Violence and Its Impact on the Emergency Nurse

Abstract

In 2002, the World Health Organization declared workplace violence to be a global epidemic with a negative impact on the retention of health personnel and delivery of health care. 1 World Health OrganizationFramework guidelines for addressing workplace violence in the health sector. https://www.who.int/violence_injury_prevention/violence/interpersonal/en/WVguidelinesEN.pdf?ua=1 Google Scholar The violence also results in significant economic, personal, and professional costs. 1 World Health OrganizationFramework guidelines for addressing workplace violence in the health sector. https://www.who.int/violence_injury_prevention/violence/interpersonal/en/WVguidelinesEN.pdf?ua=1 Google Scholar , 2 Nikathil S. Olaussen A. Gocentas R.A. Symons E. Mitra B. Review article: workplace violence in the emergency department: a systematic review and meta analysis. Emerg Med Australas. 2017; 29: 265-275https://doi.org/10.1111/1742-6723.12761 Crossref PubMed Scopus (45) Google Scholar , 3 Phillips J.P. Workplace violence against health care workers in the United States. N Engl J Med. 2016; 374: 1661-1669https://doi.org/10.1056/NEJMra1501998 Crossref PubMed Scopus (241) Google Scholar In the United States, the prevalence of workplace violence in the health care industry is 4 times higher than in other private industries. 4 Occupational Safety and Health AdministrationWorkplace violence in healthcare: understanding the challenge. https://www.osha.gov/Publications/OSHA3826.pdf Google Scholar Ease of public access, crowding, long wait times, presence of weapons, and other factors make the emergency department a highly vulnerable area, 5 Gacki-Smith J. Juarez A.M. Boyett L. Homeyer C. Robinson L. Maclean S.L. Violence against nurses working in US emergency departments. J Nurs Admin. 2009; 39: 340-349https://doi.org/10.1097/NNA.0b013e3181ae97db Crossref PubMed Scopus (226) Google Scholar , 6 The Joint CommissionPhysical and verbal violence against health care workers. Sentinel Event Alert. 2018; 59 (Published April 17, 2018. Accessed March 23, 2020): 1-9https://www.jointcommission.org/-/media/documents/office-quality-and-patient-safety/sea_59_workplace_violence_4_13_18_final.pdf?db=web&hash=9E659237DBAF28F07982817322B99FFB Google Scholar , 7 Spector P.E. Zhou Z.E. Che X.X. Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: a quantitative review. Int J Nurs Stud. 2014; 51: 72-84https://doi.org/10.1016/j.ijnurstu.2013.01.010 Crossref PubMed Scopus (288) Google Scholar , 8 Kleissl-Muir S. Raymond A. Rahman M.A. Incidence and factors associated with substance abuse and patient-related violence in the emergency department: a literature review. Australas Emerg Care. 2018; 21: 159-170https://doi.org/10.1016/j.auec.2018.10.004 Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar , 9 Stowell K.R. Hughes N.P. Rozel J.S. Violence in the emergency department. Psychiatr Clin North Am. 2016; 39: 557-566https://doi.org/10.1016/j.psc.2016.07.003 Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar especially where triage occurs. 10 Pich J.V. Kable A. Hazelton M. Antecedents and precipitants of patient-related violence in the emergency department: results from the Australian VENT study (Violence in Emergency Nursing and Triage). Australas Emerg Nurs J. 2017; 20: 107-113https://doi.org/10.1016/j.aenj.2017.05.005 Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar ,11 Lau J.B.C. Magarey J. Wiechula R. Violence in the emergency department: an ethnographic study (part II). Int Emerg Nurs. 2012; 20: 126-132https://doi.org/10.1016/j.ienj.2011.08.001 Crossref PubMed Scopus (37) Google Scholar Emergency nurses and other ED staff are at serious occupational risk of experiencing workplace violence, including verbal and physical assaults. 5 Gacki-Smith J. Juarez A.M. Boyett L. Homeyer C. Robinson L. Maclean S.L. Violence against nurses working in US emergency departments. J Nurs Admin. 2009; 39: 340-349https://doi.org/10.1097/NNA.0b013e3181ae97db Crossref PubMed Scopus (226) Google Scholar , 6 The Joint CommissionPhysical and verbal violence against health care workers. Sentinel Event Alert. 2018; 59 (Published April 17, 2018. Accessed March 23, 2020): 1-9https://www.jointcommission.org/-/media/documents/office-quality-and-patient-safety/sea_59_workplace_violence_4_13_18_final.pdf?db=web&hash=9E659237DBAF28F07982817322B99FFB Google Scholar , 7 Spector P.E. Zhou Z.E. Che X.X. Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: a quantitative review. Int J Nurs Stud. 2014; 51: 72-84https://doi.org/10.1016/j.ijnurstu.2013.01.010 Crossref PubMed Scopus (288) Google Scholar For these reasons, workplace violence has been recognized in many states as a violent crime. 12 Papa A. Venella J. Workplace violence in healthcare: strategies for advocacy. Online J Issues Nurs. 2013; 18: 5 PubMed Google Scholar Yet, at the time of this publication, only about 30 states have adopted laws that make it a felony to assault a registered nurse. 13 Emergency Nurses AssociationStates with enhanced penalties for workplace violence against emergency nurses. https://www.ena.org/docs/default-source/government-relations/ena-wpv-map-2019.pdf?sfvrsn=ad0e8b60_8 Google Scholar Other ongoing legislative initiatives include the introduction of the “HR 1309: Workplace Violence Prevention for Health Care and Social Service Workers Act” in 2019 and continued advocacy and evaluation of state-based felony reforms.