The Impact of Workplace Violence on Emergency Department Nurses: A Pilot Study

Sunday, 17 November 2013: 11:40 AM

Wanda J. Christie, MNSc, RN
College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR

Learning Objective 1: describe themes found within the experiences of the ED nurse after being assaulted by a patient.

Learning Objective 2: discuss how ED nursesí satisfaction with their coping mechanisms relate to their definition of violence.

Background:  Approximately $4.2 million is spent annually due to WPV, with twice as many nurses experiencing work related crimes than any other profession. The ANA stated that exposure to violence directly affects nurse job satisfaction and retention. Developing safe workplaces is essential to solving the growing nursing shortage. All nurses are at risk, with ED nurses at high risk.

Purpose:  Explore the impact of WPV perpetrated by patients to ED nurses. The two aims: 1) Describe specific themes found within experiences of ED nurses after being assaulted by a patient, and 2) Explore the ED nurses’ satisfaction with coping mechanisms.  

Method:  Qualitative study using phenomenology. Purposive recruitment of five RNs from a level 1 ED. Sixty to 90 minute semi-structured interviews were conducted and digitally recorded. Verbatim interview transcripts were analyzed using content analysis and constant comparison.

Results:  One major theme was defined: culture of the ED. ED nurses expressed certain personalities are needed to work successfully in emergency nursing. They love the excitement and frequent changing atmosphere; the lack of stagnancy. The definition of violence from the very ill and injured varies from literature definitions. Their definition determined how the nurse reacted and coped after a violent act. Situations defined as violent were intentional attempts to hurt the nurse. Another component of the nurse ability to cope was the environment in the ED and their working relationship with other staff.

Conclusions:   (1. Individual experiences affect how ED nurses cope with stress. (2. Common factors include department, working relationships, available peer support, feelings of safety, and type of patients. (3. ED nurses define violence based on patient intent. It is concluded that ED nurses cope with violence based on their definition of violence.

Implications for Nursing:  Coping is essential to maintain nurse satisfaction and retention in the workforce.