Abstract
Workplace violence (WPV) is a persistent threat to nurses’ safety, well-being, and professional integrity (Zoromba et al., 2025). Their qualitative study of emergency nurses in Egypt found persistent verbal and physical violence driven by work pressure, staff shortages, and inadequate protections, with perpetrators including patients’ relatives and internal staff. The authors call for systemic interventions such as robust policies and improved training. Building on those findings, this letter proposes that educational nursing programs incorporate structured self-advocacy training for clinical placements, paired with explicit reporting pathways and institutional supports, to strengthen prevention and response to WPV.
Nursing students are already exposed to WPV within clinical environments. Witnessing or hearing abuse can normalize mistreatment and undermine students’ perceptions of nursing as a caring profession (Johnston et al., 2024; Qian et al., 2023). Although WPV awareness and resilience training are gaining recognition, many curricula lack focused teaching on responding to aggression. Without proactive preparation, clinical placements risk exposing students to environments that implicitly tolerate unacceptable behaviour.
Self-advocacy, which involves asserting one’s rights, expressing safety concerns, and setting professional limits while maintaining respectful communication, is a practical strategy to respond constructively to WPV. A succinct response to verbal abuse, such as “That language is not acceptable,” can be effective and enables students to uphold professional standards without escalating conflict. It also promotes professionalism and clarifies behavioural boundaries.
Effective educational strategies to develop self-advocacy include simulation, which provides realistic scenarios for students to practice assertive language, boundary setting, and de-escalation in a safe environment and improves skill transfer to clinical settings (Dafny & Muller, 2022). Furthermore, structured debriefing sessions and reflective practices help students process WPV situations, encourage them to question accepted mistreatment, and explicitly address boundary issues (Johnston et al., 2024). In addition, visible role modelling and mentorship by academic and clinical mentors who demonstrate advocacy and intervene on behalf of students reduces students’ anxiety about speaking up and reinforces expected standards of conduct.
However, individual skills alone risk placing an unfair burden on students. Hierarchical clinical cultures, power imbalances between students and staff, and norms that discourage the expression of concerns may restrict students’ capacity to act even when they recognize problematic behaviour. Zoromba et al. (2025) also pointed out that nurses’ voices are often overlooked. Thus, responsibility for addressing WPV must not be shifted onto individual students.
Self-advocacy training should, subsequently, be directly connected to institutional policies and easily accessible reporting systems. Teaching students how and where to report incidents and ensuring timely organizational responses reduces underreporting and signals accountability (Elsharkawy et al., 2025; Lim et al., 2022). Post-incident debriefings, immediate access to counselling, and, when necessary, temporary reassignment of clinical placements are some of the organizational support mechanisms. These actions reinforce professional dignity and promote a sense of shared responsibility. Integrating self-advocacy into curricula, therefore, serves dual functions: it equips students with communication and boundary-setting skills while connecting individual competence to protective organizational systems. By connecting these elements, we can challenge the desensitization to WPV in all its forms, strengthen students’ professional identities, and create safer learning environments.
In summary, echoing Zoromba et al. (2025)’s call for systemic action, educational nursing programs should include the teaching of self-advocacy, along with clear reporting pathways and institutional protections. When individual advocacy skills are matched by organizational responsibility, educational programs can effectively protect students, uphold professional standards, and contribute to the wider mitigation of WPV within healthcare environments.
