Workplace Violence and Harassment Against Emergency Medicine Residents.
BACKGROUND
Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety.


METHODS
This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work.


RESULTS
A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe "Occasionally," "Seldom" or "Never" while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease.


CONCLUSIONS
Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.
Northwestern University, Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois.
Benjamin H
BH
Schnapp
Mount Sinai Hospital, Icahn School of Medicine, Department of Emergency Medicine, New York, New York; Columbia University, Department of Biomedical Informatics, New York, New York.
Benjamin H
BH
Slovis
Mount Sinai Hospital, Icahn School of Medicine, Department of Emergency Medicine, New York, New York.
Anar D
AD
Shah
Northwestern University, Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois.
Abra L
AL
Fant
Northwestern University, Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois.
Michael A
MA
Gisondi
Mount Sinai Hospital, Icahn School of Medicine, Department of Emergency Medicine, New York, New York.
Kaushal H
KH
Shah
New York University School of Medicine, Bellevue Hospital Center, NYU Langone Medical Center, Department of Emergency Medicine, New York, New York.
Christie A
CA
Lech
D003430:Cross-Sectional Studies; D004635:Emergency Medicine; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D010361:Patients; D010820:Physicians / Q000706:statistics & numerical data*; D012449:Safety / Q000592:standards; D017406:Sexual Harassment; D019966:Substance-Related Disorders / Q000523:psychology; D014789:Visitors to Patients; D064450:Workplace Violence / Q000706:statistics & numerical data*