title: Stress and verbal abuse in nursing: do burned out nurses eat their young?
abstract: OBJECTIVE
  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.
  
  
  BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Health Services, Saint Joseph's University, Philadelphia, PA 19131, USA. mrowe@sju.edu
authors.forename: M Michelle
authors.initials: MM
authors.lastname: Rowe
authors.forename: Holly
authors.initials: H
authors.lastname: Sherlock
mesh_terms: D000041:Absenteeism; D000223:Adaptation, Psychological; D000374:Aggression / Q000523:psychology; D000786:Anger; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology*; D003142:Communication; D005260:Female; D006784:Hospitals, Teaching; D006791:Hostility; D006801:Humans; D007400:Interprofessional Relations; D007588:Job Satisfaction; D008297:Male; D009013:Morale; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology*; D015143:Philadelphia; D011787:Quality of Health Care; D012649:Self Concept; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D014705:Verbal Behavior; D017132:Workplace / Q000523:psychology