Table 2 Factors: Rationale for underreporting of workplace violence
Nursing Categories | |
Personal Characteristics | • Female |
• Younger in age | |
• Newer nurse, less work experience | |
• Working alone | |
• Caring or empathetic personality | |
• Working in a specialty care area | |
• More violent experiences, the less likely to report | |
• Desensitized to violent patients | |
• Personal bias against reporting | |
Fear | • Losing job |
• Serious consequences | |
• Legal consequences | |
• Poor job performance evaluation | |
• Reprisals from management | |
• Revenge or retaliation | |
• Not believed | |
• Blaming victim | |
• Lack of support from colleagues | |
• Low patient satisfaction scores | |
• Causing harm to the patient by reporting | |
Lack of Knowledge About Reporting Workplace Violence | • Do not know how to report |
• What to report (ambiguous) | |
• Who to report to | |
• Never instructed on the reporting process/did not know there was a reporting process | |
• Unsure what is considered “reporting” – Does documenting in the patient chart or verbally reporting to coworkers /supervisor count? | |
Time Constraints | • Too time-consuming |
• Too busy | |
• Inconvenient | |
• Forget | |
The perception that Violence is Unavoidable | • “Part of the job” |
• Expected to “handle it” | |
• Common to their patient care area | |
• Not important | |
Perception of the Patient | • Some patients cannot control their behavior |
• Violence not intentional | |
• Patient apologized | |
Perception of the Level of Severity | • Physical violence is reported more often than verbal violence |
• Physical injury more likely to be reported | |
• Verbal violence not considered violence or not severe enough to report | |
• More likely to report if a weapon was used | |
• Increased severity of an event, increased reporting | |
• Mitigation of the violent incident is considered when deciding to report | |
Other Negative Perceptions | • Feelings of guilt or shame |
• Viewed as occurring due to the nurse’s actions | |
• Pressure from colleagues not to report | |
• Considered a bureaucratic task | |
• Viewed as a preventable event | |
• Previously reported and had a negative experience | |
Management Categories | |
Unsatisfied with Outcome | • Lack of adequate response from management following a report |
• Causes or event itself not investigated | |
• No positive changes because of reporting; useless | |
• No consequences for the perpetrator | |
• Dissatisfied with the resolution of events | |
Lack of Support to Report | • No incentive to report |
• Discouraged from reporting | |
• Not mandatory to report | |
• Lack of manager support to report | |
Culture | • Lack of willingness to defend nurses |
• Paying greater attention to patients rather than nursing staff | |
• Not taken seriously | |
• Reporting is not the norm; others do not report | |
Organizational Categories | |
Lack of Policies and Procedures [26] | • Lack of clear and detailed policies and procedures that address workplace violence |
Lack of a Reporting System | • Lack of a functioning and user-friendly reporting system for workplace violence |
Lack of Training Programs | • Lack of mandatory organizational training on workplace violence |
• Lack of violence prevention training programs | |