Research| Volume 49, ISSUE 3, P450-460, May 2023

Download started.


Qualitative Analysis of Workplace Assault Outcomes from the Perspectives of Emergency Nurses

Published:October 20, 2022DOI:



      Emergency nurses experience a myriad of negative consequences associated with workplace assault. The purpose of this study was to explore the experiences of emergency nurses using the Ecological Occupational Health Model of Workplace Assault.


      A descriptive qualitative design was used for this study. Data from 167 emergency nurse participants who described an episode of workplace assault were analyzed using a conventional content analysis method.


      Fourteen codes emerged from the qualitative data that related to 4 categories for the theme, Outcomes of Workplace Assault. The category “Consequences of Assault to Patients and Visitors” was supported by the following codes: use of limit setting; being evicted or removed from the emergency department; having charges pressed or being arrested; use of restraints; and retaliation against aggressor. “Effects on the Worker” was supported by the following codes: physical outcomes and response; psychological outcomes and response; physical support from peers; apologies; and debriefing/supportive care. “Effects on the Workplace” was supported by the following codes: calling for and response by police or security; and visitor response, support, or assistance. “Effects on Patient Care” was supported by the following codes: impact to treatment and work productivity.


      Workplace assault in the ED setting is associated with consequences of workplace assault to patients and visitors as well as negative effects to emergency nurses, the workplace, and patient care. Emergency nurses need to seek and also offer emotional support after workplace assault. Providing support could serve as a deterrent to retaliation while minimizing potential adverse impacts to nurses’ psychological health and work productivity.

      Graphical abstract

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Emergency Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mitra B.
        • Nikathil S.
        • Gocentas R.
        • Symons E.
        • O’Reilly G.
        • Olaussen A.
        Security interventions for workplace violence in the emergency department.
        Emerg Med Australas. 2018; 30: 802-807
        • Patridge B.
        • Affleck J.
        Verbal abuse and physical assault in the emergency department: rates of violence, perceptions of safety, and attitudes towards security.
        Australas Emerg Nurs J. 2017; 20: 139-145
        • Hills S.
        • Crawford K.
        • Lam L.
        • Hills D.
        The way we do things around here. A qualitative study of the workplace aggression experiences of Victorian nurses, midwives and care personnel.
        Collegian. 2021; 28: 18-26
        • Hassankhani H.
        • Parizad N.
        • Gacki-Smith J.
        • Rahmani A.
        • Mohammadi E.
        The consequences of violence against nurses working in the emergency department: a qualitative study.
        Int Emerg Nurs. 2018; 39: 20-25
        • Wright-Brown S.
        • Sekula K.
        • Gillespie G.
        • Zoucha R.
        The experiences of registered nurses who are injured by interpersonal violence while on duty in an emergency department.
        J Forensic Nurs. 2016; 12: 189-197
        • Mikkola R.
        • Huhtala H.
        • Paavilainen E.
        Work-related fear and the threats of fear among emergency department nursing staff and physicians in Finland.
        J Clin Nurs. 2017; 26: 2953-2963
        • Ramacciati N.
        • Ceccagnoli A.
        • Addey B.
        • Rasero L.
        Violence towards emergency nurses. The Italian National survey 2016: a qualitative study.
        Int J Nurs Stud. 2018; 81: 21-29
        • Sharifi S.
        • Shahoei R.
        • Nouri B.
        • Almvik R.
        • Valiee S.
        Effect of an education program, risk assessment checklist and prevention protocol on violence against emergency department nurses: a single center before and after study.
        Int Emerg Nurs. 2020; 100813: 50
        • Gillespie G.L.
        • Leming-Lee T.S.
        • Crutcher T.
        • Mattei J.
        Chart it to stop it: a quality improvement study to increase the reporting of workplace aggression.
        J Nurs Care Qual. 2016; 31: 254-261
      1. Framework guidelines for addressing workplace violence in the health sector. International Labour Organization, International Council of Nurses, World Health Organization, Public Services International. Published 2002.
        • Jeong I.Y.
        • Kim J.S.
        The relationship between intention to leave the hospital and coping methods of emergency nurses after workplace violence.
        J Clin Nurs. 2018; 27: 1692-1701
        • Levin P.F.
        • Hewitt J.B.
        • Misner S.T.
        • Reynolds S.
        Assault of long-term care personnel.
        J Gerontol Nurs. 2003; 29: 28-35
        • Gillespie G.L.
        • Gates D.M.
        • Berry P.
        Stressful incidents of physical violence against emergency nurses.
        Online J Issues Nurs. 2013; 18: 1
        • Gillespie G.L.
        • Pekar B.
        • Byczkowski T.L.
        • Fisher B.S.
        Worker, workplace, and community/environmental risk factors for workplace violence in emergency departments.
        Arch Environ Occup Health. 2017; 72: 79-86
        • Sandelowski M.
        Whatever happened to qualitative description?.
        Res Nurs Health. 2000; 23: 334-340;4<334::AID-NUR9>3.0.CO;2-G
        • Hsieh H.
        • Shannon S.E.
        Three approaches to qualitative content analysis.
        Qual Health Res. 2005; 15: 1277-1288
        • Vasileiou K.
        • Barnett J.
        • Thorpe S.
        • Young T.
        Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period.
        BMC Med Res Methodol. 2018; 148: 18
        • Lincoln Y.S.
        • Guba E.G.
        Naturalistic Inquiry.
        SAGE Publications, 1985
        • Smiley R.A.
        • Ruttinger C.
        • Oliveira C.M.
        • et al.
        The 2020 National nursing workforce survey.
        J Nurs Regul. 2021; 12 (Suppl) (S1-S96) 00027–2
        • Guerrero P.
        • Mycyk M.B.
        Physical and chemical restraints (an update).
        Emerg Med Clin North Am. 2020; 38: 437-451
        • Gurney D.
        • Gillespie G.L.
        • McMahon M.P.
        • Kolbuk M.E.
        Nursing code of ethics: provisions and interpretive statements for emergency nurses.
        J EmergNurs. 2017; 43: 497-503
        • Busch I.M.
        Peer support for health care workers emotionally affected by workplace violence.
        • Registered Nurses’ Association of Ontario
        Preventing Violence, Harassment and Bullying Against Health Workers. 2nd ed. Registered Nurses’ Association of Ontario, 2019
        • Ramacciati N.
        • Giusti G.D.
        Workplace violence in emergency departments: the health professionals and security personnel alliance.
        Emerg Med Australas. 2020; 32: 1074-1076
        • Muir-Cochrane E.
        • Muller A.
        • Fu Y.
        • Oster C.
        Role of security guards in Code Black events in medical and surgical settings: a retrospective chart audit.
        Nurs Health Sci. 2020; 22: 758-768
        • National Council for Mental Wellbeing
        Mental Health First Aid. National Council for Mental Wellbeing, Missouri Department of Mental Health. Updated 2022.
        Date accessed: September 2, 2022


      Gordon Lee Gillespie, Member, Greater Cincinnati Chapter, is a Professor, University of Cincinnati College of Nursing, Cincinnati, OH. Twitter: @glgillespie2. ORCID identifier:


      Peggy Berry is Owner, Thrive at Life, Dayton, OH. Twitter: @PberryRN. ORCID identifier: