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ENA Position Statement| Volume 46, ISSUE 3, P354-358, May 2020

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Violence and Its Impact on the Emergency Nurse

      In 2002, the World Health Organization declared workplace violence to be a global epidemic with a negative impact on the retention of health personnel and delivery of health care.
      World Health Organization
      Framework guidelines for addressing workplace violence in the health sector.
      The violence also results in significant economic, personal, and professional costs.
      World Health Organization
      Framework guidelines for addressing workplace violence in the health sector.
      • Nikathil S.
      • Olaussen A.
      • Gocentas R.A.
      • Symons E.
      • Mitra B.
      Review article: workplace violence in the emergency department: a systematic review and meta analysis.
      • Phillips J.P.
      Workplace violence against health care workers in the United States.
      In the United States, the prevalence of workplace violence in the health care industry is 4 times higher than in other private industries.
      Occupational Safety and Health Administration
      Workplace violence in healthcare: understanding the challenge.
      Ease of public access, crowding, long wait times, presence of weapons, and other factors make the emergency department a highly vulnerable area,
      • Gacki-Smith J.
      • Juarez A.M.
      • Boyett L.
      • Homeyer C.
      • Robinson L.
      • Maclean S.L.
      Violence against nurses working in US emergency departments.
      The Joint Commission
      Physical and verbal violence against health care workers.
      • Spector P.E.
      • Zhou Z.E.
      • Che X.X.
      Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: a quantitative review.
      • Kleissl-Muir S.
      • Raymond A.
      • Rahman M.A.
      Incidence and factors associated with substance abuse and patient-related violence in the emergency department: a literature review.
      • Stowell K.R.
      • Hughes N.P.
      • Rozel J.S.
      Violence in the emergency department.
      especially where triage occurs.
      • Pich J.V.
      • Kable A.
      • Hazelton M.
      Antecedents and precipitants of patient-related violence in the emergency department: results from the Australian VENT study (Violence in Emergency Nursing and Triage).
      ,
      • Lau J.B.C.
      • Magarey J.
      • Wiechula R.
      Violence in the emergency department: an ethnographic study (part II).
      Emergency nurses and other ED staff are at serious occupational risk of experiencing workplace violence, including verbal and physical assaults.
      • Gacki-Smith J.
      • Juarez A.M.
      • Boyett L.
      • Homeyer C.
      • Robinson L.
      • Maclean S.L.
      Violence against nurses working in US emergency departments.
      The Joint Commission
      Physical and verbal violence against health care workers.
      • Spector P.E.
      • Zhou Z.E.
      • Che X.X.
      Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: a quantitative review.
      For these reasons, workplace violence has been recognized in many states as a violent crime.
      • Papa A.
      • Venella J.
      Workplace violence in healthcare: strategies for advocacy.
      Yet, at the time of this publication, only about 30 states have adopted laws that make it a felony to assault a registered nurse.
      Emergency Nurses Association
      States with enhanced penalties for workplace violence against emergency nurses.
      Other ongoing legislative initiatives include the introduction of the “HR 1309: Workplace Violence Prevention for Health Care and Social Service Workers Act” in 2019 and continued advocacy and evaluation of state-based felony reforms.
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