Violence and Its Impact on the Emergency Nurse

• Published in: Journal of emergency nursing 2020-05, Vol.46 (3), p.354-358
• Main Authors: Wolf, Lisa, Perhats, Cydne, Delao, Altair, Brim, Carla B., Gentry, Judith Carol, Leaver, Sue L., Papa, AnnMarie R., Proud, Matthew Edward, Riwitis, Cheryl Lynn, Rogers, Kathryn Starr, Stone, Elizabeth L., Uhlenbrock, Jennifer Schieferle, Winger, Justin, Zaleski, Mary Ellen, Lee Gillespie, Gordon, Kolbuk, Monica Escalante
• Format: Article
• Language: English
• Subjects: Absenteeism; Advocacy; Assaults; Bullying; Burnout; Coercion; Consumers; Coordination; Crowding; Emergency medical care; Emergency Nursing; Emergency Service, Hospital; Emergency services; Epidemics; Evaluation research; Humans; Injuries; Interdisciplinary aspects; Law enforcement; Leadership; Medical personnel; Mental health; Nurses; Nursing; Occupational Health; Occupational safety; Patients; Post traumatic stress disorder; Prevention programs; Privacy; Productivity; Recruitment; Security management; Sex crimes; Societies, Nursing; Stress; Substance abuse; Supervisors; United States; Violence; Violent crime; Weapons; Workplace Violence
• ISSN: 0099-1767; 1527-2966
• DOI: 10.1016/j.jen.2020.01.005

Description 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 The violence also results in significant economic, personal, and professional costs.1-3 In the United States, the prevalence of workplace violence in the health care industry is 4 times higher than in other private industries.4 Ease of public access, crowding, long wait times, presence of weapons, and other factors make the emergency department a highly vulnerable area,5-9 especially where triage occurs.10,11 Emergency nurses and other ED staff are at serious occupational risk of experiencing workplace violence, including verbal and physical assaults.5-7 For these reasons, workplace violence has been recognized in many states as a violent crime.12 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 Other ongoing legislative initiatives include the introduction of the “HR 1309: 1 Both definitions demonstrate that workplace violence manifests in myriad ways as emotional or verbal abuse, coercive or threatening behavior, or physical and sexual assault,4 and can involve consumers, providers, and organizations.15 The patient population (eg, active substance use), along with work schedule (ie, night shift) experience level, and younger age of the health care provider, are consistent risk factors for WPV.8-10,16-18 Acts of workplace violence can cause physical and/or psychological harm to emergency nurses leading to job dissatisfaction, emotional exhaustion, burnout, secondary trauma stress, posttraumatic stress disorder, absenteeism, and intention to leave the job or the nursing profession,4,9,16-25 all of which have potential impacts on patient care due to nurses' decreased productivity, organizational commitment, and engagement.9,18,25-27 Workplace violence is seen as a contributing driver of poor nurse retention and recruitment, further exacerbating the nursing shortage and its costly consequences for health care organizations and their patients.4,18,20,25,27-29 Despite continued education, legislation, and research to increase awareness and understanding of the issue, emergency nurses are reluctant to report incidents of WPV because they believe it is not violence if they did not sustain an injury, reporting can be laborious and futile, patients are not seen as responsible because of their