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  1. Ainsworth, Laura BSN, RN
  2. Vela, Christina BSN, RN

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Stop verbal abuse and lateral violence

I read with great interest the article "Responding to Verbal Abuse" (November, 2012).* I've been an ED nurse for 29 years and have encountered verbal abuse from patients, family members, physicians, and peers. During most of my career in the ED, I was left alone to handle the abusive situations and was given no education on how to recognize, diffuse, or handle them. The high levels of abuse frequently experienced by the ED staff brought on morale problems, including decreased personal and job-related satisfaction and staff retention, which are issues described in studies about abuse.1

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When The Joint Commission addressed this issue as related to healthy work environments, I was elated. I also felt disappointed that it took extreme measures for managers and leaders to agree that abusive behaviors weren't acceptable in the workplace. It's my wish that nursing leaders and managers will continue on this trend and be proactive in recognizing and addressing human relationship issues that affect the morale and job satisfaction of nursing staff.


Thank you for addressing this issue. The nurses of today and tomorrow deserve to practice in safe and healthy work environments.



1. Valente S, Fisher D. Violence in the workplace. JOCEPS The Journal Of Chi Eta Phi Sorority. 2011;55(1):24-27.http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=5f9037df-8d2c-4991-8d7d-4. [Context Link]


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I was very pleased to read "Responding to Verbal Abuse."* This is such a prevalent problem in healthcare, yet it's rarely discussed. Working as a charge nurse on a busy medical floor, I see examples of verbal abuse far too often, and many times it doesn't come from our patients but from fellow healthcare workers. While I greatly appreciate your take on applying the "Cool off with ICE TEA" acronym, I've found literature that suggests another effective approach to verbal abuse and lateral violence: carefronting. This concept originates from a biblical viewpoint that utilizes the concepts of respect, forgiveness, and courage to confront hostility in the workplace-in other words, "caring enough to confront the person and situation in a responsible manner."1


In our profession, abusive behavior too often originates with our own colleagues. Verbal abuse is something that's very overt and obvious, but lateral violence, defined as "an act of aggression that is perpetrated by one nurse against another," can be more subtle.1 Nurses are the key to stopping verbal abuse and lateral violence. As a profession, we must take a stand.



1. Sheridan-Leos N. Understanding lateral violence in nursing. Clin J Oncol Nurs. 2008;12(3):399-403. [Context Link]




Stephenville, Tex




San Antonio, Tex.


* Individual subscribers can access articles free online at http://www.nursing2013.com. [Context Link]