Violence against nurses in non-psychiatry emergency wards

Violence against health staff is a widespread problem occurring in different ways and has multiple consequences on health personnel, health systems and even patient care. Emergency Department (ED) personnel especially nursing staff have a higher risk of being exposed to violence, but due to the lack of any recording and reporting system of such incidents, the history of related studies in our country is limited. This exploratory study was conducted in EDs of three major hospitals of Tehran University of medical sciences in 2004, in order to determine the frequency of violence against nursing staff.

Data of this cross sectional study were retrieved by questionnaire from 136 nurses working in the ED of three hospitals, Imam-Khomeini, Shariati and Sina. The questionnaire consisted of questions on sociodemographics, previous experience of different types of violence and its reporting. Data were analyzed using statistical software (SPSS) version 11.5.

Of study participants, 66.9% were female and 31.6% were male. The overall experience of violence was rather high (98.6%): 97.8% verbal violence, 39.7% physical violence and 86% other types of violence. Reporting of physical violence was more than the other types. The reasons of underreporting of violence according to the participants were belief in inefficacy of any actions in this regard and their intentions for not magnifying the incident in the workplace. Most of the nurses believed that the possible explanations for the violence incidents they faced were prolonged waiting time in ED, high direct costs, inadequate health insurance, and finally inadequate number of personnel in ED. A majority of nurses had worries about being assaulted in the ER in the future (91.1%).

Exposure to violence especially verbal violence among nurses working in EDs is high, but despite the high prevalence of worrying about reoccurrence of violence, most of the cases remain unreported and don’t result in a legal action. It seems that arrangement of systematic educational courses concerning prevention of violence and conflict resolution for ER staff, empowerment of security systems like guards, adoption of strategies to support assaulted staff and take effective legislative actions against aggression and violence in the health systems may be effective to reduce the burden problem.