Violence against nurses: a common problem in inpatient psychiatry

While violence by patients towards nurses is a familiar problem in inpatient psychiatry, previous studies have not succeeded in reflecting this phenomenon in all its complexity. Figures on rates of incidence vary greatly, partly due to diverging definitions of violence and partly because different forms of violence are not sufficiently differentiated, and cases of sexual violence are usually not recorded at all.

In addition to this, there is a contradictory picture when it comes to the question of how certain characteristics of nurses are related to the occurrence of violence towards them. These characteristics are understood by the researchers as factors such as age, gender, professional experience and number of working hours, but also the nurses’ attitude towards violence in their workplace.

A study by the University of Basel led by Professor Michael Simon has now recorded the frequency and severity of verbal, physical and sexual violence by patients towards nurses and investigated the connection between the characteristics of the nurses and the occurrence of violence.

Striking results

The study sample comprised a total of 1,128 registered and licensed practical nurses working in the German-speaking part of Switzerland. They were asked about experiences of violence by patients directed against inanimate objects, and were also asked to provide information on personal experiences with milder forms of physical and psychological as well as specifically verbal and physical sexual violence that had taken place in the previous month. Another question concerning the number of serious violent assaults, on the other hand, related to the individual’s professional career as a whole.

Over the 30-day period, 73 percent of the nurses questioned had been affected by verbal violence at least once and 63 percent had observed violence against inanimate objects. 40 percent had experienced verbal sexual violence and 14 percent reported physical sexual violence. The figure for milder forms of physical violence was 28 percent. Almost one in three nurses (30 percent) stated that they had received a serious physical injury at some time during their professional career in psychiatry.

The study reveals that the nurses’ age, gender and number of working hours are related to the frequency of experiences of violence. Younger women with a high number of working hours and less than three years of professional experience are particularly at risk of verbal sexual assault.

Existing violence prevention is not enough

The research group emphasizes that established strategies such as anger management training or alarms on the wards do not sufficiently reduce patient violence towards nurses on inpatient psychiatric wards. The group is therefore calling for more comprehensive and proactive national and international strategies to prevent violence for nursing staff in psychiatry.

Original publication

Nanja Schlup, Beatrice Gehri und Michael Simon
Prevalence and severity of verbal, physical, and sexual inpatient violence against nurses in Swiss psychiatric hospitals and associated nurse-related characteristics: Cross-sectional multicentre study
International Journal of Mental Health Nursing (2021), doi: 10.1111/inm.12905

Further information

Prof. Dr. Michael Simon, University of Basel, Department of Nursing Science, tel. +41 61 207 09 12, email: m.simon@unibas.ch