Violence against nursing staff is increasing, with 80% of A&E nurses reporting harassment or an assault in the past year, a survey suggests.
More people are being prosecuted for attacks on staff
A quarter of the 3,000 nurses surveyed by the Royal College of Nursing said they had been physically attacked.
While almost half of nurses said they had been bullied or harassed, 45% of these by a manager, in the past year.
The Department of Health said there had been a 15-fold increase in prosecutions for attacks on NHS staff.
Health minister Rosie Winterton said: "This shows that offenders can no longer regard NHS staff as soft targets, and those who do abuse staff face punishment.
"As part of our continued drive to protect NHS staff we are considering proposals to take action against verbally abusive patients and relatives who abuse our staff."
According to the RCN's Working Well - At Breaking Point Survey which quizzed 2,790 nurses last August about their working lives found they experienced more stress than the general population.
It comes as ministers are set to announce plans to fine people up to £1,000 who threaten doctors or nurses.
Some 40% of nurses said they had been harassed or assaulted in the past 12 months - this was an increase of 6% on the RCN's 2000 survey.
40% of nurses attacked or harassed
79% of A&E nurses attacked or harassed
27% physically attacked at work
25% bullied or harassed
But the survey also suggested instances of bullying had increased.
Five years ago 17% of nurses reported bullying or harassment, in the new survey nearly a quarter of respondents said they had experienced it.
Half of these said that managers were the source of the problem.
The survey also suggests nurses' psychological well-being had worsened since 2000.
Four out of 10 reported varying degrees of problems, while 14% said they had raised levels of distress which may required some help.
Beverly Malone, general secretary of the Royal College of Nursing, said the survey demonstrated the tough issues that nurses faced every day.
"If we are going to bring more people into nursing and stop others leaving we have got to tackle these problems."
Sheelagh Brewer, RCN senior employment relations adviser, said pressures on nurses were growing partly because of ongoing reorganisation in the NHS and the increasing complexity of work.
She also said that problems hospital finances which led to posts being frozen and other cutbacks piled more pressure on staff.
On bullying, she said the healthcare profession was still very hierarchical.
"There's still a culture that says it's OK to demonstrate the kind of behaviour that we now see as bullying. People are quick to blame."
Shadow Health Secretary Andrew Lansley said violence and abuse against nurses was unacceptable.
"The NHS has to respond not only a willingness to undertake prosecutions but to make sure law is as clear as it can be."
Bill Darling, chairman of the NHS Security Management Service, said staff were now more confident in reporting violence and abuse but said those that attacked nurses should and would be punished.
Julian Topping, head of Workplace Health and Employment at NHS Employers said: "We know that there is an issue with workplace stress and bullying and harassment in the NHS but we are working with trusts to tackle it."