A survey by the Joint Commission on Accreditation of Healthcare Organizations found more than 50 percent of nurses had been bullied at work and more than 90 percent said they had witnessed abusive behavior. Most verbal abuse to nurses is instigated by physicians, yet abuse from fellow nurses is the second most common type.

Study author Dianne Felblinger, an associate professor at the University of Cincinnati in Columbus, said that most verbal abuse to nurses is instigated by physicians, yet abuse from fellow nurses is the second most common type.

Felblinger said bullying causes severe emotional distress that hinders nurses' ability to do their job, and some nurses are so traumatized by the behavior they abandon their careers.

Many nurses develop serious health problems and may suffer from anxiety, depression, or insomnia. Other may direct their anger toward co-workers or patients. About 75 percent of healthcare workers believe disruptive behavior reduces patient satisfaction and care, the study said.

The study is published in the Journal of Obstetric, Gynecologic, & Neonatal Nursing.