Nurses' Perceptions of Patient Violence: Exposure, Expectation, Risk Factors and Risk Tolerance.

Abstract

Background: There are known risk factors for patient violence, but it is not known whether nurses are aware of them. Nurses' expectations regarding exposure to patient violence and risk tolerance have not been investigated.

Aim: To examine hospital-based nurses' frequency of and expectations regarding exposure to patient violence, risk factors perceived to be associated with violence and self-reported risk tolerance.

Design: Cross-sectional, descriptive design following STROBE checklist.

Results: The sample consisted of 499 hospital-based nurses. Exposure to any patient violence was high; exposure to physical violence was less common and occurred less frequently. Most nurses did not think it was possible to eliminate patient violence in hospitals and expected to be exposed to it. Some of the personal patient risk factors identified (race, veteran status) have not been noted in the literature. Most nurses were identified as having high work-related risk tolerance.

Conclusions: Patient violence is a serious occupational risk for hospital-based nurses. Some of the rhetoric related to violence towards nurses presents this risk as something that is not part of nursing work, discounting widespread exposure. It is also presented as something that ought not to be tolerated when it does occur. Both positions seem misaligned with the reality that exposure to violence is high, as is nurses' risk tolerance. When conceptualised as a serious occupational risk, opportunities for prevention, mitigation and recovery efforts can emerge. If risk tolerance is recognised as a strength, for example, it could be bolstered in the context of interventions such as robust prevention and mitigation training.