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Violence Against Nurses Working in US Emergency Departments

Gacki-Smith, Jessica MPH; Juarez, Altair M. MPH; Boyett, Lara MSN, RN, ACNP-BC, CEN; Homeyer, Cathy MSN, RN, CEN; Robinson, Linda BSN, RN, SANE, DVNE, CEN, CFN; MacLean, Susan L. PhD, RN

Journal of Nursing Administration: July-August 2009 - Volume 39 - Issue 7/8 - p 340-349
doi: 10.1097/NNA.0b013e3181ae97db

Objective: The objective of this study was to investigate emergency nurses' experiences and perceptions of violence from patients and visitors in US emergency departments (EDs).

Background: The ED is a particularly vulnerable setting for workplace violence, and because of a lack of standardized measurement and reporting mechanisms for violence in healthcare settings, data are scarce.

Methods: Registered nurse members (n = 3,465) of the Emergency Nurses Association participated in this cross-sectional study by completing a 69-item survey.

Results: Approximately 25% of respondents reported experiencing physical violence more than 20 times in the past 3 years, and almost 20% reported experiencing verbal abuse more than 200 times during the same period. Respondents who experienced frequent physical violence and/or frequent verbal abuse indicated fear of retaliation and lack of support from hospital administration and ED management as barriers to reporting workplace violence.

Conclusion: Violence against ED nurses is highly prevalent. Precipitating factors to violent incidents identified by respondents is consistent with the research literature; however, there is considerable potential to mitigate these factors. Commitment from hospital administrators, ED managers, and hospital security is necessary to facilitate improvement and ensure a safer workplace for ED nurses.

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Authors' Affiliations: Senior Research and Practice Associate (Ms Gacki-Smith); Senior Research Associate (Ms Juarez), Emergency Nurses Association, Des Plaines, Illinois; Director Midlevel Providers (Ms Boyett), Traditions Emergency Medicine, College Station, Texas; Administrative Director (Ms Homeyer), Cox Health, Springfield, Missouri; Team Leader (Ms Robinson), St Elizabeth Medical Center, Covington, Kentucky; and Former Nursing Officer (Dr MacLean) Emergency Nurses Association, Des Plaines, Illinois.

Corresponding author: Ms Gacki-Smith, Emergency Nurses Association, 915 Lee St, Des Plaines, IL 60016 (

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© 2009 Lippincott Williams & Wilkins, Inc.