An Exploration of Rural Emergency Department Nurses' Perspectives on Patient and Visitor Violence

An Exploration of Rural Emergency Department Nurses' Perspectives on Patient and Visitor Violence

Author: 
Wilma Hart-Flynn
Program of study: 
Ph.D./NUR
Abstract: 
The purpose of this phenomenological study was to explore rural emergency department nurses’ perceptions regarding violence by patients and visitors. Thirteen rural emergency department nurses from three hospitals in LaSalle, Bureau, and Grundy Counties in Illinois participated in the study. One-on-one interviews using a semi-structured discussion approach provided qualitative data related to the phenomenon. The assessment of themes emerging from the information collected took place using the hermeneutic phenomenological approach. From the interviews conducted, data were broken into coded units. The coded units were summarized and compared with each unit to determine similar words and phrases. Once the information was synthesized, patterns developed and themes were produced. Four major themes emerged from the data analysis. Victimization related to the participants feelings of anger, fear, and helplessness. Re-victimization occurred when nurses faced the violent patient or visitor in a setting away from the hospital. Lack of leader support was demonstrated by the participants’ beliefs that nursing leaders were uncaring. Knowledge deficit was associated with the nurses’ concerns about a lack of education on managing violent patients. Implications include the need for nursing leaders to provide support and caring for the nurses facing violence by being present after a violent event and working collaboratively with the emergency department nurses to develop policies and processes to reduce violence in the rural emergency department. The participants also noted education on managing violent patients was needed to improve safety in the emergency department.
Dedication: 
I dedicate my dissertation work to all the brave emergency department nurses who face violence on a daily basis. These dedicated nurses demonstrate professionalism in every action they take and all the care they provide. I admire and appreciate all you do for patients and the nursing profession. You are truly a phenomenal group of people. I also dedicate this work to my husband Tom, without his sacrifice, support and encouragement I never would have completed this journey. I give special thanks to my friends and co-workers who read and re-read my work, offered suggestions, and became as excited as I did with each milestone accomplished. I also want to dedicate my dissertation to my parents. My Dad always told me I could accomplish anything I wanted with hard work and perseverance. He taught me to never give up on my dreams. And to my Mom, you taught me the value of learning. She taught me an education can take me places I never dreamed of going. Although they are no longer with me, I know they are sharing in the joy of this accomplishment.
Acknowledgements: 
Many people assisted in the completion of my doctoral journey. First, I would like to thank my husband Tom for his patience and support throughout the program. He picked me up when I was down and pushed me forward when I thought I had nothing left to give. You were my rock. I also want to thank my friends and fellow students Julie and Kim for always being there when I had questions and providing encouragement to make certain we all completed this journey together. I have the utmost respect for my mentor and committee members: Dr. Hsiu-Chin Chen my mentor for all her support and wise counsel, Dr. Pamela Springer for her encouragement and excitement that kept me moving forward, and to Dr. Sharon Beasley, your attention to detail made this dissertation the best it could be.