The article examines the objective, findings, and clinical context described in Workplace Violence Targeting Nurses: An Emergency Department Crisis.
Approach:
Study design and data: A cross-sectional investigation surveyed 337 nurses across 11 EDs in one health system and linked responses to administrative and electronic medical record data.
WPV definition: WPV included bullying, unwanted sexual attention, threats, verbal abuse, and physical violence by patients, visitors, or coworkers.
Analysis: The study used multivariable mixed-effects logistic regression to assess associations between WPV and selected individual, team, and ED characteristics.
Key Findings:
Overall, 87.8% of participants reported WPV in the preceding month.
Among 296 nurses reporting WPV, 98.6% reported incidents involving patients or visitors; 20.3% also reported coworker-perpetrated WPV, most often bullying.
Overtime was associated with higher odds of WPV; night-shift work and employment at a freestanding ED were associated with lower odds.
The association between racial or ethnic minority status and lower WPV odds was not statistically significant.
Interpretation:
The article describes WPV as a widespread and unacceptable ED problem. It cautions that the overtime association may reflect greater time exposed to the workplace rather than a distinct effect of overtime, and that odds ratios can overstate relative risks when outcomes are common. It also notes that combining patient- and coworker-perpetrated violence may obscure differences relevant to prevention.
Limitations:
The cross-sectional design does not establish causation.
The study population was drawn from 11 EDs in one health system.
Approximately 85% of participants identified as White, limiting interpretation of subgroup findings.
The proportion of nurses working overtime was not reported in the context provided.
The high prevalence of WPV complicates interpretation of odds ratios.
Patient- and coworker-perpetrated WPV were considered together in analyses, potentially obscuring distinct patterns.
Conclusion:
The article calls for further research on team- and system-level prevention and on coworker-perpetrated WPV, with multidisciplinary involvement from clinicians, hospital leaders, and policymakers.
