Original Research: Patient-to-Nurse Violence During One-to-One Assignments: A Silent Epidemic

Nurses and nursing assistants given one-to-one ("sitter") assignments are placed with one patient for long periods of time. Some of these patients require a sitter for reasons that include dementia, traumatic brain injury, psychiatric disturbances such as delirium, and risk of self-harm. Some may become verbally abusive, physically violent, or both, putting the assigned staff member in danger.

The study purpose was to investigate workplace violence from the perspective of nurses and certified nursing assistants working one-to-one assignments who had experienced violent encounters with patients or visitors.

This qualitative cross-sectional study used a phenomenological approach. Participants were nurses and nursing assistants at one hospital in the western United States. Data were collected in five focus groups, which were conducted online; a semistructured interview guide allowed researchers to elicit participants' responses and foster discussion. Thematic analysis was used to identify themes in the data.

A total of 13 nurses and nursing assistants participated. Four themes emerged: silent epidemic, culture of unsafety, emotional occupational hazard, and policy and response.

This study adds to the work of researchers who are asking difficult questions about workplace violence. It's our hope that the participants' comments and insights, as well as their recommendations, can move the needle in improving prevention and follow-up practices related to patient-initiated workplace violence.