South African emergency nurses’ perceptions and experiences of workplace violence: A qualitative study

ElsevierVolume 83, December 2025, 101694International Emergency NursingAuthor links open overlay panel, , , Highlights•

The study emphasizes the need for a safe workplace, particularly in emergency departments.

Urgent need for evidence-based strategies to improve staff safety in emergency care.

Addressing workplace violence is crucial for nurses’ health and patient relationships.

AbstractBackground

Workplace violence (WPV) is a persistent challenge in emergency departments (EDs), exacerbated by complex sociocultural dynamics, institutional shortcomings, and insufficient support systems. Emergency healthcare providers in South Africa work in high-pressure environments, frequently encountering aggression from patients and families who misunderstand the nature of emergency care.

Aim

To explore nurses’ perceptions and experiences of workplace violence in the emergency departments in South Africa.

Methods

This study used a qualitative descriptive design. Five semi-structured focus group discussions with 20 emergency nurses in South Africa. Data were analysed using thematic analysis. The study followed the COREQ guidelines.

Findings

Three themes emerged: contributors to violence, barriers to reporting workplace violence, and environmental and institutional challenges. Contributors to violence were frequently fuelled by public misconceptions about emergency care procedures, particularly unrealistic triage expectations and staff confrontational behaviours. Barriers to reporting were evidenced by unclear reporting protocols, fear of retaliation or futility, and a culture of managerial indifference. The identified environmental and institutional challenges included insufficient security presence, hazardous physical environments, and a lack of structured support mechanisms.

Conclusion

In South African EDs, WPV is exacerbated by socio-cultural misunderstandings, managerial complacency, and structural weaknesses. Addressing these issues will necessitate comprehensive strategies, such as improved institutional leadership, formalised reporting systems, and proactive safety interventions.

Keywords

Nurses

Experience

Perceptions

Workplace violence

Emergency departments

South Africa

Qualitative study

© 2025 The Authors. Published by Elsevier Ltd.

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