Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Ann M. Mayo, DNSc, RN, FAAN, Chairperson; Eileen K. Fry-Bowers, PhD, JD, RN, CPNP-PC, FAAN, Committee Member; Vicky Bowden, DNSc, RN, Committee Member; Razel Milo, PhD, DNP, FNP-C, APRN, Committee Member


pediatric nurse, psychological safety, verbal abuse, violence prevention climate, workplace violence


Purpose: The purpose of this study was to describe the relationships among demographic characteristics, verbal abuse, violence prevention climate, and team psychological safety.

Specific Aims: Specific aims were to describe: (1) demographic characteristics, verbal abuse, violence prevention climate, and the perception of team psychological safety by pediatric nurses; (2) relationships among select demographic characteristics, verbal abuse, violence prevention climate, and team psychological safety; and (3) the variance in team psychological safety accounted for by select demographic characteristics, verbal abuse, and violence prevention climate.

Background: Psychological safety is a key element for nursing practice and healthcare teams. Patient and employee safety is a fundamental tenant in the healthcare industry. Unfortunately, violent acts towards healthcare professionals are 16 times higher than other industries. Verbal aggression has been increasing and pediatric nurses are particularly vulnerable to verbal abuse.

Methods: A non-experimental study with a descriptive, correlational design was used to conduct this study. The sample size was 528 pediatric nursing professionals. Data were collected via email. Three instruments (Team Psychological Safety Survey, Verbal Abuse Questionnaire, Violence Prevention Climate 12) were used along with additional demographic questions and one COVID-19 related question.

Results: All respondents reported receiving one or more types of verbal threats within the past three months. The most frequent perpetrators of verbal abuse in this study were parents/visitors (75.9%.) Most participants (63.1%) reported they had never officially reported any acts of verbal abuse. Although the multiple linear regression model was not significant, six of the predictor variables (VPC-12-B, being sworn at, receiving indirect threat, doctor as perpetrator, co-worker as perpetrator) from the model were individually significant and associated with perceived psychological safety of pediatric nurses.

Implications: More research in this area is recommended. The findings of this study confirm verbal abuse and verbal threats are prominent problems in nursing practice whether nurses decide to report them or not. Interventions to mitigate the negative impact of abuse on a pediatric nurse’s personal and professional well-being are needed to prevent further stress, burnout, and loss of nurses in the profession.

Document Type

Dissertation: Open Access



Available for download on Sunday, November 30, 2025