Table 4

Additional quotes to support identified themes about workplace violence appraisals and coping processes

ThemesSubthemesQuotes
WPV as a frequent, inevitable occupational hazard“It personally, makes me really sad that this is a component. It’s not even like a maybe; it’s like a when. When it will happen. It’s not an if“. (Nurse, 6)
“I just see it as inevitable, occupational hazard, kind of like many shifts and weekends and holidays, like if you’re going to care for the people that no one else wants to care for”. (Physician, 23)
“It happens every day.… I would say pretty much every day, to some extent, someone is out of control and we have to have, you know, some kind of confrontation like this”. (Security, 1)
Manifestations of burn-out among participantsEmotional exhaustion“Even though I think I’m pretty jaded to it, it probably increases stress levels and makes you feel unwell… And you can only take so much and try to help people to get that behavior returned to get violent behaviors it does wear on you physically and emotionally deep down inside”. (Nurse, 9)
“There are days that it gets me really, really stressed out. And at the end of the day, I just feel really wiped out, and that I don’t have anything left to give”. (Medical Assistant, 18)
Depersonalisation“He is literally just an (expletive). And so that’s just a bad person. So that doesn’t make me feel bad at all”. (Physician, 14)
“And I’ve watched over the years I’ve watched the sweetest nicest people coming to this job and it doesn’t take very long and they’re jaded and they’re changed and it’s sad”. (Nurse, 17)
Decreased personal efficacy“I don’t know. I think I went into it thinking it was going to be like… Like I was helping people and fixing and adding to their lives and not… It’s completely different than what I had thought I was going to do. You still have those moments, but when you’re cleaning up the urine and having these people spit at you and you’re putting people in restraints… That’s not what I expected. That’s not what I thought I was going to be doing”. (Nurse, 17)
Diminished job satisfaction“I think probably a year into my role here as a medical assistant I for sure wanted to be an emergency room nurse and I still want to, but I have lately been definitely thinking about whether or not that it’s something I want to do after I get done with nursing school do I want to continue working in emergency department where this is going to be the norm for my life for the next 30 years? Or do I want to maybe work in a cardiac ICU, somewhere a little quieter something where it’s a little… Where the environment is a little more control… I sometimes question whether or not this is something I want to do full-time, long-term”. (Medical Assistant, 18)
“I had a very naïve idea of what the day today actually looks like. And yeah it’s been… this ends up being part of the day today and sometimes it can be a little bothersome and you really like wonder whether or not… If you’ll be able to do it for as long as you hoped you could”. (Nurse, 20)
Variability in primary cognitive appraisals of WPVNegative primary appraisals—harm and threat appraisals“If it gets really personal, people get up in my face, somebody tries to like actually get physical, then I get a lot more upset”. (Nurse, 6)
“And so I was typing a note. And I didn’t even realise it and I turned around and she was like behind me and over me. And I felt physically threatened. And realised that not only did I feel physically threatened but there was nobody to call to help me”. (Advanced Practitioner, 22)
Positive primary appraisals—challenge appraisals“It helps me… kind of builds my, I guess, confidence in future incidences. Kind of you get tools from everything. You get new ways to do certain things with each person”. (Security, 15)
“You get a little perspective and you realise, look, no one got hurt, surprisingly, it turned out fine. The patient got the care the patient needed. I think the important part is to reflect and say, gosh, how should I handle that differently? What am I going to do going forward differently? And then kind of with some resilience, move on”. (Physician, 23)
Variability in secondary cognitive appraisals of WPVSecondary appraisals indicating adequate resources to address WPV events“Like I do see that certain events do impact other staff members more than it impacts me and I think that for people who do get into those situations, sometimes the social resources may not be available for them to process”. (Nurse, 11)
“I’ve always had that mentality where I can kind of just destress and cope with things a lot easier than some people would, like a… or just normal visitors here”. (Security, 7)
Secondary appraisals indicating inadequate resources to address WPV events“I was happy to see three officers come towards me when this event occurred, but none of them were in arm’s reach that would’ve stopped it. They would’ve been able to help after, but they wouldn’t have been able to stop it. Nobody would’ve stopped it. But I just… I don’t know. I just… this is not… doesn’t feel like a safe place”. (Nurse, 17)
Reported use of both avoidant and approach coping mechanismsAvoidant coping strategies“Once the patient is either calmed down or they’re placed in the restraints and everyones safe in their rooms, then I usually just like, I’ll sit down, kind of just like do some charting and then kind of take like a good 5 min sit-down session. I’m pretty good after that”. (Medical Assistant, 16)
“Honestly, I think the easiest way to cope with things is just to simply just forget about them, kind of like erase it from your memory bank, because I have other patients I’ve got to take care of”. (Nurse, 10)
Approach coping strategies“I just… I depend a lot on my co-workers and making sure, was there anything that I missed? Was there anything I did? Do you know what I mean? Like that made the situation worse or… I should’ve moved off? Whatever. You know what I mean? What could I have done? I’m a good talker, so just talking about it and getting it out there and getting feedback from the people I trust on how things went, that’s how I deal with it”. (Nurse, 9)
“And then we have somebody who’s obviously not well, is very much struggling with her relationships with her kind of emotional volatility, that kind of very willfully contributes to her crises. And so when you have somebody responding out of that place, a very compromised place, and so I don’t take it personally. This person has to walk around in that pain. And so those things I think promote my compassion”. (Social worker, 2)
  • WPV, workplace violence.