Nurses' attitudes toward the reporting of workplace violence in the emergency department

Background: The literature indicates that the incidence of workplace violence against nurses in emergency departments is grossly underreported. The underreporting of violence is an issue, as the true nature and frequency of violent incidents occurring in the emergency department is unknown. Without this knowledge it is difficult to address the problem of workplace violence. Aim: The aim of this study was to identify the attitudes, barriers and enablers of emergency nurses to the reporting of workplace violence. Method: Using a phenomenological approach, two focus groups were conducted at a tertiary level emergency department to collect the data. The data were audio-recorded, transcribed verbatim and analysed using thematic analysis. Findings: Violent incidents in this emergency department are underreported by nurses. The current formal reporting system was found to be a major barrier to reporting as it was difficult and time consuming to use. Nurses did report violence using methods other than the designated formal reporting system. Nurses' attitudes towards violence influenced their decision to report. Nurses accepted violence as part of their normal working day, and therefore were less likely to report it. Violent incidents were not defined as 'violence' if no physical injury was sustained, and therefore it was not reported. Nurses were also motivated to report formally in order to protect themselves from any possible future complaints made by perpetrators. Conclusion: This study showed that while emergency nurses do report violence, they do not use the formal reporting system. When they did use the formal reporting system they were motivated to do so in order to protect themselves. As a consequence of underreporting formally, the nature and extent of workplace violence remains unknown.