Physical and psychological consequences for nurses affected by workplace violence: a scoping review

Workplace violence (WPV) represents a major threat to nurses' health and safety, leading to significant psychological and physical consequences. Despite widespread documentation of its prevalence, evidence on the specific outcomes affecting registered nurses (RNs) remains fragmented and has not been systematically synthesized. The findings of this review extend the current understanding of WPV by demonstrating its cumulative effects on individual RNs, workplace dynamics, and the sustainability of healthcare organizations. They also reveal critical gaps in the literature, particularly regarding longitudinal data, intervention strategies, and the evaluation of organizational policies. These insights provide the foundation for a detailed discussion of the implications of WPV for nursing practices, workforce stability, and health system resilience.

The aim of this scoping review was to identify and map the available evidence on the psychological and physical consequences of WPV among RNs, with particular attention to short- and long-term outcomes and differences across clinical and cultural contexts.

This scoping review was conducted following the PRISMA-ScR and JBI guidelines. Studies in English, published between January 2020 and March 2025, with quantitative, qualitative, and mixed-methods designs were included. Searches were conducted in PubMed, CINAHL, PsycINFO, Web of Science, and Scopus, complemented by gray literature sources (Google Scholar, ProQuest Dissertations & Theses) and stakeholder consultation. The search strategy, developed with the support of librarians and healthcare experts, combined controlled vocabulary and keywords and was adapted to each database via the SR Accelerator, which is based on the PCC framework (population, concept, context). Source selection, data extraction, and data synthesis followed the JBI approach.

A total of 5,598 relevant articles were identified, 15 of which met the inclusion criteria. Psychological violence was the most frequently reported form, with outcomes including anxiety, fear, posttraumatic stress, depression, reduced resilience, and cognitive impairments. The physical consequences included sleep disturbances, chronic fatigue, and musculoskeletal pain. Workplace violence emerged as a significant determinant of job satisfaction and turnover intention, with lower job satisfaction mediating up to 44% of the effect of violence on nurses' intention to leave. Exposure to WPV also contributes to burnout, emotional exhaustion, and feelings of insecurity, highlighting gaps in organizational support and preventive strategies. Important knowledge gaps remain regarding long-term outcomes and cross-context comparisons.

WPV compromises not only nurses' psychological and physical well-being but also their organizational climate, quality of care, and patient safety. The lack of adequate postincident institutional support and the underestimation of the problem further exacerbate its impact. Integrated strategies for prevention, monitoring, and management are urgently required, including standardized protocols, targeted training, and accessible psychological support systems. At the same time, further research is needed to explore long-term physical and psychological outcomes and to evaluate the effectiveness of institutional interventions aimed at sustaining resilience and safeguarding patient safety.