Date of Graduation


Document Type


Degree Name

Doctor of Education (Ed.D.)


School of Education


Leadership Studies


Organization & Leadership EdD

First Advisor

Patricia Mitchell

Second Advisor

Darrick Smith

Third Advisor

Betty Taylor


The purpose of this study was to increase understanding of the reporting patterns of WPV Type II in acute hospital settings. Although some patients are abusive toward nurses, that the abuse is underreported to hospital administrators. Qualitative studies identified common themes for underreporting including fear of being blamed, abuse considered part of the job, and not having sufficient time to fill out a formal report. This study is the first quantitative study to explore the changes in mean scores of organizational-culture factors under two mutually exclusive conditions: registered nurses (RNs) who do not report hospital incidents and RNs who do report them. Findings include several statistically significant mean score differences in the two groups of nurses on organizational justice and safety-culture scales. This is also the first study to determine if WPV Type II is underreported to a higher degree than other types of hospital incidents such as needle stick injuries, patient falls, and medication errors. The two highest rates for underreporting were verbal abuse at 65% and mild physical abuse at 51%. Higher rates were statistically significant. The percentage of RNs who experienced verbal abuse was 83% and mild physical abuse 54%. For every 100 nurses, 54 experienced and did not report verbal abuse and 28 experienced and did not report mild physical abuse. Examples of verbal abuse include patients or their families making graphic detailed threats to kill RNs.