A recent survey by the Nursing Times shows almost half of all nurses had been physically assaulted in the course of their work, and eight out of 10 had suffered verbal abuse.

Only 9% had taken time off work, despite 88% of those who had been physically attacked needing medical treatment and 40% needing counselling.

The survey shows most nurses back a mandatory prison term for perpetrators of violence.

Other studies show that nearly half of all NHS trusts do not have policies on violence at work.

'Violence for its own sake'

Linda Holt, of the A & E Nursing Association, who proposed the motion in Harrogate, said violence should not be tolerated and those who used it should be prosecuted.

Nurses told of how they had seen their colleagues attacked and said much violence was not reported.

"We should not be expected to tolerate daily violence," said Ms Holt on Monday.

"Nurses should have the right to withdraw their care if they are threatened with violence."

But David Harding Price, a mental health nurse, said it was not always easy to know what to do because you cannot just deny a mentally ill person care.

He said trusts needed to take action to protect their staff.

He had recently seen a social worker in his unit attacked and threatened with murder. "People are frightened and violence is one of the reasons people are not coming into nursing," he said.

Michael Hayward, a children's nurse from Portsmouth, said it was not just in A & E or on mental health wards where violence was a problem.

Fifteen members of one family attacked doctors, nurses and porters on his ward recently.

Mr Hayward served in Northern Ireland as a military policeman before taking up nursing. He said he felt less frightened dealing with 10 drunken paratroopers than he did dealing with the public in the NHS.

"Because in the military I had the necessary power, legislation, back-up and training to do the job," he said. "As a nurse, I feel powerless, alone and frightened."

Another nurse called on management to invest more in protecting staff by paying security personnel a better wage.

The only note of caution came from Clive Horton of the RCN Learning Disability Nursing Forum who said a minority of people with learning disabilities showed aggressive behaviour.

In some instances, he said, aggression could have a communication function.

"Can zero tolerance be implemented for all staff?" he asked.

Linda Holt said the motion was not intended to deny treatment to vulnerable patients.

She added that management needed to ensure training and proper staffing for departments dealing with vulnerable patients.