The first ever review of the experience of hospital A&E staff reveals that they have resigned themselves to patient violence and aggression.
In the UK, there were 70,555 total reported assaults on NHS staff in 2016. Around the world, one in four hospital staff has experienced physical abuse.
A review co-authored by Dr Ian Smith and Dr Rebecca Ashton looked at the experiences of staff in 18 countries.
They found that the highest reports of both verbal and physical aggression are in Accident and Emergency departments, with nurses subject to regular verbal and physical abuse.
Clinical psychologist Dr Ian Smith from Lancaster University said: "Staff appear to passively accept violence and aggression, often when preventative and reactive strategies were inconsistently enforced."
One healthcare worker said: "People can swear at us, spit at us, bite at us...try and hurt us and nobody puts an incident report in."
Staff saw some patient's violence as being more in their control than others.
"If the patient has dementia, that's a bit different than a drunk patient or just a patient angry about waiting time."
But Drs Ashton and Smith said staff often missed signs of increasing aggression before an attack, and found it hard to understand why they were being attacked then they were trying to help.
Staff also found it difficult to be both a caregiver and the target of abuse.
"My biggest hurdle was that I feel like a victim, rather than getting to be in the "superman" role."
The studies reviewed revealed staff managing in isolation, often feeling inadequate and guilty.
"Nobody cared at all, not even the head nurse. You feel abandoned."
Experiencing violence and aggression led to feelings of powerlessness, with some reluctant to work in Emergency Departments.
The authors said: "These accounts imply that staff's sense of self-worth was dependent on their ability to care and "rescue" patients."