Attitudes toward patient aggression amongst mental health nurses in the ‘zero tolerance’ era: associations with burnout and length of experience

UK government policy now officially encourages an attitude of 'zero tolerance' towards aggression against health care staff. This study examines levels of such tolerance amongst a group of mental health care staff and associations between tolerance and other occupational and stress factors. Thirty-seven staff completed a Tolerance Scale (from the Perceptions of Aggression Scale) and the Maslach Burnout Inventory. Tolerance for aggression was higher amongst more experienced staff (P < 0.01) and high tolerance was associated with low emotional exhaustion, low depersonalization and high personal accomplishment (P < 0.01). Some staff endorse positive statements about patient aggression and a tolerant attitude may be linked to low burnout. Nurse attitudes to patient aggression therefore are complex and do not necessarily equate with an approach of 'zero tolerance'.