supply of U.S. nurses has met demand, partly because the 2008 recession tamped down the need, Brewer said.

But another shortage is predicted, because nearly half of the nation’s 3 million registered nurses are over age 50.

In the articles, the researchers concluded that hospitals and other employers “must actively work to remove incivility” by adopting preventive measures that have been proved to work. These include thorough orientation of new nurses, sensitivity training, counseling and referral programs, and “zero tolerance” policies that punish lapses regardless of accidental mistakes or extenuating circumstances.

“Leaders set the tone,” Brewer added. “A zero-tolerance policy has to come from leadership.”

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