There is an article published by Journal of Advanced Nursing, titled Mosaic of verbal abuse experienced by nurses in their everyday work that should be read by every nurse that has tolerated demeaning or verbally abusive behaviour whilst on duty, and also by every member of the public who has had a nurse care for them.
This was an observational study conducted over 1150 hours at inpatient and emergency department wards in a large acute metropolitan teaching hospital on the outskirts of a major Australian city.
It found an everyday, sustained ‘mosaic’ of non-verbal threatening behaviours, verbal insults, threats and physical assaults.
This mosaic was classified into 3 categories:
- Verbal abuse that was largely sexual.
- Ridicule and unreasonable demands
- Hostility, threats and menacing language.
Patients and less commonly their family and friends were observed to make sexualized insults, judgements, threats, or suggestions that targeted nurses through sexualized demeaning language. The sexualized taunts and insults conveyed stereotypical gendered assumptions about nursing and nurses. The sexualized and strongly pejorative language included descriptions of nurses as ‘c*nts’, ‘-’, ‘bitches’, ‘whores’, and ‘sluts’. The insults were made in public spaces in front of others. By labelling their femininity as deviant, these insults explicitly debased the character of a particular nurse by drawing attention to their supposed sexual worth. The following interaction was observed to occur in a busy waiting room; the outburst was triggered when a nurse did not bring ice quickly enough when requested.
Patients Friend (said about the nurses): ‘All these f*cking lazy c*nts, we pay taxes for this! She’s a f*cking whore’ (directed at the individual nurse).
Demeaning insults included openly questioning whether ‘they (nurses) know how to do their jobs’ and debasing the character and competence of nurses was observed to occur through such accusations as: ‘You’re lying, you’re falsifying’, and ‘You are animals’, ‘You bastards… this is a joke’. Associated with these insults were attacks on services provided with remarks that they were ‘disgraceful’ and swearing and cursing that was directed at the actions of nurses through comments such as ‘bullshit’ and ‘for God’s sake get it right’. Patients and their visitors demanded nurses act more quickly, fetch the doctor ‘I need the bloody doctor’, or bring food when demanded ‘NOW’. Demands that followed gendered and sexualized attacks had an implied overtone of slovenliness: ‘Hurry up, there’s people waiting here, not only me, everybody else. F*cking hurry up’.
Hostility & threats:
By sustaining the hostile dynamic, these behaviours served to provide further opportunities for an escalation or continuation of the violence. Threats of complaint or legal action followed several incidents of verbal abuse and demand. In one incident, a family member complained: ‘Your hospital is going to be all over the media’ while she filmed staff on her camera phone. Threats of harm were observed to be directed occasionally at other treating staff (ambulance officer and doctor), but were most commonly aimed at nurses, either as a group or individually. The threats included several different types of violence: killing, shooting, blowing up, punching, and stabbing with a needle.
I have provided some short excerpts from this article but it is well worth trying to get hold of the entire study which is far more explicit.
It is interesting to note your own reactions when reading these accounts.
I cannot think of many other environments where this would be tolerated (could you imagine walking into a bank and telling the fucking bitch tellers to get your money out before you fucking job them? Yeah…good luck with that), yet often we consider the correct ‘professional’ response is to absorb or let the comments roll off our backs so we can get on with care delivery. Even when there are direct threats being made.
So. I would be interested in anyone who would like to recount their own experiences with verbal abuse whilst on duty.
What did you feel?
How did you respond?
What acute support were you given from your colleagues and from your hospital?