Investigation of the risk of violence in nurses working in the emergency departments of Diyala city hospitals in Iraq

Health facilities, professional associations, and governmental groups are all working to prevent violence in the medical field. However, workplace violence (WPV), especially violence toward nurses, continues to be a concern in medical institutions worldwide. In the Iraqi emergency departments, violence against nurses has become very common, and many nurses think that violence is part of their job. This study aims to investigate the risks of violence on the nurses handling the emergency department and to examine the relationship between nurses' level of exposure to violence, their intention to leave the job, the risk of violence, the potential for exposure to risks of violence in the future and the quality of the work environment. A descriptive and relational cross-sectional study was performed. The sample consisted of 200 nurses working in emergency departments of hospitals in Diyala city in Iraq, which was reached using the non-probability (targeted) sampling method. Data was collected through a self-report tool that includes socio demographic data for nurses, general information about violent incidents, scales of Intention to Leave Work, Risk of Violence, Violent Events at Work, Probability of Future Exposure to Violence and The Quality of the Work Environment. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 26. The study revealed that nurses are exposed to a high risk of violence, 30.5%, in their workplace. 31.9% of nurses had experienced violence four or more times in the previous year. 54% of the nurses reported being exposed to four or more incidents of physical violence in the previous year. Patients' relatives committed 79% of violent incidents. The study's results regarding nurses' views on the quality of the work environment showed that 38% of nurses strongly disagree with the idea that the quality of work environment is sufficient. The rate of exposure to violence in the workplace in the emergency department varied according to the years of experience in the emergency department. There was a high incidence of violence at work from 1 to 9 years of experience (49.5%) compared to other years of experience (10 to 19 years, 20 to 29 years, and 30 to 40 years) by 31.0%, 11.0%, 8.5%, respectively. After being subjected to violence, half of the nurses reported feeling of anger, followed by disappointment (26%), stress (13%), aggrieved (6%) and reduced work enthusiasm (5%). 35.6% of the nurses expressed the possibility of violence in the future. They agreed and strongly agreed (28%) to look for a job in a new profession other than nursing next year, while 63% of them agreed or strongly agreed to look for a new job outside their current hospital. In addition, exposure to violence at work and the level of risk for violence were negatively correlated with the quality of work environment. The level of risk for violence were positively correlated with exposure to violence at work. The possibility of violence in the future was positively correlated with the nurses' decision to leave their jobs. The researcher concluded that relatives of patients cause the most violent incidents in the emergency department. Young nurses have less nursing experience, less experience in the emergency department, and are at greater risk of violence. Many nurses reported being at constant risk of violence four or more times during different work periods. When they experience violence, they seek help and feel angry and disappointed. Therefore, many nurses are considering leaving their jobs due to increased violence in the workplace and reporting the possibility of future violence. As a result, work-related violence toward nurses is an important topic to focus on in producing effective preventive policies.