The purpose of this study was to explore the nature of verbal abuse as it affects hospital staff nurses and supervisors, including its influence on the intent of these nurses to leave the organization. This study was designed to: determine verbal abuse incidence and the relative aversiveness of verbal abuse based on category of abuser; describe differences in verbal abuse aversiveness among nurses in a variety of clinical practice areas; and, determine nurses' psychological responses to verbal abuse. The conceptual framework for examining this issue was drawn from the literature on anger and social alienation.

This study was conducted in two phases; the first phase involved administration of The Verbal Abuse Self Report to 99 graduate nursing students. In the second phase, data were collected from The Verbal Abuse Survey which was mailed to the population of 1,347 staff nurses and nurse supervisors.

Verbal abuse was found to be prevalent in the work place, with 97% of Study Phase I subjects and 89.3% of nursing staff and 91.5% of supervisory nurses in Study Phase II reporting they had experienced verbal abuse in their work experience as a nurse.

Five categories were identified as sources of verbal abuse, including physicians, patients, family and visitors, supervisors, and peers. The patient was the most frequently reported category of abuser. Patients' families and physicians were second and third in incidence of verbal abuse for staff nurses, whereas physicians were second and patients' families were third in order of frequency for nurse supervisors.

Exposure to verbal abuse was reported to have a negative psychological response by nurses in Study Phase II. Staff and supervisors most frequently reported feelings of anger, powerlessness, hostility, embarrassment, harassment, confusion, and fear, in response to verbal abuse exposure. Respondents reported that experience with verbal abuse decreased their morale and negatively impacted on the quality of the patient care they delivered, which included a higher incidence in error rate for a select number of staff (9%) and supervisors (7%).

A relationship was found between the relative aversiveness of verbal abuse and staff nurses' and nurse supervisors' stated intent to leave the organization. (Abstract shortened with permission of author.).