Exposure to hostile behaviors in nursing: a cross-sectional study in a Trauma Clinic in Barranquilla (Northern Colombia)

This study describes exposure to hostile behavior among nursing staff at a specialized orthopedics and trauma clinic in Barranquilla, Colombia. An observational, descriptive, and cross-sectional design was used to estimate the frequency and profile of hostile manifestations, using the Galián Muñoz et al. (2018) questionnaire as a basis and contextually adapted. The study involved 97 workers with direct care roles; 71.1% were women, 51.5% were aged 30–50 years, with a higher proportion of workers from the Emergency Department (27.8%), predominantly nursing professionals (53.6%), rotating shifts (41.2%), and permanent/indefinite contracts (84.5%). The instrument included a sociodemographic-occupational block and 14 ordinal items (0–5) on exposure to verbal/attitudinal hostility and low-intensity physical aggression. Anonymity and ethical standards were guaranteed in accordance with international and national standards. The scale showed high internal consistency (α = 0.89). The overall exposure index was 2.96 ± 0.64 (range 1.07–3.93), indicating intermediate and sustained exposure. The most frequent items corresponded to questioning clinical decisions, exaggerated attribution of responsibility, ironic jokes, and reproaches for delays or lack of information; to a lesser extent, pushing/shoving and material damage associated with anger were reported. The results confirm that incivility and verbal hostility constitute the core of exposure, with a transversal presence across services and greater pressure in high-demand settings. These findings support the need for multicomponent institutional strategies that integrate workflow redesign and anticipatory communication, de-escalation and conversational skills training, reporting channels with feedback, and post-incident support. Reducing everyday hostility toward nursing staff is a priority to protect staff well-being and strengthen patient safety.