The impact of workplace violence on nurses in South Taiwan

Abstract

The purpose of this study was to explore the prevalence of workplace violence (WPV) committed by patients and their family members against healthcare workers in south Taiwan. WPV incident questionnaires were completed by 205 nurses from a medical facility in south Taiwan. Sixty-two percent of the nurses reported experiencing WPV. The majority of the cases consisted of verbal abuse including threats of violence or threatening words from patients or families. The verbal expressions of violence were mainly due to misunderstanding and drunkenness on the part of patients and their families, and personal problems in the nurses’ relationships with doctors and co-workers. The cases of physical WPV reported by the nurses were perpetrated by patients who were mentally unstable.

The findings of this study may help hospitals and nurses in avoiding, reducing, and controlling incidents of WPV.

Introduction

Conflicts and disputes between patients and healthcare providers have increased in Taiwan (Chao et al., 1997). Patients and their families tend to make strong demands on medical staff concerning meeting patient needs and pursuing what they consider to be proper medical treatment. Most doctors do not seem to be very interested in empowering patients by supplying good health information, offering options, or listening. Nurses act as the “public face” and “intermediaries” of the hospital, between patients and desk staff, technicians, and doctors, especially in the emergency room, are usually the first person that patients and their families meet; therefore, nurses are often blamed. Most patients dare not blame the doctors, because they are afraid that a physician may refuse to care for and treat them properly. In effect, nurses become the scapegoat (Chao et al., 1997).

The US Department of Transportation (2004) defines “workplace violence” as “Assaults, other violent acts or threats which occur in or are related to the workplace and entail a substantial risk of physical or emotional harm to individuals, or damage to government resources or capabilities.” Workplace violence (WPV) in this study refers to physical assault or verbal threatening of nurses by patients, families, or co-workers while nurses performed their duties (Yang et al., 1997). High frequencies of WPV have been reported in Taiwan and America (Chao et al., 1997; Levin et al., 1998; Little, 1999; Rosenthal et al., 1992). True rates of violence are unknown and may be assumed to be higher than documented. Mayer et al. (1999) found that 71.7% of emergency department nurses under-reported incidents of WPV.

As a consequence of experiencing WPV, a nurse may decide to relocate within a facility or to another healthcare facility, or leave nursing altogether. The financial costs of WPV include decreased work time, decreased productivity, and decreased medical costs (Mahoney, 1991).

The increased incidence of violence in healthcare settings has become a major problem for nurses (Chao et al., 1997; Chambers, 1998; Sullivan and Yuan, 1995). Studies of WPV have, however, focused on its occurrence in hospital psychology units (Lu et al., 1996) and emergency rooms (Chao et al., 1997; Yo et al., 1998). Those studies indicate that workplace violence in healthcare settings is significant and needs to be stopped. The purpose of this study was to describe the WPV reported by nurses in Taiwan.