Healthcare News & Insights

Report: Only half of attacks on ER nurses reported


A new study by the Emergency Nurses Association (ENA) reveals startling levels of violence against emergency department nurses.

A nine-month survey of emergency department nurses found that each week 8% to 13% experience some form of physical violence at work. More than half the nurses surveyed said they had experienced verbal or physical abuse at work in the past week.

Among those who experienced physical violence, 15% said they were injured — and in half of those cases, no action was taken against the abuser.

As disturbing as the level of violence is, hospitals’ reactions do little to help. Three-fourths of the nurses who reported violent incidents said they received no response from the hospital. When hospitals did respond, it was most often to give the aggressor a warning.

Who’s at risk — and when

According to the survey, the abusive person was typically either a patient or a patient’s relative in 97% of physical abuse cases, and 91% of incidents of verbal abuse. The most common location for an aggressive act was in a patient room (80% of incidents). About 23% of the abuse took place in common areas, such as elevators, stairwells and hallways; 15% of incidents took place at the nurse’s station. (Some incidents carried into one or more locations.)

Nurses are at most risk when triaging patients (38% of incidents), restraining or subduing patients (34%) or performing an invasive procedure (31%). Male nurses were more likely to be assaulted than female nurses –15% of men reported incidents compared to 10% of women.

Call to action

The ENA has asked the Occupational Safety & Health Administration (OSHA) to change its current guidelines on violence prevention into mandatory standards (downloadable PDF) that hospitals and other health facilities would be required to follow.

The current guidelines recommend hospitals do the following:

  • establish a zero-tolerance policy toward both physical violence and verbal abuse
  • encourage reporting of all incidents
  • ensure employees who report incidents don’t face reprisals, and
  • have an ongoing relationship with a liaison in law enforcement to handle incidents as they arise.

The ENA also said hospitals should debrief employees who report incidents to tell them whether the police had been contacted and if the perpetrator was warned, arrested, sent for a psych consult or fled the scene. As for prevention, the ENA encouraged more hospitals to use panic buttons, silent alarms, enclosed nurses’ stations and improved lighting to create an overall safer facility for everyone.

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