Background: Healthcare workers face a daily threat that has a potential to injure them both psychologically and physically, patients who are violent. The actual prevalence of verbal and physical violence is not known as professionals tend to under-report violent incidences. Violence faced by healthcare workers at the hands of patients and/or visitors is not discussed openly. Reflecting this hidden narrative, little can be found in the existing literature that explores the physical and psychological toll of sitting with a patient for long hours in a one-to-one assignment. There is an existing culture and undercurrent that violence is just “part of the job”.
Purpose: The purpose of this study was to gain understanding of the experience of staff asked to complete a one-on-one assignment (also known as a sitter) with a patient who has become verbally and/or physically violent.
Method: The method of phenomenology was used in five focus groups conducted virtually clinical nurses and nursing assistants who were employed in a hospital setting. Focus groups were conducted with five or fewer participants and were recorded for transcription purposes. A semi-structured interview guide lead focus group discussion about the experience of patient to healthcare worker violence in a one-on-one assignment. All interview transcripts were transcribed word-for-word and analyzed for codes and themes in an iterative and repetitive qualitative analysis process.
Results: Qualitative analysis produced 4 themes: (1) Silent Epidemic, (2) Culture of UNsafety, (3) Emotional Occupational Hazard, and (4) Policies and Response. Presentation of findings will include discussion of each of theme with participate quotes to support each.
Implications: Resources and policies currently in place may not be robust enough for clinical applicability at the bedside. Staff should be encouraged to report events when they occur no matter the diagnosis of the patient and provide necessary feedback toward the goal of improving safety of patients and staff. Regular educational offerings to ensure staff are competent in de-escalation techniques, current policy, and last resort clinical judgement actions that protect their own safety are essential.