TY - JOUR

T1 - A Qualitative Meta-synthesis of Emergency Department Staff Experiences of Violence and Aggression

AU - Ashton, Rebecca

AU - Morris, Lucy

AU - Smith, Ian Craig

N1 - This is the author’s version of a work that was accepted for publication in International Emergency Nursing. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in International Emergency Nursing, 39, 2018 DOI: 10.1016/j.ienj.2017.12.004

PY - 2018/7

Y1 - 2018/7

N2 - Introduction Patient and visitor violence or aggression against healthcare workers in the Emergency Department (ED) is a significant issue worldwide. This review synthesises existing qualitative studies exploring the first-hand experiences of staff working in the ED to provide insight into preventing this issue. Method A meta-ethnographic approach was used to review papers. Results Four concepts were identified: ‘The inevitability of violence and aggression’; ‘Staff judgments about why they face violence and aggression’; ‘Managing in isolation’; and ‘Wounded heroes’. Discussion Staff resigned themselves to the inevitability of violence and aggression, doing this due to a perceived lack of support from the organisation. Staff made judgements about the reasons for violent incidents which impacted on how they coped and subsequently tolerated the aggressor. Staff often felt isolated when managing violence and aggression. Key recommendations included: Staff training in understanding violence and aggression and clinical supervision. Conclusions Violence and aggression in the ED can often be an overwhelming yet inevitable experience for staff. A strong organisational commitment to reducing violence and aggression is imperative.

AB - Introduction Patient and visitor violence or aggression against healthcare workers in the Emergency Department (ED) is a significant issue worldwide. This review synthesises existing qualitative studies exploring the first-hand experiences of staff working in the ED to provide insight into preventing this issue. Method A meta-ethnographic approach was used to review papers. Results Four concepts were identified: ‘The inevitability of violence and aggression’; ‘Staff judgments about why they face violence and aggression’; ‘Managing in isolation’; and ‘Wounded heroes’. Discussion Staff resigned themselves to the inevitability of violence and aggression, doing this due to a perceived lack of support from the organisation. Staff made judgements about the reasons for violent incidents which impacted on how they coped and subsequently tolerated the aggressor. Staff often felt isolated when managing violence and aggression. Key recommendations included: Staff training in understanding violence and aggression and clinical supervision. Conclusions Violence and aggression in the ED can often be an overwhelming yet inevitable experience for staff. A strong organisational commitment to reducing violence and aggression is imperative.

KW - Workplace Violence

KW - Aggression

KW - Emergency Services

KW - Emergency Department

KW - Health Personnel

KW - Qualitative Studies

U2 - 10.1016/j.ienj.2017.12.004

DO - 10.1016/j.ienj.2017.12.004

M3 - Journal article

VL - 39

SP - 13

EP - 19

JO - International Emergency Nursing

JF - International Emergency Nursing

SN - 1755-599X

ER -