The extent, nature, and precipitating factors of nurse assault among three groups of registered nurses in a regional medical center

doi:10.1067/men.2002.121835

Journal of Emergency Nursing

Volume 28, Issue 1, February 2002, Pages 11-17

https://doi.org/10.1067/men.2002.121835 Get rights and content

Abstract

Introduction: This study investigated nurse perceptions of the incidence and nature of verbal and physical assault or abuse by patients and their family members or visitors. Methods: A survey was given to ED, ICU, and general floor nurses in a 770-bed acute care north Florida medical center. Results: The response rate was 68.8% (86 out of 125). Large percentages of nurses reported being victims of verbal assault or abuse and physical assault by patients and family members or visitors; 88% reported being verbally assaulted and 74% reported being physically assaulted while at work in the past year. ED nurses reported the highest rates of these incidences, with 100% reporting verbal assault and 82.1% reporting physical assault within the past year. Assaults were most commonly perpetrated by patients with cognitive dysfunction (79.1%), patients with substance abuse (60.5%), and persons who were angry because of the patient's condition (55.8%). Surprising information: the most common causes of assault by family members and visitors were anger related to enforcement of hospital policies (58.1%), anger related to the patient's condition/situation (57%), anger related to long wait times (47.7%), and anger related to the health care system in general (46.5%). Discussion: Nurses were confused about what legally constitutes “assault” and “abuse”; nurse rights versus patient rights; and policies and procedures for reporting assault or abuse incidences. Our results indicate that nurses are experiencing abusive and assaultive behavior from family members and visitors just as often as they are from patients, and ED nurses are at higher risk. Nurses perceive a lack of institutional support and an institutional emphasis on patient rights and satisfaction and do not feel safe in the workplace.

Section snippets

Methods

This descriptive, comparative study was conducted in a 770-bed acute care North Florida regional medical center to assess the extent, nature, and precipitating factors of nurse assault by patients and visitors or family members among 3 specialty groups of RNs. The convenience sample (n = 125) consisted of all RNs employed in the emergency department, cardiovascular ICU, medical/surgical ICU, intermediate care unit, coronary care unit, general medical/surgical floor, pulmonary specialty floor,

Results

Eighty-six of 125 surveys were completed and returned, for a response rate of 68.8%. The majority of respondents were married, white women between the ages of 26 to 30 years and 36 to 50 years. Approximately 45% of the nurses held a bachelor's degree in nursing and had 1 to 5 years' experience in nursing and in their specialty area. Nearly 45% of the nurses worked 12-hour shifts, and 40.7% worked 8-hour shifts. Approximately 49% of the nurses worked more than 50% of the time on the day shift,

Discussion

Findings from this study are consistent with previous research regarding verbal and physical assault or abuse against nurses.6, 7, 8 The causes of assault by patients found in this study were also consistent with previous research,8, 9, 10, 11 specifically, cognitive dysfunction resulting from dementia, substance abuse withdrawal, and acute delirium. Our findings regarding assault and abuse occurrences from family members or visitors, however, are unique in that little has been reported. Our

Limitations

A convenience sample of nurses in one individual hospital limits the ability to generalize the results to the entire nursing population. Minority and male respondents were underrepresented. The night shift nurses said that they were “too understaffed and busy” to fill out the questionnaire on time, and thus they also were underrepresented in this study, possibly underrepresenting the actual incidence of assault or abuse. More input from the night shift is needed because it is a shift with fewer

Implications for practice and education

Considering the large percentage of nurses who reported being assaulted in the workplace, it is important for nurses to be educated at the undergraduate level about assault and abuse, including state definitions of assault, techniques for self-defense, and aggression diffusion training. Hospital administrators and managers must provide clear policies and procedures regarding assault and abuse against hospital employees. Incident reports should be considered mandatory for any incidences of

Recommendations for future research

A larger sample from more than one institution and with more ethnic and gender diversity is needed to provide a more accurate picture of the incidence and nature of assault and abuse by patients and family members and visitors. More research is needed to determine if assault and abuse awareness education, self-defense training, aggression reduction training, and improved security measures reduce the incidence of assault and abuse and/or improve the emotional well-being and job satisfaction of

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^*: For reprints, write: Deborah D. May, ARNP, MSN, 1004 Landings Loop, Tallahassee, FL 32311; E-mail: [email protected].

^**: J Emerg Nurs 2002;28:11-7.

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ResearchThe extent, nature, and precipitating factors of nurse assault among three groups of registered nurses in a regional medical center*,**

Abstract

Section snippets

Methods

Results

Discussion

Limitations

Implications for practice and education

Recommendations for future research

Arch Psychiatr Nurs

Ann Emerg Med

Ann Emerg Med

Violence against nurses: a silent epidemic. Workplace Violence Prevention Reporter

Violence in the workplace: risk factors and prevention strategies

Nurse abuse

Concern

Nurse assault survey

The extent, nature, and response to victimization of emergency nurses in Pennsylvania

J Emerg Nurs

Violence and sexual harassment: impact on registered nurses in the workplace

Am Assoc Occup Health Nurs J

Causes of staff abuse in health care facilities

Am Assoc Occup Health Nurs J

Research
The extent, nature, and precipitating factors of nurse assault among three groups of registered nurses in a regional medical center*,**