Workplace violence

In Australia, health care settings have been identified as one of the most violent working environments. At some point in your career as a nurse, midwife or student you are very likely to witness or be involved in a violent or aggressive situation.

If you would like a hand dealing with workplace violence you can call our confidential support line 24/7 on 1800 667 877.
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Recognising workplace violence

Workplace violence refers to verbal, physical or psychological abuse, and/or threats of violence.

It includes spitting, biting, throwing objects, racial vilification, sexual harassment or any form of indecent physical conduct and can be perpetrated by patients, relatives, members of the public, and other employees.

When workplace violence occurs between team members it is referred to as horizontal violence or workplace bullying and harassment. 

Bullying and harassment

Workplace bullying is primarily psychological, and includes both perceived and/or actual psychological harm. It encompasses single and isolated events as well as repeated and persistent negative behaviours towards the employee being bullied.

Walrafen, Brewer, and Mulvenon (2012) found in their small study of 227 nurses in the USA that 77% of surveyed nurses reported that they had actively witnessed horizontal violence. The same study found that 53% of individuals felt that they had experienced bullying behaviours from co-workers.

The horizontal violence behaviours included:

  • nonverbal negative innuendo (such as raising eyebrows, face-making) 
  • covert or overt verbal affront (snide remarks, withholding information, abrupt responses) 
  • undermining clinical activities (not available to help, turning away when asked for help) 
  • sabotage (deliberately setting up a negative situation) 
  • bickering among peers 
  • scapegoating 
  • backstabbing 
  • failure to respect the privacy of others (gossiping/talking about others without their permission), or
  • broken commitments and/or broken confidences (repeating something that was meant to be kept confidential).

Internal workplace bullying and harassment is workplace violence. It is increasing and has potentially devastating physical, emotional and psychological health consequences for those exposed. 

Understanding your workplace

It is important that you read and are aware of your organisation's policy and procedures relating to workplace violence including bullying and harassment.

If you are being exposed to workplace violence it is essential that you seek support in a timely manner, regardless of whether you are directly involved or are on the edge of the violence.

What can I do next?

Why not read some of our other articles that relate to looking after your health:

Our service provides free and confidential support 24/7, to nurses, midwives and students Australia wide. If you would like to speak to someone call 1800 667 877, or you can request support via email.

If you would like to know a bit more about the service before getting in contact — take a look through accessing support.


Einarsen S, Hoel H, Zapf D & Cooper CL (2011) The concept of bullying and harrassment at work: the European tradition. In Bullying and Harrassment in the Workplace: Developments in Theory, Research and Practice (Einarsen S, Hoel H, Zapf D & Cooper CL eds). CRC Press, Boca Raton, FL, pp. 3–39.

Hesketh KL, Duncan SM, Estabrooks CA, Reimer MA, Giovannetti P, Hyndman K & Acorn S (2003) Workplace violence in Alberta and British Columbia hospitals. Health Policy 63, 311–321.

Hoel H & Cooper CL. (2000). Destructive conflict and bullying at work. Unpublished report, University of Manchester Institute of Science and Technology (UMIST).

Pich, J., Hazelton, M., Sundin, D., & Kable, A. (2010). Patient-related violence against emergency department nurses. Nursing & Health Sciences, 12(2).

Walrafen, N„ Brewer, M. K„ & Mulvenon, C. (2012). CNE series. Sadly, caught up in the moment: An exploration of horizontal violence. Nursing Economics$: The Journal for Health Care Leaders, 30(1), 6-12, 49.

Wells, J., & Bowers, L. (2002). How prevalent is violence towards nurses working in general hospitals in the UK? Journal of Advanced Nursing, 39(3), 230–240.


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