title: Impact of conflict and violence on workers in a hospital emergency room.
abstract: BACKGROUND
  Emergency room (ER) work includes dealing with situations of conflict and aggression. The diversity and unpredictability of these situations and the lack of pre-established procedures to guide workers in dealing with these phenomena affect and weaken their physical and mental health.
  
  
  OBJECTIVE
  The purpose of the article is to learn about conflict and aggression at work and its impact on the workers in a hospital emergency room.
  
  
  METHODS
  The method is a transversal, exploratory, descriptive and observational study, carried out from September to November 2008, using direct observation procedures and interviews.
  
  
  METHODS
  Two hundred and eighty emergency room workers participated in the observations and eleven interviews were carried out with workers from several professional categories.
  
  
  RESULTS
  The work process is marked by overload, individualization of responsibilities, time pressures and deadlines for making decision, little space for exchange and sharing, lack of support or guidance. The strong pressure to provide care quickly causes conflict and aggression among users and the different professional teams. These situations arise from problems in work organization and users in excess of the ER service capacity.
  
  
  CONCLUSIONS
  The article recommends changes in the work process that can simultaneously improve both the quality of care for patients and provide protective measures for workers.
authors.affiliation: Curso de Terapia Ocupacional da Faculdade de Medicina da USP, São Paulo, Brazil. lancman@usp.br
authors.forename: Selma
authors.initials: S
authors.lastname: Lancman
authors.forename: Elisabete Ferreira
authors.initials: EF
authors.lastname: Mângia
authors.forename: Melissa Tieko
authors.initials: MT
authors.lastname: Muramoto
mesh_terms: D000818:Animals; D003220:Conflict, Psychological; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007400:Interprofessional Relations; D008603:Mental Health; D012637:Security Measures; D016526:Workload / Q000523:psychology; D064450:Workplace Violence / Q000523:psychology*