Running head: VIOLENCE IN NURSING

Violence in Nursing

Jessica Elliott

Delaware Technical Community College

NUR 340- Nursing Research

Dr. Heacock

February 23rd, 2020

VIOLENCE IN NURSING 2

An issue that impacts almost all areas of nursing is workplace violence. Whether there is

a violent patient, family, member, or even co-worker, workplace violence is never acceptable.

While this violence may not always be intentional, such as alcohol or drug withdraw, brain

tumors, or mental health issues, there needs to be better resources to appropriately handle these

events. Approximately 75% of all workplace violence occurs in healthcare, however, only 30%

of nurses and 26% of physicians have ever reported these workplace violence incidents. (Rock,

2019) Workplace violence places nurses in danger for both physical and verbal abuse. Almost all

nurses have experienced some type of workplace violence. (Wong, Ray, & Iennaco, 2019) In

order to prevent workplace violence in nursing, new education and/ or research needs to be

introduced to nurses on this subject. When workplace violence occurs in the field of nursing, it

places both patient’s and nurses in danger and can lead to low retention rates among nurses.

(Martinez, 2016)

Problem Statement

Workplace violence has a high prevalence in the nursing field. Due to this violence,

nurses are becoming injured, burned out, and are even leaving the field- creating even more

problems. The purpose of this paper is to find new ways to help prevent and manage workplace

violence in the nursing field.

Review of Literature

In order to clearly analyze this issue, multiple types of research were involved. These

include qualitative, quantitative, and evidence-based practice research articles. Wong, Ray, and

Iennaco (2019), provided qualitative research on workplace violence among hospital workers.
VIOLENCE IN NURSING 3

This approach focused on finding ways to help nurses feel more comfortable while caring for

violent patients. It did not focus on lowering any percentages. Therefore, a handoff tool was

developed to better inform nurses about certain patient behaviors before assuming caring for

them. (Wong, Ray, & Iennaco, 2019) Schartz and Bjorklund (2019), also provide qualitative

research on the prevention of workplace violence in healthcare. To decrease violent incidents,

“violence management” courses were implemented. Through these courses, de-escalation skills

were taught. Overall, there was a decrease in violent incidents. (Schartz & Bjorklund, 2019)

Rock (2019), and Arnetz, Hamblin, Sudan, and Arnetz (2018) both provided quantitative

research on violence towards nurses. Nearly 75% of all workplace related violence occurs in the

healthcare field, however, only 30% of nurses report this violence to their superiors. For action to

be taken against workplace violence, these accounts must be accurately documented. (Rock,

2019) In addition, Arnetz, Hamblin, Sudan, and Arnetz (2018), conducted a study among 15,000

hospital nurses and healthcare technicians regarding violence in the workplace. Data from this

study showed that staff interaction and safety climate variables were associated with reported

workplace violence. Additionally, conflict among coworkers increased the amount of verbal

workplace violence. (Arnetz, Hamblin, Sudan, & Arnetz, 2018)

In addition to the previous qualitative and quantitative resources, an evidence-based

practice source was used as well. Martinez (2016), focused his evidence-based practice on the

lack of nurses reporting violent episodes. If violence is not reported, action cannot be taken

against it. When more education was provided to nurses about workplace violence and when to

report, there was a decrease in violent events. This ultimately led to higher safety levels for both

nurses and patients. (Martinez, 2016)

VIOLENCE IN NURSING 4

Analysis

Throughout this research it was noted there is a high prevalence of violence in the field of

nursing. However, it was also noted there is a lack of nurses reporting these violent events.

While there are steps to prevent this violence, it is just as important to report when it does

happen.

Recommendations

Violence in the nursing field impacts nursing and other healthcare professionals nearly

every single day. Nurses strive to take the best care of their patient’s as possible, but this can be

hard when violent patients, family members, or coworkers come in the way of this. While there

may be steps to help combat patient violence, not all facilities have steps to help prevent violence

among family members of coworkers. Prevention is key, but measures to stop violence once it

starts are important as well. Some facilities have a certain “code” for verbal abuse situations,

whether it be a patient, family member, or coworker. At Peninsula Regional Medical Center in

Salisbury, MD, this is called a “Code Navy.” When this is called, a security member and a

nursing supervisor arrive to the area and help to diffuse the situation. For more nurses to be free

from violence at work, more safety measures should be in place.

Summary

Nurses have a difficult job, often, this is further complicated by accidental or intentional

violence directed towards them. While the best way to stop violence is to prevent it, this cannot

always happen. Reporting violence and learning methods to de-escalate situations are the best

options currently available for nurses to combat violence.

VIOLENCE IN NURSING 5

Conclusion

While caring for the safety of others, the safety of nurses is not always a priority. Verbal

and physical violence exist for nurses and healthcare workers alike. While research on this topic

is still limited, more resources for nurses are being developed. It is important for nurses to know

their risk for violence and how to prevent it. In addition, it’s also important that violence is

reported to help prevent future episodes of violence.

VIOLENCE IN NURSING 6

References

Arnetz, J., Hamblin, L., Sudan, S., & Arnetz, B. (2018, August 11). Organizational determinants

of workplace violence against hospital workers. Journal of Occupational and

Environmental Medicine. 60(8) 693-699. doi: 10.1097/JOM.0000000000001345

Martinez, A. (2016, August 30). Managing workplace violence with evidence-based

interventions: A literature review. Journal of Psychosocial Nursing and Mental Health

Services. 54(9) 31-36. doi: 10.3928/02793695-20160817-05

Rock, A. (2019, July 3). Statistics you should know: Workplace violence in healthcare. Campus

Safety. Retrieved from: https://www.campussafetymagazine.com/hospital/workplace-

violence-in-healthcare-statistics/

Schwartz, F. & Bjorklund, P. (2019, April). Quality improvement project to manage workplace

violence in hospitals. Journal of Nursing Quality Care. 34(7) 114-120.

Wong, A., Ray, J., & Iennaco, J. (2019). Workplace violence in health care and agitation

management: Safety for patients and health care professionals are two sides of the same

coin. The Joint Commission Journal on Quality and Patient Safety, 45(2) 71-73.