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Study measures impact of verbal abuse on new RNs

Tuesday June 18, 2013
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Nurses who are verbally abused by nursing colleagues report lower job satisfaction, unfavorable perceptions of their work environment and greater intent to leave their job, according to a study of newly licensed RNs.

Researchers with the RN Work Project, a program of the Robert Wood Johnson Foundation, surveyed 1,407 newly licensed RNs about how often they were verbally abused by nurse colleagues: never (designated as a low level of abuse); one to five times in the last three months (moderate); or more than five times in the last three months (high).

They found that 49% of respondents had experienced some verbal abuse, although only 5% had experienced abuse more than five times in the past three months. Being spoken to in a condescending manner and being ignored were the most frequently reported types of abuse in the study, which is scheduled for publication in the Journal of Nursing Scholarship.

RNs working in Magnet hospitals and those working in ICUs were the least likely to report high levels of verbal abuse.

"The verbal abuse we found to be most common is best characterized as passive-aggressive," Wendy Budin, RN-BC, PhD, FAAN, a study investigator and adjunct professor at the New York University College of Nursing, said in a news release. "Rather than yelling, swearing, insulting or humiliating behavior, most early career RNs report that the abuse they experienced involved condescension or lack of acknowledgement.

"This kind of subtle abuse is less likely to be reported and more likely to be overlooked as a problem, which makes it all the more insidious and all the more important that hospital administrators work to confront and prevent it."

RNs working day shifts experienced higher levels of verbal abuse than those working evening and weekend shifts. RNs working eight-hour shifts were less likely to experience abuse than RNs working 12-hour shifts. Staffing shortfalls also were correlated with higher levels of abuse.

Intent to leave a job was highly correlated with the levels of abuse new RNs experienced, according to the study. RNs who reported no verbal abuse were least likely to plan to leave in the next three years. Those who experienced moderate to high levels of abuse were most likely to say they intended to leave their positions in the next 12 months, but also indicated they planned to stay in nursing.

"If hospital and health systems want to retain these new nurses, they need to make changes that will end this kind of abuse," Carol Brewer, RN, PhD, FAAN, professor at the University of Buffalo School of Nursing and a co-director of the RN Work Project, said in the news release.

The researchers noted a need for evidence-based strategies, including structured interventions, to decrease and eliminate verbal abuse and to help new nurses cope with abuse. They suggest therapeutic communication, assertiveness training and conflict management strategies may help new nurses cope with perceived abuse. They recommend zero-tolerance policies and mandatory hospital-wide programs for all employees about the impact of verbal abuse and other disruptive behaviors.

Read the study abstract: http://onlinelibrary.wiley.com/doi/10.1111/jnu.12033/abstract.

Learn more about the RN Work Project, a 10-year study of newly licensed RNs that began in 2006: http://rnworkproject.org.


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