Violence in Nursing Care as a Practice Issue

Table of Contents

Nursing Issue

There is a prevalence of violence in nursing care. Nurses are exposed to a variety of threats from patients in the workplace. These may include verbal and emotional abuses as well as physical assaults. Violent patients are not restricted or controlled. The issue results in adverse outcomes for the nurses by contributing to psychological and physical health issues in an already high-stress workplace environment (Speroni, Fitch, Dawson, Dugan, & Atherton, 2014). As a result, the quality of nursing care may decline and cause patient dissatisfaction or negative health outcomes.

Measures (Indicators) to Support the Issue

The frequency of violence against nurses is common. Approximately 57.2% of nurses have experienced at least one type of violence recently. Emotional and verbal abuse tends to be the most common with a 53.4% incidence rate. Others include assault at 16.1%, bullying at 14.2%, sexual harassment at 7.6%, and racial harassment at 2.6%. The most concerning measure is that 70% of the nurses facing workplace violence choose not to report it, employment-related consequences. Perpetrators of workplace violence for nurses are most commonly patients (36.6%) and their family (17.5%) (Cheung, Lee, & Yip, 2017).

As a result of workplace violence, nurses have indicated a number of adverse consequences which has contributed to suffering beyond the individual incident. Physical health deteriorated due to potential injuries, stress-related chronic conditions, and sleeping problems. Mental health risks are a significant factor leading to negative emotions, anxiety, stress, and development of disorders such as depression. Often, these risk factors lead to disruptions in life or personal relationships outside of work. As a result of these outcomes, there were effects on professional integrity as nurses experienced loss of interest in work, decreased interactions with patients, and overall disruption in nursing care (Hassankhani, Parizad, Gacki-Smith, Rahmani, & Mohammadi, 2017).

Stakeholders in Improving the Nursing Issue

  1. Nurses are a significantly vulnerable occupational group in the exposure to workplace violence. That is due to their position in the medical hierarchy and a low degree of autonomy in work duties.
  2. Patients are significantly impacted by the issue. While only a small percentage of patients perpetuates violence, it is still a common factor, most commonly occurring due to dissatisfaction with care or mental health problems. However, as a result, the care quality of the patient body as a whole begins to decline.
  3. Hospital administration is responsible for implementing strategies in place for the protection of nurses and competently addressing any potential incidents. Currently, there is inconsistency in monitoring and addressing the issue in hospital settings.
  4. Human resource management in hospitals is partially involved. This stakeholder is responsible for staff management, including scheduling, attrition rates, and training which can all be causes of violence against nurses. Furthermore, this stakeholder is responsible for evaluating violence reports and providing staff support.
  5. Regulatory bodies such as the U.S. Department of Labor and Department of Health and Human Services are both interested in reducing workplace violence. The Occupational Safety and Health Administration (OSHA) has explicit guidelines and recommendations to reduce workplace violence in the healthcare sector.
  6. Nursing labor unions and organizations are actively involved in attempting to prevent the high incidence of workplace violence against nurses. This includes advocating for safer workplace environments, protection in place for nurses, and hospital administrations focusing on resolving the issue. These organizations may offer legal and financial support.

Analyze the Causes of the Nursing Issue

There are multifactorial causes to this issue. Many times, the reason a patient or their family initiates violence is due to their perception of inadequate care. This includes unmet expectations, lack of sufficient information, rejection of requests, or financial complications.

Organizational factors may play a role. Poor planning and coordination results in decreased quality or delay of care for patients. Scheduling can impact the patient flow and workload pressures for nurses, further aggravating dissatisfaction amongst patients. Communication amongst staff and with patients could lead to conflicts that result in workplace violence as well. Finally, the lack of clinical competence and proper stress management on behalf of the nurses themselves is a root issue (Najafi, Fallahi‐Khoshknab, Ahmadi, Dalvandi, & Rahgozar, 2017).


Cheung, T., Lee, P. H., & Yip, P. S. F. (2017). Workplace violence toward physicians and nurses: Prevalence and correlates in Macau. International Journal of Environmental Research and Public Health, 14(8), 879. Web.

Hassankhani, H., Parizad, N., Gacki-Smith, J., Rahmani, A., & Mohammadi, E. (2017). The consequences of violence against nurses working in the emergency department: A qualitative study. International Emergency Nursing. Web.

Najafi, F., Fallahi-Khoshknab, M., Ahmadi, F., Dalvandi, A., & Rahgozar, M. (2017). Antecedents and consequences of workplace violence against nurses: A qualitative study. Journal of Clinical Nursing, 27(1-2). Web.

Speroni, K. G., Fitch, T., Dawson, E., Dugan, L., & Atherton, M. (2014). Incidence and cost of nurse workplace violence perpetrated by hospital patients or patient visitors. Journal of Emergency Nursing, 40(3), 218-228. Web.

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