252 A Qualitative Study of the Experience of Abuse by Health Care Workers in the Emergency Department

Abstract

To collect and perform a qualitative analysis on the narrative stories about the experiences of residents and other health care workers (HCWs) in the ED with violence in the workplace. To bring to light the types of abuse that occur in the ED and illustrate the toll it has on HCWs through sharing their narratives. This survey research study was performed at a single, large, academic, tertiary care ED in the southeastern United States. The survey gathered demographic information and asked about the prevalence, experience, and reporting of workplace violence via both multiple choice, multiple answer, and open-ended question styles. Descriptive statistics were used to analyze demographic responses as well as the multiple choice and multiple answer responses. Narrative responses were analyzed using thematic analysis. 80% of the respondents reported at least one incident of verbal assault by a patient in the prior year. Physical assault was reported by 34%. 63% of surveyed health care workers reported feeling unsafe, and 49% reported having been asked to do something within the prior year that made them feel unsafe or uncomfortable regarding their physical or emotional well-being. Of those who experienced assault, 22% reported they felt it was motivated by race or ethnicity, 21% felt it was due to their sex or sex identity, 21% related it to their age, and 2% to their sexual orientation. Of those who had experienced physical assault or violence, 20% filed a formal hospital incident report or police report, while another 19% did not discuss the incident with anyone. Examples of narratives within each theme include the following: Assault/Threats “I was told by a patient that his ‘groin’ hurts and during GU examination, I was told that his pain would go away if I stroke the shaft of his penis.” Feeling Unsafe “A patient became upset related to narcotics and threatened to kill staff. He was escorted out but only to the hospital front door. He was waiting in the ambulance bay when I got off work at 2am and I had to quickly get back inside and call hospital police.” Resignation “Workplace violence is unfortunately part of the job. It’s concerning that charges can be filed against a health care professional for too much force but nothing can be done when a patient punches, kicks, bites, scratches, pulls hair, or generally assaults you. I’m not here to get beaten up. This culture needs to change before a nurse gets killed by a patient.” Impact on care “I’ve experienced multiple encounters with intoxicated patients being verbally abusive and threatening. It has definitely impacted my ability to provide care.” Together, these narratives provide a glimpse of the experiences of abuse and the personal toll that it takes. Further research is needed on this topic to develop and implement successful measures to reduce the prevalence of violence against HCWs and to mitigate the emotional toll the violence and abuse take on residents and other HCWs.