“Abuse Will Not Be Tolerated”: What This Sign in My Local A&E Made Me Think About Civility
Last week, in my local A&E, I noticed a bold blue sign declaring:
“Abuse will not be tolerated in this emergency department. We have the right to refuse your care if you are abusive to our colleagues.”
The message was clear, firm, and entirely understandable. Healthcare staff across the UK face unprecedented levels of verbal and physical abuse. In 2023, NHS data showed that one in three staff experienced harassment or violence from patients or the public. It’s no wonder that many trusts are taking a zero-tolerance stance.
But as I stood reading that sign, I wondered: does this approach help create a more civil, compassionate environment, or does it simply manage the symptoms of a deeper problem?
The Need for Boundaries — and Balance
There’s no question that boundaries matter. Healthcare professionals deserve to feel safe at work. But research in behavioural psychology suggests that the way we communicate boundaries can influence how people respond.
Messages framed around prohibition and punishment (“don’t”, “will not be tolerated”) tend to trigger defensiveness, especially in high-stress settings like emergency departments, where patients are anxious, in pain, or frightened.
Conversely, values-based and empathy-driven communication helps to de-escalate tension before it becomes abuse. For example:
“Our team is here to care for you. Please treat us with the same respect and kindness we offer you.”
Simple language change, but psychologically, it moves from power and control to shared humanity and mutual respect.
What the Research Says
Behavioural and communication research consistently finds that positive framing is more effective in promoting cooperation and civility:
A 2021 study in the Journal of Health Communication found that empathetic signage and language in hospitals reduced aggressive incidents by 30%.
The Civility Saves Lives campaign, founded by NHS consultant Chris Turner, shows that respectful communication improves staff performance, team trust, and even patient outcomes.
Neuroscience research shows that language perceived as threatening activates the brain’s fight-or-flight response, making aggression more likely rather than less.
So while signs like “Abuse will not be tolerated” are born from necessity, they may unintentionally reinforce an adversarial tone — “us versus them” — instead of fostering a shared sense of care and community.
From Zero Tolerance to Proactive Civility
The goal isn’t to remove boundaries — it’s to reframe them with empathy and clarity. Imagine if, instead of warning patients what not to do, hospitals also reminded everyone what we all can do to make care safer and kinder.
For example:
“We’re here to help. Let’s treat each other with kindness and respect.”
“Please speak to us calmly — we promise to listen.”
“Together, we can make this a safe space for care.”
Small shifts like these communicate the same boundary, but in a way that invites cooperation rather than fear or defiance.
What This Means for Civility Beyond Healthcare
The sign in my local A&E is a microcosm of a bigger truth: you can’t demand civility; you have to model and invite it.
In every workplace, whether it’s an emergency department, an office, or a boardroom, the tone of communication matters.
Rules maintain order, but respectful language builds culture.
At The Civility Gap, we believe that promoting civility means moving beyond “zero tolerance” and towards positive engagement, where safety, empathy, and respect are seen as everyone’s responsibility.
Final Thought
Next time you see a “No abuse will be tolerated” sign, don’t see it as a warning — see it as a reflection of how stretched our systems have become.
And then ask the deeper question: what would it take for this sign not to be needed at all?
That’s the gap we aim to close.