Abstract
Purpose: This presentation reviews the literature to explore the experience of workplace violence towards healthcare workers from patients/families in the emergency department as a global phenomenon.
Background: Attention to workplace violence (WPV) in emergency departments (ED) by patients or families toward healthcare workers in the US has been increasing (Carey & Hendricks, 2023; Doehring et al., 2024; McLaughlin & Khemthong, 2024). Since EDs are a point of entry to care, WPV can be exacerbated due to the fast-paced and unpredictable environment (McLaughlin & Khemthong, 2024). Patients are commonly admitted experiencing pain, substance use issues, and mental health crises which may trigger verbal or physical abuse (Carey & Hendricks, 2023). Other ED stressors like high volume of patients, understaffing, and long wait times can contribute to WPV from patients and families (Carey & Hendricks, 2023; McLaughlin & Khemthong, 2024). In some ED environments WPV has become normalized and is not reported consistently in the belief that there are no solutions (Buterakos et al., 2020).
Method: CINAHL, PubMed, and Google Scholar were used to search for articles published between 2018 and 2024 to answer the research question, “Do other countries experience WPV towards healthcare workers in the ED similar to the US?” Search terms included workplace violence; emergency department/room; violence and nurses. Twelve articles were chosen representing projects completed in Australia, Brazil, China, Denmark, France, Italy, India, Iran, Jordan, Korea, Portugal, and Turkey.
Findings: The experiences of physical and verbal WPV related to patients/families toward healthcare workers in the ED, including nurses, revealed similarities. As individuals this included physical injury (or fear of it), psychological and emotional stress, and the impact of this on their personal lives. Women reported this more than men, and racial/ethnic attacks were also experienced. As professionals, WPV influenced factors such as intent to leave, mistrust that employers will not take action to protect them, and increased incivility among peers related to displaced frustration. The reflection that WPV was an expected part of working in the ED was also reported.
Conclusion: As the entry point for people in crisis, the experience of violence in the ED by healthcare workers is a global phenomenon. While it is an occupational risk, continuous action must be taken to ensure the safety and well-being of healthcare workers.
Notes
References:
Ahluwalia, T., Singh, S., Gandhi, N., Toy, S., Douglass, K., Blanchard, J., & Davey, K. (2024). Violence in the emergency department: A quantitative survey study of healthcare providers in India. International Journal of Emergency Medicine, 17(1). https://doi.org/10.1186/s12245-024-00653-x
Al Natour, A., Abuzaid, L., & Hweidi, L. I. (2022). Nurses’ experiences of workplace violence in the emergency department. International Nursing Review, 70(4), 485–493. https://doi.org/10.1111/inr.12788
American Nurses Association. (2021, March). Workplace violence. https://www.nursingworld.org/practice-policy/advocacy/state/workplace-violence2/
Andersen, L. P., Jaspers, S., Andersen, D., Karlsen, I., & Aust, B. (2024). A participatory and comprehensive intervention to improve violence prevention in two high-risk occupations: effect and process evaluation of a stepped wedge cluster randomised trial. BMC Public Health, 24(1), 1043. https://doi.org/10.1186/s12889-024-18527-5
Antão, H. S., Sacadura-Leite, E., Manzano, M. J., Pinote, S., Relvas, R., Serranheira, F., & Sousa-Uva, A. (2020). Workplace violence in healthcare: A single-center study on causes, consequences and prevention strategies. Acta Médica Portuguesa, 33(1), 31–37. https://doi.org/10.20344/amp.11465
Buterakos, R., Keiser, M. M., Littler, S., & Turkelson, C. (2020). Report and prevent: A quality improvement project to protect nurses from violence in the emergency department. Journal of Emergency Nursing, 46(3), 338–344.e7. https://doi.org/10.1016/j.jen.2020.02.010
Cao, Y., Gao, L., Fan, L., Zhang, Z., Liu, X., Jiao, M., Li, Y., & Zhang, S. (2023). Effects of verbal violence on job satisfaction, work engagement and the mediating role of emotional exhaustion among healthcare workers: A cross-sectional survey conducted in Chinese tertiary public hospitals. BMJ Open, 13(3). https://doi.org/10.1136/bmjopen-2022-065918
Carey, I., & Hendricks, K. (2023). Workplace violence against healthcare workers using nationally representative estimates of emergency department data, 2015-2017. American Journal of Industrial Medicine, 66(4), 333–338. https://doi.org/10.1002/ajim.23463
D'Ettorre, G., Caroli, A., Pellicani, V., & Ceccarelli, G. (2020). Preliminary risk assessment of workplace violence in hospital emergency departments. Annali di Igiene: Medicina Preventiva e di Comunita, 32(2), 99–108. https://doi.org/10.7416/ai.2020.2334
Dafny, H. A., & Beccaria, G. (2020). I do not even tell my partner: Nurses' perceptions of verbal and physical violence against nurses working in a regional hospital. Journal of Clinical Nursing, 29(17-18), 3336–3348. https://doi.org/10.1111/jocn.15362
Davey, K., Ravishankar, V., Mehta, N., Ahluwalia, T., Blanchard, J., Smith, J., & Douglass, K. (2020). A qualitative study of workplace violence among healthcare providers in emergency departments in India. International Journal of Emergency Medicine, 13(1). https://doi.org/10.1186/s12245-020-00290-0
Doehring, M. C., Palmer, M., Satorius, A., Vaughn, T., Mulat, B., Beckman, A., Reed, K., Spech Dos Santos, T., & Hunter, B. R. (2024). Workplace violence in a large urban emergency department. JAMA Network Open, 7(11), e2443160. https://doi.org/10.1001/jamanetworkopen.2024.43160
Heshmati-Nabavi, F., Hemati-Esmaeili, M., Pouresmail, Z., Mazlom, S., & Reihani, H. (2018). Educational and managerial policy making to reduce workplace violence against nurses: An action research study. Iranian Journal of Nursing and Midwifery Research, 23(6), 478–485. https://doi.org/10.4103/ijnmr.ijnmr_77_17
Jeong, I. Y., & Kim, J. S. (2018). The relationship between intention to leave the hospital and coping methods of emergency nurses after workplace violence. Journal of Clinical Nursing, 27(7-8), 1692–1701. https://doi.org/10.1111/jocn.14228
Kiymaz, D., & Koç, Z. (2023). Workplace violence, occupational commitment and intention among emergency room nurses: A mixed-methods study. Journal of Clinical Nursing, 32(5-6), 764–779. https://doi.org/10.1111/jocn.16331
McLaughlin, L., & Khemthong, U. (2024). The prevalence of type II workplace violence in US nurses 2000 to 2022: A meta-analysis. Western Journal of Nursing Research, 46(3), 248–255. https://doi.org/10.1177/01939459231222449
Pai, D. D., Sturbelle, I. C., Santos, C. dos, Tavares, J. P., & Lautert, L. (2018). Physical and psychological violence in the workplace of healthcare professionals. Texto Contexto - Enfermagem, 27(1). https://doi.org/10.1590/0104-07072018002420016
Touzet, S., Occelli, P., Denis, A., Cornut, P. L., Fassier, J. B., Le Pogam, M. A., Duclos, A., & Burillon, C. (2019). Impact of a comprehensive prevention programme aimed at reducing incivility and verbal violence against healthcare workers in a French ophthalmic emergency department: an interrupted time-series study. BMJ Open, 9(9), e031054. https://doi.org/10.1136/bmjopen-2019-031054
Sigma Membership
Omega Nu
Type
Poster
Format Type
Text-based Document
Study Design/Type
Literature Review
Research Approach
N/A
Keywords:
Workforce, Stress and Coping, Acute Care, Clinical Practice, Workplace Culture, Workplace Violence, Emergency Departments
Recommended Citation
George, Katelyn and Elting, Julie Kientz, "Workplace Violence in the ED as a Global Phenomenon: Literature Review" (2025). Biennial Convention (CONV). 43.
https://www.sigmarepository.org/convention/2025/posters_2025/43
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
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Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-30
Workplace Violence in the ED as a Global Phenomenon: Literature Review
Indianapolis, Indiana, USA
Purpose: This presentation reviews the literature to explore the experience of workplace violence towards healthcare workers from patients/families in the emergency department as a global phenomenon.
Background: Attention to workplace violence (WPV) in emergency departments (ED) by patients or families toward healthcare workers in the US has been increasing (Carey & Hendricks, 2023; Doehring et al., 2024; McLaughlin & Khemthong, 2024). Since EDs are a point of entry to care, WPV can be exacerbated due to the fast-paced and unpredictable environment (McLaughlin & Khemthong, 2024). Patients are commonly admitted experiencing pain, substance use issues, and mental health crises which may trigger verbal or physical abuse (Carey & Hendricks, 2023). Other ED stressors like high volume of patients, understaffing, and long wait times can contribute to WPV from patients and families (Carey & Hendricks, 2023; McLaughlin & Khemthong, 2024). In some ED environments WPV has become normalized and is not reported consistently in the belief that there are no solutions (Buterakos et al., 2020).
Method: CINAHL, PubMed, and Google Scholar were used to search for articles published between 2018 and 2024 to answer the research question, “Do other countries experience WPV towards healthcare workers in the ED similar to the US?” Search terms included workplace violence; emergency department/room; violence and nurses. Twelve articles were chosen representing projects completed in Australia, Brazil, China, Denmark, France, Italy, India, Iran, Jordan, Korea, Portugal, and Turkey.
Findings: The experiences of physical and verbal WPV related to patients/families toward healthcare workers in the ED, including nurses, revealed similarities. As individuals this included physical injury (or fear of it), psychological and emotional stress, and the impact of this on their personal lives. Women reported this more than men, and racial/ethnic attacks were also experienced. As professionals, WPV influenced factors such as intent to leave, mistrust that employers will not take action to protect them, and increased incivility among peers related to displaced frustration. The reflection that WPV was an expected part of working in the ED was also reported.
Conclusion: As the entry point for people in crisis, the experience of violence in the ED by healthcare workers is a global phenomenon. While it is an occupational risk, continuous action must be taken to ensure the safety and well-being of healthcare workers.
Description
Attention to workplace violence (WPV) in emergency departments (ED) by patients or families toward healthcare workers in the US is increasing. Physical and mental health crises in the ED, combined with long wait times or staffing issues, can increase volatile behavior of patients and families. To investigate the global experience of ED WPV and its impact on healthcare providers, this review compared literature from the US and 12 other countries, revealing many universal themes.