Violence is part of the job, say nurses, as study shows only 1 in 6 incidents are reported

The majority (92%) said they had been verbally abused, 69% had been physically threatened and 52% had been physically assaulted. A total of 2,354 incidents were reported to the research team, with nurses facing an average of two to 46 incidents a year.

"Many of the nurses who took part in the research said that they did not report incidents because they felt that workplace violence was just part of the job" says lead author Dr Rose Chapman, from Curtin University of Technology in Perth, Western Australia.

The 113 nurses who took part in the study were mainly female, in their early 40s and had been in the profession for between six months and 40 years, with an average service of just under 18 years. Nearly two-thirds worked part-time.

The number and nature of incidents varied depending on what department the nurses worked in:

• A quarter of the nurses (25%) experienced weekly events, 27% monthly events and 25% one event every six months. The remainder had not experienced any violence.
• Incidents were highest in the emergency department, where staff reported an average of 46 incidents over the previous year, and in mental health, where the average was 40 incidents.
• The lowest incidents were reported by midwives (an average of two incidents each) and surgical staff and paediatric staff (an average of four incidents each).
• 40% of staff had been involved in an incident with a weapon and 3% said it was a weekly occurrence. Weapons included guns (6%), knives (3%) and hospital equipment (32%). Weapon-related incidents were more common in the emergency department (weekly) and mental health (monthly).

Reporting practices also varied:

• Despite experiencing more problems, nurses working in the emergency department were much less likely to report any incidents (42%) than staff in other areas (76%).
• Half of all the nurses (50%) said they had reported an incident verbally -- to their immediate manager (29%), other senior nursing staff (14.5%) and/or to their friends or colleagues (6%). But only 16% of incidents were officially reported.
• 30% did not report incidents because they felt workplace violence was part of the job and 50% said that when they had reported an event, senior managers had failed to take action.
• However 70% said they would report an incident if they or a colleague were injured or there was a chance they would be laying charges or making a claim for compensation.

"The nurses in our study were reluctant to report episodes of workplace violence unless they considered the event to be serious" says Dr Chapman. "This finding was supported by a retrospective audit of the hospital's formal incident reports, which showed that 96% of the reporting nurses had received one or more injuries as the result of a violent incident in the workplace.

"Understanding why nurses do or do not report incidents is very important as it can help educators and administrators to develop programmes that help to reduce workplace violence. Further research on how individuals adapt to violence in the workplace is also warranted."

"Workplace violence is never acceptable and it is a very sad indictment of society today that so many of the nurses in this study saw these incidents as part of their job" says journal Editor Roger Watson from the University of Sheffield, UK.

"Many of the studies published by the nursing media have focused on public facilities, but this study shows that violence is also an issue when patients are receiving private health care.

"It is vital that workplace violence is tackled to ensure that healthcare systems are able to retain good quality, trained staff. Any studies that provide an insight into how staff cope with violence, and what influences their decision to report incidents, are to be welcomed."