High levels of verbal abuse by physicians are closely associated with more negative work environments for newly licensed RNs, according to a recent study.
Nurses who experienced high or moderate levels of abuse by physicians had less favorable perceptions of their work environments, lower intent to stay in their jobs and lower commitment to their organizations, according to the study by the RN Work Project, a program of the Robert Wood Johnson Foundation.
A high level of verbal abuse was defined as more than five such incidents in the last three months, while a moderate level meant at least one incident in the last three months. Those who experienced the most frequent abuse also perceived poor collegial relations between RNs and physicians, poor workgroup cohesion and more work-family conflict. Higher levels of verbal abuse from physicians also were correlated with more verbal abuse among nurse colleagues.
Another recent study by the RN Work Project found that newly licensed RNs who were verbally abused by nursing colleagues reported lower job satisfaction, unfavorable perceptions of their work environment and greater intent to leave their current jobs.
For the study, published on the website of the journal Nursing Outlook, researchers surveyed 1,328 newly licensed RNs about how often they were verbally abused by physicians and the nature of the abuse. They found that RNs who were the most likely to experience verbal abuse by physicians were younger, working in hospital settings, working day shifts and working on units that were short-staffed.
“One of the most striking findings is that higher levels of verbal abuse by physicians are correlated with poorer perceptions of the work environment across the board,” Carol Brewer, RN, PhD, FAAN, a study investigator and professor at the University of Buffalo School of Nursing, said in a news release.
“It also seems that verbal abuse is contagious. One potential explanation is that negative behavior exhibited by one member of a group spills over to other members of the group and hurts the group dynamic.
“We also see that in a stressful environment, including one in which there is physician-to-RN abuse, there is more likely to be RN-to-RN abuse as well.”
Similar to the findings regarding abuse by other RNs, this study revealed that working in Magnet hospitals was associated with lower levels of verbal abuse by physicians.
“Physicians’ verbal abuse of nurses is a longstanding problem and one we need to do much more to address,” study investigator Christine T. Kovner, RN, PhD, FAAN, professor at the New York University College of Nursing, said in the news release. “It hurts morale, breeds further verbal abuse and is associated with nurse intention to leave, particularly among younger nurses.
“All of these things ultimately reduce the quality of patient care. Healthcare organizations need to do much more to create positive, healthy work environments.”
The researchers noted a variety of methods have been proposed to prevent verbal abuse, but suggest those methods must be part of a holistic approach to improving the work environment because targeting only verbal abuse is insufficient. They also said any policies put in place should be developed in cooperation with nursing leaders, key physicians and administrators.
Other investigators for the study were Rana Obeidat, RN, PhD, Faculty of Nursing, Zarqua University, Jordan; and Wendy Budin, RN-BC, PhD, FAAN, adjunct professor, College of Nursing, New York University.