Violence in Nursing - J

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.
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)

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.

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.

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.

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Running head: VIOLENCE IN NURSING

Delaware Technical Community College

NUR 340- Nursing Research

February 23rd, 2020

violence in the nursing field.

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

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

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

nurses and patients. (Martinez, 2016)

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

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

options currently available for nurses to combat violence.

reported to help prevent future episodes of violence.

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

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

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

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