By Gary Evans, Medical Writer

How bad is the level of violence in healthcare? A shocking one-quarter of new nurses report being physically assaulted and 70% report experiencing verbal abuse.

“These are nurses who are just out of school so they cannot have practiced anywhere longer than 2.5 years at the time of our survey,” says Lynn Unruh, PhD, RN, LHRM, a professor at the University of Central Florida in Orlando.

‘Disturbing’ Results

Unruh and colleagues surveyed newly licensed registered nurses (NLRNs), selected from the Florida Board of Nursing data, to study any links between the work environment and workplace violence and injuries.1 Almost half of the 414 nurses who responded worked in community nonteaching hospitals.

Nearly all worked an average of 38 hours per week in 12-hour shifts, and 62% worked day shifts Many participants cared for an average of five patients in recent shifts, the researchers reported.

These reports of verbal abuse may reflect the fact that the nurses are new to the field and unaccustomed to the stressful work culture.

“A lot of times new nurses are not necessarily treated with the gentleness that they might perceive they need,” Unruh says. “Their preceptor or doctors might be a little brusque with them and they may interpret that as verbal abuse—and it very well may be.”

The survey did not ask the source of the verbal abuse, meaning it could be patients, patient families, and co-workers.

“We need to be much more sensitive to new nurses and training new nurses than we have been,” she says.

The majority of violence in healthcare typically is patient to healthcare worker, but the survey did not specifically determine the source of the violence reported by 25% of the nurses.

“That is pretty disturbing,” Unruh says. “The physical violence is most likely from patients or family members because it is much less likely a colleague would be physically abusive.”

In any case, the finding that 25% of new nurses report violence within the first few years on the job is disconcerting.

“I worked as a nurse for many years and I experienced this to some degree, but it was actually much later in my career,” she says. “I don’t recall ever having any ... violence problems when I was a new nurse. Over the accumulation of a number of years I had some incidents, but 25% is high.”

Most of the other findings in the study generally correlate with past nursing studies, although there were some outliers.

“What is new about these findings is the discovery of the extent to which injuries and violence are part of NLRNs’ workplaces,” the researchers reported. “These are problems likely to create dissatisfaction with work and the profession, and could lead to leaving one or both. Given the need to better retain NLRNs in their jobs and in the profession, these issues must be addressed.”


1. Unruh L, Asi Y. Determinants of Workplace Injuries and Violence Among Newly Licensed RNs. Workplace Health Saf 2018;1: doi:10.1177/2165079918756909.