PRINCETON, NJ (ASRN.ORG)- A new survey by the Emergency Nurses Association suggests that more than one-half of emergency department (ED) nurses experience physical violence in the workplace. The report, which was based on an online survey conducted in spring 2007 of 3,465 ED nurses nationwide, also finds that one in four ED nurses reports being physically assaulted while on the job more than 20 times during the past three years. In addition, the report finds that one in five ED nurses reports having been verbally abused in the workplace more than 200 times during the last three years. 

Physical and verbal assaults were most likely to be committed by patients and visitors under the influence of alcohol or illicit drugs or by psychiatric patients being cared for in the ED, and were most likely to occur during periods of crowding, prolonged wait times or when there was a shortage of ED nurses. Meanwhile, nurses working in pediatric EDs were the least likely to experience workplace violence, while nurses who worked the weekend or night shifts were the most likely to experience violence. In addition, the survey finds that male nurses were more likely to be subject to workplace violence than their female counterparts. 

As a result of such violent episodes, slightly more than two-thirds of ED nurses rated their perception of safety in the ED as a five or lower on a 10-point scale. Moreover, one in three ED nurses indicated that workplace violence had caused them to consider leaving their job. Meanwhile, the report found that barriers to reporting ED violence included ambiguous policies for reporting incidents; fear of retaliation by ED management or other clinicians; the perception that reporting such incidents was a sign of incompetence or weakness; and an attitude that violence in the ED is to be expected. 

To address the issues, the report recommend that ED staff be informed that senior administration is aware of the incidents and that they support efforts to prevent and mitigate violence and develop clear and consistent procedures for reporting violent incidents. In addition, the report recommends that hospitals establish a culture of acceptance for reporting violence incidents, provide access to medical care and follow-up counseling as needed for victims of workplace violence, and appoint an interdisciplinary task force to identify vulnerabilities in the ED and develop a plan for preventing, mitigating, responding to and reporting violence.

Acknowledging that current laws aimed at protecting ED nurses from violence vary from state to state, and are nonexistent in some states, the report call for the development of federal and state laws to address the issue.

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