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Evid Based Nurs 11:29 doi:10.1136/ebn.11.1.29
  • Qualitative

Staring, tone of voice, anxiety, mumbling, and pacing in the ED were cues for violence toward nurses

L Luck

Correspondence to: Ms L Luck, James Cook University, Queensland, Australia; lauretta.luck@jcu.edu.au

QUESTION

Which components of observable behaviour in patients, their families, and friends indicate a potential for violence toward nurses in the emergency department (ED)?

DESIGN

Instrumental case study using a concurrent mixed-method approach.

SETTING

33-bed ED in a public hospital in Australia.

PARTICIPANTS

20 ED nurses (90% women).

METHODS

Phase 1 comprised thematic analysis of 50 hours of unstructured participant observation, an unstructured interview with 3 nurses, and researcher journaling. In Phase 2, these findings provided items for a structured observation tool to collect quantitative data and informed the content for the qualitative interview guide. Qualitative data collection comprised 290 hours of participant observation on 51 separate occasions over 5 months (16 violent events were observed); 16 recorded, semi-structured, 45–60 minute interviews with nurses; 13 recorded, informal, and unstructured 30–40 minute field interviews, some of which occurred after a violent event was witnessed; review of organisational documents; and research journaling. Violent behaviour was defined as physical or non-physical (eg, abusive or …

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