Workplace Violence

Violence in emergency departments has reached epidemic levels and emergency nurses are particularly vulnerable. In fact, the healthcare industry leads all other sectors in the incidence of nonfatal workplace assaults, and the emergency department is a particularly vulnerable setting. It’s currently a felony to assault an emergency nurse in 31 states, and we’re working hard to make it a felony in all 50 states.

ENA believes emergency nurses have the right to education and training related to the recognition, management, and mitigation of workplace violence. The mitigation of workplace violence requires a “zero tolerance” environment instituted and supported by hospital leadership.

The resources below were designed to help emergency nurses conduct and participate in research and quality improvement initiatives aimed at preventing, mitigating, and reporting workplace violence.



Guiding Principles: Mitigating Violence in the Workplace 
The American Organization of Nurse Executives (AONE) and ENA created these Guiding Principles to assist nurse leaders in systematically addressing measures to manage and reduce violence against health care professionals. The guiding principles include steps to systematically reduce lateral, as well as patient and family violence in the workplace.

Position Statement: Violence in the Emergency Care Setting (2014) 
ENA recognizes emergency nurses are at significant occupational risk for workplace violence and emergency nurses have the right to personal safety in the work environment.

Online Education

Know Your Way Out: Recognize, Avoid, Prevent and Mitigate Emergency Department Violence
Developed by ENA with a grant from OSHA, this two-hour interactive, online course is designed for nurses, managers, and staff who work in emergency care settings. Participants will learn how to recognize risk factors, apply prompt and appropriate responses, implement organizational prevention strategies, and report and analyze patterns of violence. 


Workplace Violence Toolkit
This Workplace Violence Toolkit, developed by ENA leadership and your peers, offers practical solutions to the problem of violence in emergency departments all across the country. You will be provided with the resources to address this issue at all levels of the institution such as hospital administration, division or department management, educators and staff. The templates and tools provide an easy step-by-step procedure for customizing a violence prevention plan that will meet the needs of your department.

Research and Articles

Nothing Changes, Nobody Cares: Understanding the Experience of Emergency Nurses Physically or Verbally Assaulted While Providing Care
Journal of Emergency Nursing, January, 2014 
This qualitative study was designed to better understand the experience of emergency nurses who have been physically or verbally assaulted while providing patient care in US emergency departments. The findings are consistent with existing literature but with an added contribution of clearly identifying an underlying cultural acceptance of violence in the emergency department, as well as a distinct lack of cue recognition.

Emergency Department Violence Surveillance (EDVS) Study (2011)
ENA initiated a workplace violence surveillance study to collect data on a quarterly basis via an online survey from emergency nurses on the occurrence of violence toward nurses and the processes used to respond to workplace violence. This two-year report represents analysis of eight consecutive rounds of data collected approximately three months apart.

Violence Against Nurses Working in US Emergency Departments 
JONA: Journal of Nursing Administration, July/August 2009
A total of 3,465 emergency nurse ENA members participated in a cross-sectional study aimed at investigating emergency nurses' experiences and perceptions of workplace violence, the types of and frequencies of assaults, and the contributing factors to workplace violence.

Working to promote safe practice and safe care.