Violence in the emergency department: a multicentre survey of nurses' perceptions in Nigeria

Emergency department (ED) violence is common and widespread. ED staff receive both verbal and physical abuse, with ED nurses bearing the brunt of this violence. The violence is becoming increasingly common and lethal and many institutions are still improperly prepared to deal with it.

A questionnaire based survey of the perception of violence among nurses working in six tertiary hospitals' EDs across five states in Nigeria was conducted.

81 nurses were interviewed with a male to female ratio of 1:4. Most were right about the definition of violence. About 88.6% of respondents have witnessed ED violence while 65.0% had been direct victims before. Nurses followed by doctors were the usual victims. The acts were carried out mostly by visitors to the ED. Men were usually responsible for the violence, which usually occurred in the evenings. Weapons were not commonly utilised: only 15.8% of the nurses had been threatened with a weapon over a 1-year period. The main perceived reasons for violence were overcrowded emergency rooms, long waiting time and inadequate system of security. All the institutions were lacking in basic strategies for prevention. While most of the nurses were not satisfied with the EDs that were considered not safe, few would wish for redeployment to other departments/units.

There is a need to make the EDs safer for all users. This can be achieved by a deliberate management policy of 'zero' tolerance to workplace violence, effective reporting systems, adequate security and staff training on prevention of violence.