bullying and violence

Bullying and Violence in the Healthcare Industry

In 2019, over 20,000 American workers suffered trauma from workplace violence. Of these, 70% were employed in the healthcare and social assistance industries.

Then came the pandemic.

Like gasoline on a fire, COVID-19 sent stress levels skyrocketing among patients and clinicians alike. Continuing safety concerns have elevated violence in the healthcare workplace to a national issue — one that not all healthcare professionals may feel equipped to confront.

Dealing with verbal abuse from patients

For many healthcare professionals, violence or abuse from patients is an unfortunate reality. Just like physical PPE, it’s critical for nurses to be prepared with the skills necessary to protect themselves and their patients from violence.

In a dangerous situation, the first and most important thing is to maintain control of their own emotions and actions. In a tense or highly charged atmosphere, that might not be easy. Reacting in kind to verbal abuse or physical violence may feel instinctive, even natural, but it can lead quickly to worse outcomes, including potential termination and litigation.

So what can a nurse do?

When it comes to verbal abuse from patients, take time to check the source of their complaint. A patient frustrated that they’re not getting the attention they think they need may lash out. In cases like these, diplomacy is critical. Spend a minute or two communicating with the patient. Let them know the status of their care and assure them they are receiving the best possible care. Many people just want to know that their concerns are not falling on deaf ears as they stew in their own stress while waiting in a hospital bed.

Next steps

If the verbal abuse continues even after a nurse has communicated with the patient, it’s often best to fall back on the simplest strategy: ignore them. Many times, loud and irate individuals engage in abusive behavior in order to get a rise out of those nearby, so it’s possible that simply ignoring them might cause the problem to abate.

Critical in these cases, as in all cases, is documentation. Make sure to document everything that you can. Writing down what a patient complains about and how it was handled can help protect against internal issues and litigation.

Related: Violence in the Healthcare Workplace

Dealing with physical violence

When it comes to outright physical violence from patients, the hands-off approach is often the best: stay back and stay safe. Most hospitals employ staff that have training in specifically dealing with physically restraining patients.

If you do not have that kind of training, make sure to have one present if you ever feel like a patient could become physically combative. As always, make certain everything is documented to the best of your ability.

Bullying in the workplace

Before tackling patient-related violence, this somber fact bears repeating: bullying from coworkers is just as common. 60% of new nurses quit their first job within the first six months due to the behavior of their co-workers, while nearly 50% of nurses believe that they will experience bullying at some time in their careers.

When it comes to bullying, the first rule is to keep a cool head. As with verbal abuse from patients, it’s tempting in the moment to snap back at a bully, but doing so can and most likely will cause more problems. Responding to bullying in kind (especially violently) can easily be grounds for punitive action or termination.

On the other hand, maintaining composure in the midst of a heated situation gives the other party less ammunition against you. Another simple way to counteract bullying is to politely but firmly call it out when it occurs. Oftentimes, bullies will only continue their bullying behavior if they believe that the person they are targeting won’t fight back or stand up for themselves.

Related: Preventing Workplace Sexual Harassment for Healthcare Professionals

Keeping a paper trail

If confronting the bully doesn’t work, documenting the bullying as it occurs is a wise long-term strategy. Start a documentation trail. Keep a small notebook on hand and write down dates, times, witnesses, verbatim comments, and any behaviors you believe undermine a culture of safety and a professional work environment.

Keep growing this documentation trail until you are at the point where you can file a formal complaint. You can also inform the bully in question that their behavior is being documented for future use. This can serve as an effective deterrent, as the threat of punishment is oftentimes enough to dissuade this type of behavior.

If the bullying continues and you have been keeping up with your documentation of its occurrences, follow through with a formal complaint. Many people are reluctant to go through proper channels to resolve what they believe to be a personal issue, but remember: HR departments exist for a reason. There’s no point in willingly working in an unbearable environment when the solution might be a few floors away.

One final note. If the bullying behavior progresses to physical violence, move directly to filing a formal complaint. Dealing with nasty words is one thing, but no one should subject themselves to potential assault and injury from coworkers in any healthcare environment.


  1. https://www.researchgate.net/publication/278212176_Prevalence_and_Cost_of_Workplace_Violence_Experienced_by_Nurses_Employed_in_a_Community_Hospital_System
  2. https://www.beckershospitalreview.com/hr/5-thoughts-and-statistics-on-nurse-bullying.html