More than half of emergency nurses say they've been "spit on," "hit," "pushed or shoved," "scratched," and "kicked" while on the job, according to a national online survey by the Emergency Nurses Association.
It gets worse. One in four of the 3,465 emergency nurses surveyed for Violence Against Nurses Working in U.S. Emergency Departments say they've been assaulted more than 20 times in the past three years, and one in five nurses have been verbally abused more than 200 times during the same period.
"People who work in helping professions shouldn't have to put their physical and emotional well-being on hold to do their jobs," says ENA President Bill Briggs, RN. "Emergency nurses provide crucial healthcare services. Their departments and their hospitals depend on them being able to deliver high-quality care. They can't do that if they're in danger of being verbally or physically abused."
More than half of the nurses say one or more factors played a role in their abuse, including: patients and visitors who were drunk or using illicit drugs; psychiatric patients in the ED; crowding; long wait times; and staff shortages. More than two in three (67%) of emergency nurses rate their perception of safety in the ED at five or lower on a 10-point scale, and one in three say they had considered leaving their hospital or emergency nursing altogether because of the violence.
Reports of violence are lowest in pediatric emergency departments and highest during night shifts and on weekends. Male emergency nurses are more likely than female nurses to be assaulted. Workplace violence is lower in facilities that have strong policies for reporting and responding to the violence.
Conversely, violence is higher in facilities that have barriers to reporting violence, where nurses complain of: a perception that reporting violent incidents might have a negative effect on customer service reports; ambiguous policies for reporting incidents; fear of retaliation by superiors; perceptions that reporting incidents is a sign of incompetence; the attitude that violence is to be expected; and a lack of support from administration.
The ENA has several recommendations to reduce ED violence that include:
- Ensuring that ED staff know that senior administration is aware of the issues and support efforts to prevent violence.
- Establishing a culture of acceptance for reporting violence.
- Developing clear procedures for reporting violence.
- Providing access to medical care and follow-up counseling for ED staff who are assaulted.
- Appointing an interdisciplinary task force to identify ED vulnerabilities and develop a plan for preventing, mitigating, responding to, and reporting violence.
- The report's authors also recommend federal and state laws to protect ED nurses from violence. Laws protecting emergency nurses vary widely by state, and several states have no such laws.
The 69-question survey was published today in the July/August issue of the Journal of Nursing Administration, and was based on the results of an online survey that was conducted in April and May 2007. Nearly 84% of the respondents were women.