Experiences and perceptions of emergency department nurses regarding workplace violence

Abstract

The purpose of this the study was to describe the experiences and perceptions of the Emergency Department (ED) nurses regarding workplace violence. The setting of the study was four emergency departments at two public hospitals in the Gauteng Province. Included were Trauma ED, Medical ED, Paediatric ED and General ED. An explanatory sequential mixed method design was used to describe the experiences and perceptions of emergency department nurses regarding workplace violence. Data was collected in two phases. Phase one constituted the quantitative phase which used a survey. Survey data was collected through a structured questionnaire. The second phase constituted the qualitative phase of the study. Data was collected through semi-structured interviews. The results of the quantitative and qualitative data were analysed and reported separately, thereafter integrated and used to make recommendations for the prevention of work-related violence and promote a safe working environment in the emergency department.

The final sample of the quantitative data comprised of 85 (out of 138) respondents, yielded a response rate of 61.59% for the study. Data were collected from ED nurses using a validated questionnaire developed by the Emergency Nurses Association (ENA, 2010). Data were analysed using descriptive statistics (frequencies, means and standard deviation).

Findings of the study, revealed that most nurses agreed that they felt not or less safe in the emergency department (M = 4.07; SD 2.18). The results of the survey identified that most (>80%) nurses working in the ED had experienced some form of workplace violence. Physical violence such as being hit, punched, slapped, kicked, pinched, pushed, shoved or scratched was experienced by at least three-quarters (>75%) of nurses.

Additionally, documented evidence recognizes that most nurses failed to report it (81.2%; n = 69). It was also noted that around 30% (n = 25) of the nurse respondents agreed that they were advised to report the incidence, even though they did not do so. In this study, the greater majority of nurses agreed that they had not received any training in preventing or mitigating ED workplace violence, as opposed to some training 10 to 12 months and 7 to 9 months ago (5.9% and 4.7%), respectively.

In Phase 2 of the study, data was collected from nurses (n = 15) who were purposively selected using semi-structured interviews to obtain qualitative information on their opinions regarding workplace violence in the ED. Data collected was analysed using a Clarke and Braun method of qualitative thematic analysis. Fifteen categories were identified in which five themes, which provided the fundamental structure of the findings for the discussion, emerged and included the following:  Contributing factors of workplace violence  Factors that hinder reporting  Inefficient performance of security officers  Unsafe environment  Helpful strategies

In conclusion, the study identified workplace violence as an issue and recognizes the effects of violence on staff members is of significant concern that should be addressed with leadership support to recognize and decrease workplace violence in the ED.