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Institutional Silence and Informal Coping: A Qualitative Descriptive Study of Nurses' Experiences of Workplace
1Department of Medical-Surgical Nursing, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia.
Background/Objectives:
Saudi evidence on workplace violence (WPV) against nurses is largely survey-based. This study explored how nurses in three Riyadh hospitals experienced and coped with WPV, the institutional factors shaping their responses, and the improvements they proposed.
Methods:
In this qualitative descriptive study, 17 purposively recruited registered nurses from a tertiary government, a specialised government, and a private hospital took part in face-to-face semi-structured interviews (January-March 2026). Data were analysed using reflexive thematic analysis and reported according to COREQ.
Results:
The findings describe participants' experiences and are not prevalence estimates. Four themes were constructed: (1) everyday exposure to violence and its cumulative burden; (2) coping through personal strategies and peer support; (3) institutional silence and gaps in organisational protection; and (4) balancing self-protection and therapeutic care. Participants described relying on personal and peer resources where they perceived institutional protection as insufficient. Their priorities for improvement, reported separately, centred on de-escalation training, simpler reporting, timely post-incident support, and leadership accountability.
Conclusions:
In participants' accounts, informal coping absorbed harms that organisational systems did not address. Hospital managers could use these findings to check whether reporting, post-incident follow-up, training, staffing, and security arrangements work in practice. Participants' proposals require evaluation.
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