Worker-to-worker violence in hospitals: Perpetrator characteristics and common targets

Background and Objectives: Worker-to-worker (Type III) violence in hospitals is primarily non-physical but threatens worker psychological health. Despite theories about why this violence is perpetrated, less is known about the perpetrators themselves. This study aimed to identify individual and job-related characteristics of Type III perpetrators and common perpetrator-victim dyads within a large hospital system.

Methods: Descriptive study based on data collected within a large hospital system, where employees report workplace violence via a central, standardized surveillance system. Employees report both physical assault and non-physical acts, such as verbal aggression, harassment and bullying. For the period 2010 to 2012, 199 documented Type III incidents were analyzed.

Results: The majority of the incidents (74.4%) were verbal aggression, followed by harassment (10.1%), bullying (7.5%), assault (4.5%) and threats (3.5%). Perpetrators were mostly female (74.4%) and worked full-time (60%), with a mean age of 45.2 years and a mean tenure of 11.7 years at this hospital system; 9.4% were repeat offenders. The majority of perpetrators were identified as Nursing staff (40.6%), followed by Allied Health Professionals (AHP, 12.8%), Patient Care Associates (PCA, 11.7%), and Medical Residents (9.4%). The most common perpetrator-victim dyads were Nurse-to-Nurse (21.6%), PCA-to-Nurse (8.6%), AHP-to-Nurse (7%), Medical Resident-to-Nurse (6.5%), and Nurse-to-PCA (6.5%).

Conclusions: In this sample, nurses were involved in nearly all Type III events as the perpetrator or the victim. Common dyads of aggression can indicate poor relationships between workers of certain job categories, and therefore may identify work-related factors that provide points of intervention.