The latest release of an ongoing national survey of more than 7,000 ED nurses found that rates of physical violence and verbal abuse against nurses did not decrease between May 2009 and January 2011.

In the 12 months from January 2010 to January 2011, 53.4% of nurses reported experiencing verbal abuse and 12.9% reported experiencing physical violence over a seven-day period, compared with 54% reporting verbal abuse and 11% reporting only physical violence in the first year of the Emergency Department Violence Surveillance Study. The Emergency Nurses Association conducts the study at three-month intervals.

Of the nurses surveyed who indicated experiencing physical assault, nearly half (48.3%) said they were grabbed or pulled. The most common forms of verbal abuse were yelling or swearing, with nearly nine in 10 (89%) nurses reporting these forms of abuse. Patients were the perpetrators in nearly all incidents of physical violence (97.8%) and verbal abuse (92.3%).

The study also found that a patient's room was the most dangerous place for an emergency nurse, with more than four out of five (82%) incidents of physical violence occurring in that location. More than half (55.7%) of patients who physically assaulted nurses were under the influence of alcohol, 46.8% were under the influence of illicit or prescription drugs and 45.2% were psychiatric patients.

In most cases of assault, nurses did not file a formal report, but did notify someone; 66% of nurses indicated they did not formally report physical violence and 86.1% did not file a formal report when verbally assaulted. Most of the nurses surveyed who were physically assaulted did notify security personnel (65.7%), an immediate supervisor (64.2%), another emergency nurse (63.2%) and/or an emergency physician (54.6%). Only 8% of those who experienced physical violence and 16.9% of those who experienced verbal abuse did not notify anyone.

The study also found that in almost half (46.7%) of the cases of physical violence, no action was taken against the perpetrator. In nearly three-quarters (71.8%) of such cases, nurses received no response from the hospital about the assault.

The survey also revealed that rates of physical violence and verbal abuse were higher when security personnel were present. However, the survey did not address whether the security presence was a contributing factor to a higher level of reported violence.

EDs in hospitals with higher commitment to safety and reporting policies, particularly those with zero-tolerance policies, had lower rates of physical violence and verbal abuse. Of the nurses who reported not experiencing any physical violence or verbal abuse in the previous seven days, nine in ten (91.8%) worked in facilities with reporting policies.

According to the report, more than a third (36.7%) of emergency nurses have considered leaving their current jobs because of workplace violence. Nearly one in 10 (9.5%) has considered leaving nursing entirely and the same proportion has considered looking for a job in another hospital. Almost one in five (17.7%) has considered looking for a job in non-emergency nursing.

The full report is available as a PDF at