The Adaptation Process of Emergency Nurses Facing Workplace Violence: A Grounded Theory Study

Abstract

Abstract: Introduction: Workplace violence (WPV) is considered to be one of the most important and complex issues in health care system. Violence against emergency nurses is rising dramatically in Iran and all around the world. Facing Violence affects not only nurses but also the entire health care system with serious consequences. Nurses are trying to adapt with workplace violence in order to escape from its horrible consequences. Since the adaptation is process, interactive, social, and culturally dependent concept. Despite the studies conducted, there is still a knowledge gap in this regard. Thus, this study was conducted with the aim of exploring the adaptation process of emergency nurses with WPV. Methods: This qualitative study was conducted through a grounded theory approach between 2015-2017. The participants were experience nurses working in emergency departments of Tabriz and Urmia hospitals. Recruiting participants was initiated using purposeful sampling. It followed by theoretical sampling until data saturation was achieved. The main tool for collecting data were comprehensive and unstructured interviews. A total of 24 interviews were performed with 21 participants. Data were analyzed by using MAXQDA-10 software based on Corbin and Strauss (2008). Findings: Data analysis showed that main concern of participants was emerged as "fear of suffering". Contextual factors which caused creating the main concern in participants include "perceived multiple violence","disorganized control and supervision"," "lack of professional competence of personnel" and"workplace stressful atmosphere". The main strategy which nurses used in confronting with their main concern was "mastering and escape suffering". Mastering and escape suffering was the main and dominant psycho-social process among the data and includes two steps" violence reduction" and " elimination of suffering". It will eventually lead to stability or deterioration. Conclusions: Nurses are vulnerable to face various types of violence in the emergency department. They are afraid and worried about the harm and suffering caused by violence. They use different strategies of mastering in order to adapt to violence and stabilize their work environment. The results of this study can be used by managers, Health-care system planners and the nurses themselves in order to facilitate the process of coping with stressful situations, such as dealing with the violence.