Abstract
Nurses received the highest rate of workplace violence due to their close interaction with clients and the nature of their work. There have been relatively few qualitative studies focus on nurses’ perceptions of and experiences with the antecedents, dilemma and repercussions of the patient and visitor violence (PVV), leaving a considerable evidence gap. The aim of this study was to explore nurses’ experience of PVV in emergency department, the impact of PVV on quality of care, and supports needed after exposure to such incidents. We conducted semi-structured interviews with a purposive and snowball sample of nurses, and analyzed the content of the interview transcripts. A total of 10 nurses were approached and agreed to participate. Those participants ranged in age from 24 to 41 years old, eight female and two male nurses, and the majority of them (80%) held a university Bachelor degree in nursing. The average time in nursing practice was 7.2 years. We conceptualized five analytical themes, which comprised: (1) multifaceted triggers and causes of PVV; (2) experiences following PVV; (3) tangled up in thoughts and struggle with the professional role; (4) self-reflexivity and adjustment; and, (5) needs of organizational efforts and support following PVV. This paper provides compelling reasons to look beyond solely evaluating the existence of workplace, and considering the perceived professional inefficacy, impacts of being threatened or assaulted in nurses. There are also urgent needs in provision of prevention and management of workplace training programs to ensure the high-quality nursing care.
Highlights
Workplace violence (WPV) is prevalent in healthcare and remains a complex and serious occupational hazard in the health care settings [1,2]
Five analytical themes regarding the experiences of nurses emerged: multifaceted triggers and causes of patient and visitor violence (PVV), experiences following PVV, tangled up in thoughts and struggle with the professional role, self-reflexivity and adjustment, and needs of organizational efforts and support following PVV (Table 1)
Our findings are consistent with the results from many previous studies that the impact of WPV and PVV in particular on nurses is associated with unpredictable psychological distress or trauma [40–44], difficult adjustment process [44], struggle with the role as a nurse [40–44], changes of the meaning of work [31,45], ineffective coping [46], decreased quality of care [31], and the needs of supports in the aftermath of incidents [40–44]
Summary
Workplace violence (WPV) is prevalent in healthcare and remains a complex and serious occupational hazard in the health care settings [1,2]. The incidents of WPV in emergency departments (EDs) are increasing and have become one of the most significant and problematic issues [3]. The intrinsic work feature of EDs is different from other health care settings [4]. WPV in EDs is most likely to occur as a result of unmanageable conflict that escalates and turns into an impulsive and unplanned physical or non-physical aggression. Overt dominance and power and control over others may be less among the perpetrators. This results in violence in EDs, which is different from other forms of violence
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