565348
research-article2015
WHSXXX10.1177/2165079914565348Workplace Health & SafetyWorkplace Health & Safety
vol. 63 no. 1
Violence Against Nurses in Emergency
Departments in Jordan
Nurses Perspective
Muhammad W. Darawad, RN, PhD1, Mahmoud Al-Hussami, RN, MPH, DSc, PhD1, Ali M. Saleh, RN, PhD1,
Waddah Mohammad Mustafa, RN, PhD1,2, and Haifa Odeh, RN, MSN1
Abstract: Violence against nurses in emergency
departments (EDs) has become a widespread phenomenon
affecting nurses job satisfaction and work performance.
Literature is scarce regarding prevalence rates and causes
of violence directed toward nurses in Jordan. The present
study investigated violence experienced by Jordanian nurses
in EDs and causes of violence from their perspectives. This
descriptive study collected data from 174 Jordanian ED
nurses. The majority of the participants (91.4%) reported
experiencing violence (verbal 95.3% vs. physical 23.3%).
According to participants, the most common causes
of violence in the ED were crowding and workload
(75.9%), and the least was care of patients with dementia
or Alzheimers disease (35.6%). Violence is common in
Jordanian EDs, giving rise to many heath and behavioral
consequences. Health care administrators are obligated to
protect nurses from violent incidents by providing adequate
safety measures, beneficial administrative procedures, and
sincere efforts to overcome the causes of this phenomenon.
Keywords: violence, emergency department, nurses, Jordan
T
he nature of nurses work in hospital emergency
departments (EDs) includes encountering a variety of
patients with various health conditions ranging from mild
upper respiratory infections to life-threatening injuries and
illnesses. Emergent patients might be accompanied by relatives
who have physical and emotional stress (Ergun & Karadakovan,
2005). The emotional distress and prejudices of patients and
their companions about emergency status can encourage them
to adopt an aggressive approach to staff. This approach has
increased violence against nurses in EDs and has become a
widespread phenomenon (Gillespie, Gates, & Berry, 2013;
DOI: 10.1177/2165079914565348. From 1The University of Jordan and 2Al Farabi College. Address correspondence to: Muhammad W. Darawad, RN, PhD, Associate Professor, Faculty of Nursing,
The University of Jordan, Amman, 11942 Jordan; email: m.darawad@ju.edu.jo.
For reprints and permissions queries, please visit SAGEs Web site at http://www.sagepub.com/journalsPermissions.nav.
Copyright 2015 The Author(s)
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Workplace Health & Safety
ARTICLE
World Health Organization, 2005) that is more likely to occur in
hospitals than in primary health care centers (Adib, Al-Shatti,
Kamal, El-Gerges, & Al-Raqem, 2002) and in EDs and
psychiatric units than other hospital units (Hesketh et al., 2003).
Furthermore, violence and assault in hospital EDs is one of the
most common occupational hazard for nursing professionals
(Presley & Robinson, 2002).
Given that many incidents of violence against nurses are
unreported (Ergun & Karadakovan, 2005), it is estimated that
35% to 80% of nurses have been assaulted physically at least
once during their careers (Clements, DeRanieri, Clark, Manno, &
Wolick Kuhn, 2005). The violence can be verbal, physical, or
both. For instance, Celik, Celik, Agirbas, and Ugurluoglu (2007)
reported that the prevalence rates of verbal and physical
violence among Turkish nurses were reported to be 91.1% and
33%, respectively. A previous Turkish study reported a
prevalence rate of 98.5% for verbal violence and 19.7% for
physical violence (Ergun & Karadakovan, 2005). In the United
States, 25% of ED nurses reported experiencing physical
violence more than 20 times in a 3-year period, and 20%
reported experiencing verbal abuse more than 200 times during
the same period (Gacki-Smith et al., 2009). In Jordan, AbuAlRub
and Al-Asmar (2011) reported that 22.5% of Jordanian nurses
experienced physical workplace violence and were unsatisfied
with the way incidents were handled.
Regarding the causes of violence, Gacki-Smith et al. (2009)
reported crowdedness, long waiting times, misconceptions of
staff behaviors, perceiving staff as uncaring, holding or boarding
patients (in which patients who are classified as less critical wait
for longer time before being receiving care), nursing shortage,
and lack of strict visiting policy to be among the most common
causes of violence against ED nurses. Poor communication,
including language barriers between nurses and patients, along
with low opinions of the nursing profession were reported to
 Workplace Health & Safety
Applying Research to Practice
Violence against nurses is common in hospital emergency
departments. Such incidents have both health and
behavioral consequences for nurses. Healthcare
administrators have the obligation to eliminate violent
incidents by providing adequate safety measures, beneficial
administrative procedures, and sincere efforts to overcome
the causes of this phenomenon. Also, knowing that the
perpetrators are almost always patients companions should
encourage administrators to enact strict visiting policies.
Further, the evening shift (3 p.m. to 11 p.m.) should be
treated as high risk because most violent incidents occur
during that shift. Finally, strict legislation to protect nurses
and punish perpetrators could prevent future violence
against nurses in emergency departments.
be other possible causes of violence (Adib et al., 2002). Also,
the incidence of physical abuse directed toward ED nurses was
found to be correlated with more years spent in the ED (Ergun
& Karadakovan, 2005). Other factors associated with workplace
violence may include absence of effective legislation,
inappropriate management of violent incidents, limited
resources, lack of cultural and social awareness, and
inexperienced security staff (AbuAlRub & Al-Asmar, 2011).
Increasing incidents of violence against nurses have
negative effects on their job satisfaction and work
performance (Hesketh et al., 2003). According to Celik et al.
(2007), verbal and physical violence against nurses can have
negative effects on their physical and mental health (e.g.,
headache), work (e.g., decreased productivity, increased
turnover intention), and social life (e.g., disrupted family
life). Repeated disturbing memories and thoughts of the
attack, being super-alert and on guard, and feeling
everything to do is an effort were among the complaints of
nurses who experienced these violent incidents (AbuAlRub &
Al-Asmar, 2011). Furthermore, violence negatively affects
institutions by increasing turnover and decreasing quality of
nursing care (Oweis & Diabat, 2005).
Recently, Jordanian hospitals have witnessed an increasing
number of violent incidents against nurses, some of them lethal,
which is consistent with the literature that demonstrates violence
is present in almost every country. However, literature is scarce
regarding the prevalence and causes of both verbal and physical
violence against nurses in Jordan. This study investigated
Jordanian nurses experience and perception of violence in
Jordanian EDs. The specific purposes of this study were to (a)
determine the percentage of nurses who have experienced verbal
and physical violence while working in Jordanian EDs, (b)
identify responses of these nurses, (c) determine the causes of
violence against ED nurses from nurses perspectives, (d) explore
Jordanian nurses thoughts about violence and legal procedures,
and (e) identify differences in violence experience based on
nurses demographic characteristics.
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January2015
Method
A descriptive design using a self-reported cross-sectional
survey was used to collect data from Jordanian ED nurses
between April and July 2013.
Setting and Population
According to the Ministry of Health (2010) Statistics, the
Jordanian health care system is divided into governmental,
military, university, and private institutions. The government
sector operates 27 hospitals, accounting for 37% of all hospital
bed capacity; the military sector operates 11 hospitals, providing
24% of all bed capacity; university hospitals account for 3% of
total bed capacity; and the private sector provides 36% of all
hospital bed capacity. Only those hospitals with more than 300
beds and large EDs were included in the study population, and
two hospitals within the study population in each sector were
randomly selected from a list of sector-specific hospitals.
Sample
To select participants for this study, the researchers first
randomly selected participating hospitals from all Jordanian
hospitals stratified as governmental, university, and private
hospitals using simple random sampling techniques. Participants
were recruited from the population of nurses who met the
eligibility criteria. The eligible nurses in this study included
those who had earned a diploma (nursing assistant) or
bachelors or masters degrees (registered nurse) in nursing, and
worked in an ED for at least 3 months.
Instrument
Researchers used the questionnaire developed by Ergun and
Karadakovan (2005) to measure study variables, except for the
causes of violence for which questions were adapted from
Gacki-Smith et al. (2009). The study survey had four parts; the
first part measured the incidence of verbal (e.g., shouting,
threatening) and physical (e.g., slapping, kicking) violence, and
the conditions associated with those incidents (e.g., how many
times, shift of incidence, perpetrator identity); the second part
explored responses of the affected nurses (e.g., sick leaves,
incident reporting); the third part assessed causes of violence
against nurses from nurses perspectives; and the fourth part
assessed nurses beliefs about violence and legal procedures.
Face and content validity were established by the authors of the
instruments. Participants demographics were gathered via a
special data sheet developed by the researchers and included
participants ages, gender, marital status, titles, education levels,
years of experience in nursing and in ED, and training about
violence management.
Ethical Considerations
This study was approved by the Scientific Research
Committee at Faculty of Nursing, The University of Jordan, and
participating hospitals. Participation was voluntary and
vol. 63 no. 1
anonymous (i.e., no personal identifiers were recorded). The
researchers assigned nurses identification numbers rather than
using their names to access actual research data by the research
team. Furthermore, detailed information about the objectives of
the study was provided to participants via the questionnaire
cover letter; if the nurse agreed to participate, returning the
completed questionnaire was considered consent.
Data Collection Methods
A detailed explanation about the aims of and procedures for
the study was given to nurse managers and charge nurses on
the participating units. A list of the estimated number of
available nurses was prepared from the selected hospitals 1 day
before data collection. At the time of data collection,
participants were personally interviewed and invited to
participate; those who agreed were given the questionnaire.
Each questionnaire included a cover letter explaining the study,
its aims, and how to complete and return the survey. Self-
completed questionnaires were returned to the researchers in
envelopes via special drop boxes. Participants completed the
questionnaires during their break times or at home.
Data Analysis
Descriptive statistics were used to describe participants
characteristics and characterize the distribution of variables. In
addition, chi-square and point biserial correlations were
calculated to test differences in violence experience by
participants demographics. All statistical procedures used the
Statistical Package for the Social Sciences Version 17 (SPSS Inc.,
Chicago, Illinois, the United States), and the significance level
was set at p < .05 (two-tailed).
Results
Sample Description
A total of 300 nurses were invited to participate in the study;
174 participated for a response rate of 58%. As shown in Table
1, the mean age of the participants was 27.1 4.4 years, 63.2%
were single and 35.1% were married, and 78.2% had earned a
bachelor degree in nursing. Almost 80% of the participants had
practiced in the ED less than 5 years. Most of the nurses
working in the EDs were anxious about potential verbal and/or
physical violence, 77% of respondents felt unsafe in the ED, and
only 41.4% reported learning how to manage violence in the
workplace.
Violence Experience
When participants were asked about violence experience,
the majority of them (91.4%) reported experiencing workplace
violence; 95.3% reported verbal violence compared with 23.3%
reporting physical violence. Most of the incidents occurred in
the previous 3 months, which indicated that violence occurred
frequently in the ED. Also, more than half (50.3%) of the
incidents occurred during the evening shift, and patients
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Workplace Health & Safety
relatives or friends were commonly the perpetrators (51.1%).
Finally, about half of the nurses (52.2%) reported violence one
to three times. Details of violence experiences are illustrated in
Table 2.
Response to Violence
Regarding their response to violence, nurses reported the
majority of these incidents (51.7%) via written formal
statements, and 69.5% of nurses reported satisfaction with the
reporting procedures. Reasons given for not reporting included
legal procedures not accomplished (49.1%) and reports not
considered (43.4%). Moreover, 69.8% of the study participants
reported taking sick leaves as a result of the inquiry.
Causes of Violence
Regarding the causes of violence reported by participants
(Table 3), the most common cause of violence cited in the ED
was crowding/workload (75.9%), followed by shortages of both
nursing and medical staff (69.5%). However, the least common
cause of violence in the ED was the care of patients with
dementia or Alzheimers disease (35.6%) and ED procedures
(50%).
Nurses Thoughts About Violence
and Legal Procedures
When asked about violence and legal procedures, the
majority of nurses (64.4%) agreed they should be educated
about the prevention and management of assault as a part of
in-service education. Although most of the participants believed
it was ethically appropriate (63.8%) and right (53.4%) for nurses
to take legal action against patients or relatives who physically
assaulted them, the majority of the participants (66.1%) reported
that they would not take legal action if physically assaulted by a
patient or a relative. Furthermore, most of the nurses (68.4%)
did not believe that being physically assaulted by patients or
relatives affects nurses psychologically. However, more than half
of the nurses (50.6%) agreed that the same rights should apply
to the patients and relatives if they experience similar behaviors
by nurses. Detailed responses about violence and legal
procedures are shown in Table 4.
Differences in Violence Experience
Based on Nurses Demographics
Chi square was used to examine the differences between
nurses frequency of experiencing verbal violence experiences by
nurses gender, health care sector, marital status, educational level
and career title. The results showed a statistically significant
difference in study settings, 2(2) = 8.51, p < .05. However, the
other demographic characteristics showed no significant
differences in the frequency of violence by gender, marital status,
educational level, or career title, 2(1) = .013, p = .910; 2(2) =
3.92, p = .141; 2 (3) = 2.253, p = .324; 2(1) = 1.730, p = .188,
11
 Workplace Health & Safety January2015

Table 1. Demographical and Professional Characteristics of the Sample (N = 174)

Characteristics n (%) M (SD)

Gender
Female 72 (41.4)
Male 102 (58.6)
Marital status
Single 110 (63.2)
Married 61 (35.1)
Other 3 (1.7)
Education
Diploma 34 (19.5)
Bachelor 136 (78.2)
Master 4 (2.3)
Staff training about the management of violence
Yes 72 (41.4)
No 102 (58.6)
Age 27.1 4.4
ED experience 3.2 2.7
Feel safe in ED
Yes 40 (23)
No 134 (77)

Note. ED = emergency department.

respectively (Table 5). Finally, a point biserial correlation between
violence experienced and years of nursing experience,
emergency experience, and age revealed a significant negative
relationship for all three variables (r = .263, p = .000; r = .218,
p = .004; r = .203, p = .007, respectively).
Discussion
This study investigated the prevalence of violence against
nursing staff in EDs in Jordan. The findings of this study were
similar to those reported in the literature. For instance, the rate of
violence was found to be 91.4% (95.3% verbally, 23.3% physically).
The wide difference between verbal and physical violence could
be attributed to most individuals expressing their anger verbally
rather than physically. These figures are close to those (98.5% and
19.7%, respectively) reported by Turkish ED nursing staff (Ergun &
Karadakovan, 2005), which supports the international endemicity
of this phenomenon (Gillespie et al., 2013).
The rate of physical violence found in this study was close
to the rate (22.5%) reported in a previous Jordanian study
(AbuAlRub & Al-Asmar, 2011), indicating that the underlying
factors causing violence against nursing staff are still prominent
in Jordan. Understanding the nature of work within Jordanian
EDs could explain the rate of violence and the similarity with
the previous study. In general, Jordanian EDs are crowded and
open; separate rooms are not used except in private hospitals,
with no limit on the number of visitors. In such units, it is easy
to be influenced by noise and crowdedness that lead to
aggressive environments conducive to violence. Usually, patients
are accompanied by many relatives, who do not want to stay in
the waiting rooms that are small and inconvenient; little
information is conveyed to relatives regarding patients
conditions, which may lead to frustration and aggressive
behaviors. No actual triage is used in Jordanian EDs, and
patients are classified by type of service needed (e.g., medical,
surgical, pediatric, or gynecology). Finally, security guards are

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vol. 63 no. 1 Workplace Health & Safety

on duty. However, the risk of violence directed toward ED

Table 2. Details of Violence Experience nurses is expected to negatively affect nurses organizational
commitment and turnover intention (Al-Hussami, Darawad,
n (%) Saleh, & Hayajneh, 2013).
Violence experienced during career Many family members or friends accompanying patients in
the ED, which can produce an aggressive volatile environment,
Yes 159 (91.4) is a characteristic of Jordanian culture. Knowing that most
Jordanian EDs are open to the public explains why family
No 14 (8.6)
members and friends are frequent perpetrators of violence.
Number of violent incidents Similar results were found in previous studies in Jordan (Ahmad,
2012), Turkey (Celik et al., 2007), and the United States
1-3 times 83 (52.2)
(Nachreiner et al., 2007). Therefore, the security infrastructure
4-9 times 43 (27.0) (e.g., doors, receiving system, and security guards) must be
reconstructed to overcome this problem.
10-15 times 12 (7.5) It was noteworthy that high rates of experienced violence
>16 times 21 (13.2) caused 30.2% of study nurses to take sick leaves. Knowing that
Turkish ED nurses reporting no sick leaves after experiencing
Most recent incident violence (Ergun & Karadakovan, 2005) may indicate the severity
0-3 months 90 (56.6)
of the violence experienced by Jordanian nurses. However,
disturbed physical and emotional health is common after
4-6 months 40 (25.2) experiencing violence (Celik et al., 2007; Nachreiner et al.,
2007). Another remarkable result is that 56.6% of the affected
7-11 months 17 (10.7)
nurses reported the incidents, and 76.1% were satisfied with the
1-5 years 12 (7.5) outcome. This finding was contrary to the results of a previous
Jordanian study that found 71.5% of Jordanian nurses were
Time of incidence dissatisfied with how incidents were handled (AbuAlRub &
Morning shift 35 (22.0) Al-Asmar, 2011). A possible explanation could be increased
awareness among nurses regarding the importance of reporting
Evening shift 80 (50.3) violent events because violence against ED nurses has become
Night shift 44 (27.7) a widespread phenomenon in Jordan.
When asked about the causes of violence in EDs,
Perpetrator participants ranked crowdedness/workload in [the] ED as the
most common cause followed by staff shortage, which is
Patient 37 (21.3)
associated with more violent incidents occurring during the
Family or friends 89 (51.1) evening shift (i.e., the most crowded shift). The major causes of
violence in this study were different than those reported by
Both 33 (19.0) Gacki-Smith et al. (2009) who found patients being under the
influence of alcohol and illicit drugs as major causes,
reflecting a cultural difference in violence against ED nurses.
However, the least common causes were care of patients with
hospital employees with no actual authority, and even they are dementia [and] Alzheimers [disease] in [the] ED preceded by
sometimes victims of violence. Therefore, extra efforts beyond ED procedures. Similarly, Gacki-Smith et al. (2009) reported
these noted are needed to address this phenomenon, care of patients with dementia [and] Alzheimers [disease] in
particularly modification of the entire Jordanian ED structure. ED and no [or] poorly enforced visiting policy as the least
Of concern are the findings that more than 50% of violent common causes of violence in their study. This discrepancy
incidents took place during the evening shift, and 51.1% of the indicates that it is not patient care or nursing procedures that
perpetrators were family members or friends. The same results result in violence, but rather the conditions in which nursing
were reported in other studies from Jordan (AbuAlRub & staff are providing care or performing procedures. This finding
Al-Asmar, 2011), Saudi Arabia (Almutairi, Alkhatib, Boran, & confirms the responsibility of hospital and nursing
Mmbarak, 2013), and Turkey (Ergun & Karadakovan, 2005). administrators to provide a safe working environment for
Such findings could result from high workloads during the nurses.
evening shift compared with other shifts, which indicate that Nurses responses about violence and legal recourses were
nursing ED managers must pay special attention to assigning contradictory. Although most of the participants thought it
more nurses to the evening shift, and nurses and security ethical and right for them to take legal action after being
guards working the evening shift must be more cautious while assaulted, most of them also reported that they would not do

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 Workplace Health & Safety January2015

Table 3. Causes of Violence in ED

Causes Disagree (%) Neutral (%) Agree (%)

Crowding/workload in ED 6.3 17.8 75.9
Shortage of ED staff (nurses and physician) 5.7 24.7 69.5
Patients/visitor under influence of alcohol 12.1 20.7 67.2
Drug-seeking behavior 6.8 28.2 64.9
No/poorly enforced visitor or staff behavior 4 31.6 64.4
Patients/visitors under influence of illicit drugs 7.5 29.9 62.6
Misconception by patients/visitors that staff is uncaring 5.5 33.9 60.9
Poor communication between health care provider and patient/ 17.2 21.8 60.9
family
Patients/visitor perception that staff is uncaring 12.6 30.5 56.9
Care of psychiatric patients in ED 13.8 32.8 53.4
Emergency department procedures 16.1 33.9 50
Care of patients with dementia/Alzheimers disease in ED 25.3 39.1 35.6

Note. ED = emergency department.

so. They further reported that nurses are not psychologically
affected by such events. Self-blame was also evident in nurses
responses. Similar contradictions were reported by Ergun and
Karadakovan (2005) who explained this phenomenon by the
relatively short duration of experience and the lack of
continuing education that could influence nurses professional
response and reaction to violent episodes. In the same vein,
58.6% of participants reported no staff training about violence
management in spite of the high frequency of violent events.
Therefore, ongoing staff development about occupational stress
and violence management, which should focus specifically on
younger nurses and new ED nurses, is needed.
Examining categories of nursing staff with the highest rates
of violence showed that nurses in both university and
government hospitals had more violence experiences than
nurses in private hospitals. This finding was similar to the
results of previous studies in Jordan (AbuAlRub & Al-Asmar,
2011) and Australia (Hegney, Plank, & Parker, 2003) and may be
attributed to less safety measures at both university and
government hospitals (e.g., being open to the public and caring
for more patients from lower socioeconomic status because the
cost of care is much higher in private hospitals). Therefore,
health care administrators in both university and government
hospitals have an obligation to provide more security measures
in their EDs, especially limiting access by larger numbers of
nonpatient individuals. Also, the government hospitals should
adopt effective policies for preventing and managing violent
incidents, as well as enacting legislation to punish aggressors
(AbuAlRub, Khalifa, & Habbib, 2007).
Similarly, younger nurses, new nurses to the ED, and less
experienced nurses reported more violent incidents than their
older, more seasoned counterparts. These results were
consistent with those reported by Australian nurses (Hegney
et al., 2003) but contradicted by data reported by Turkish nurses
(Ergun & Karadakovan, 2005). However, this finding could be
related to Jordanian Arabic culture in which individuals show
more respect to older individuals; experienced nurses also may
have less contact with patients than less experienced nurses due
to task distribution. Therefore, younger, less experienced nurses
should be the primary focus of continuing education programs
about violence management. Also, continuous assessment of the
psychological status of ED nurses could be beneficial in this
regard.
Study Limitations
This study asked Jordanian nurses to recall incidents of
violence within the past 5 years. Therefore, results may be
affected by recall bias, and generalizability is limited due to the
studys descriptive exploratory design. The limited number of
participants constitutes another limitation, for which future
studies with larger national samples are recommended.
However, the results of this study, along with other similar
studies, increase occupational health nurses understanding of

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vol. 63 no. 1 Workplace Health & Safety

Table 4. Nurses Thoughts About Violence and Legal Procedure

Self-Related Disagree Neutral Agree

Self-related
If I were physically assaulted by a patient/relative, I would take legal action 66.1 20.1 13.8
Nurses can expect to be physically assaulted sometime during 60.3 24.7 14.9
their careers
Nurses who are physically violated by a patient/relative cannot do their 58.6 29.9 11.5
job properly afterward
Being physically assaulted by patients/relatives affects nurses 68.4 27 4.6
psychologically
Prediction of patient/client assault is within the competence and ability 37.9 42.5 29.6
of qualified nurses
Nurses who are assaulted and have only minor injuries should not 23.6 28.7 47.7
report the assault
Nurses who are physically violated are less competent clinically than 35.6 35.6 28.7
staff who are not assaulted
It is unacceptable for nurses to respond similarly when being 43.1 35.1 21.8
physically assaulted by patient/client
Patient/relative related
Patients/relatives are responsible for all their behaviors although patients/ 17.2 36.2 46.6
relatives tend to display assaulting behavior, they should still be admitted
to EDs
Patients/relatives have the right to take legal actions against nurses who 16.7 32.8 50.6
have physically assaulted them
Procedure related
Nurses should be educated about the prevention and management 13.2 22.4 64.4
of assault as part of their in-service education
It is ethically appropriate for a nurse to take legal action against a 9.2 27 63.8
patient/client who has physically assaulted him or her
My unit does not accept patients/relatives if it is not equipped or staffed 24.7 33.9 41.4
to treat them safely
Nurses who take legal action against a patient/relative are in jeopardy 28.7 37.9 33.3
of losing their jobs
The employment pattern and physical environment of this unit 25.9 36.8 37.4
are adequate and so will prevent assaults by patients/clients
Nurses have the right to take legal action against patients/relatives who 16.7 29.9 53.4
have physically assaulted them

this phenomenon of violence in Jordanian EDs so that better Using a self-reported questionnaire could not describe all the
solutions can be developed to limit violence and its effects. issues contributing to violence in EDs. Future studies are

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 Workplace Health & Safety January2015

Table 5. Comparisons Between Violence Experience and Dichotomous Demographics

Violence Chi-square test

2
Variable Yes No df p value
Study setting
Educational 41 1 8.519 2 .014*
Governmental 70 4
Private 48 10
Gender
Male 93 9 .013 1 .910
Female 66 6
Marital status
Single 97 13 3.92 2 .141
Married 59 2
Others 3 0
Educational level
Diploma 33 1 2.253 2 .324
Bachelor 122 14
Master 4 0
Title
RN 126 14 1.730 1 .188
LPN 33 1
Note. RN = registered nurse; LPN = licensed practical nurse.
*p < .05.

recommended using actual rates and consequences of violence
documented in formal registries, interviewing victims of
violence, and conducting qualitative studies that explore nurses
actual experience with violence.
Conclusion
This study explored the prevalence of violence toward
Jordanian ED nurses, which was common and comparable to
the literature. Verbal violence was more common than physical
violence; younger and less experienced nurses were more likely
to experience violence than older, more seasoned nurses; and
nurses in private hospitals reported less violence than nurses in
university and government hospitals. Violence against nurses
had many consequences, including sick leaves and affected
physical and emotional health. Health care administrators have
an obligation to prevent violence against nurses by providing
adequate safety measures, efficient administrative procedures,
and sincere efforts to overcome the causes of this phenomenon.
Acknowledgments
The authors acknowledge The University of Jordan for funding
this study. Also, sincere thanks to the participants and to the
directors of nursing within the participating hospitals.
Conflict of Interest
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.

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vol. 63 no. 1
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Author Biographies
Dr. Muhammad W. Darawad is an associate professor at Faculty
of Nursing-The University of Jordan, with an advanced degree in
critical care and clinical nursing. Dr. Darawad is a member of
many nursing associations including Sigma Theta-Jordan
Charter, California Board of Nursing. He has many publications
in different peer-reviewed nursing journals and has participated
in many local and international professional events.
Dr. Mahmoud Al-Hussami is an associate professor at Faculty of
Nursing-The University of Jordan, with advanced degrees in
nursing administration and public health. Dr. Al-Hussami was
the head of the Community Health Nursing Department and was
recognized for the Research Achievement Prize in his institution.
He has many publications in different peer-reviewed nursing
journals and has participated in many local and international
professional events.
Dr. Ali M. Saleh is an assistant professor at Faculty of Nursing-
The University of Jordan, with advanced degrees in nursing
administration and quality assurance. Currently, Dr. Saleh is
appointed as the dean assistant for quality development in his
institution. He is a member of many nursing associations
including Jordan Nurses and Midwives Council and Jordan
Society of Scientific Research.
Dr. Waddah Mohammad Mustafa is an assistant professor at Al
Farabi College, with an advanced degree in nursing
administration. Dr. Mustafa has participated in many local and
international professional events. He is a member of many
nursing associations including Jordan Nurses and Midwives
Council.
Mrs. Haifa Odeh is a part-time clinical instructor at Faculty of
Nursing-The University of Jordan, with a masters degree in
clinical nursing. Mrs. Odeh is a clinical nurse specialist in the
intensive care unit. She is a member of the Jordan Nurses and
Midwives Council.
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