Workplace violence in the Emergency Department in the Kingdom of Saudi Arabia

Waleed Alshehri1, Virginia Plummer2, Paul Jennings3

1 Monash University, School of Nursing and Midwifery (
2 Monash University, School of Nursing and Midwifery (
3 Monash University, Department of Community Emergency Health and Paramedic Practice (

Background: Workplace violence (WPV) occurs in any industry or occupation, but the health industry is at high risk. Healthcare professionals are at increased risk of WPV because they are working with the public, sometimes work with unstable or volatile persons, handling prescription drugs, and working late hours at night. Workplace violence occurs in every healthcare setting, but there are some areas at higher risk of WPV such as mental health units, and the Emergency Department (ED). Health care workers in the ED are at risk for WPV and are routinely exposed to WPV from patients and their families/friends.

Aim of the study: The aim of this study is to explore the WPV among the ED nurses and doctors in the Kingdom of Saudi Arabia (KSA).

Method: A correlational quantitative cross sectional design was used to collect data from six public hospitals in the KSA by utilizing an anonymous self-administered questionnaire.

Result: A total of 288 ED nurses and doctors participated ,73 (25.7%) participants were subjected to physical assault, 76 (27.2%) to physical threat, 196 (69.8%) to verbal abuse, and 47 (17.3%) to sexual harassment. Patients’ families/friends were the main source of WPV. Male patients or patients’ families/friends were the most common source of WPV for physical assault, physical threat and sexual harassment, except for verbal abuse were both genders were involved equally. Most of the participants (n=220; 78.9%) agreed they are vulnerable to WPV and 198 (69.7%) agreed that WPV affects their professional performance.  Furthermore, most of the participants (n=117; 41.5%) indicated that they are not sure if they could manage WPV and 230 (82.7%) have indicated that they need training/more training in dealing with WPV. Participants reported that an increase in the number and the quality of the security staff, improving the patient admission process, and educating the public about when to use the ED would reduce the WPV in the ED. In addition, there was a significant relationship between the prevalence of physical assault and the absence of WPV prevention training (p=0.040). Furthermore, there was a significant difference in the perception of participants regarding the acceptance of WPV as a part of the job and the job of the participants. Nurses were found to be more accepting of WPV more than doctors (p=0.019).

Conclusion: Workplace violence is prevalent among the ED nurses and doctors in the KSA especially verbal abuse. The findings are congruent with the existing literature however the recommendations for policy practice education and research need to be consistent with Saudi Culture and cognisant of the multicultural workforce. The utilisation of the findings for development of a WPV prevention policy in ED is recommended for further research.


I am a PhD candidate studying at Monash university. Right now, I am doing my PhD in Nursing as full time and fully sponsored by the Saudi government. I worked in the emergency department of two tertiary hospitals in the Kingdom of Saudi Arabia for more than 8 years. Furthermore, I worked in different areas in the ED. since I started doing my master, I focused on the management issues that prevent the ED nurses from providing their optimal care in the proper manner such as occupational stress and workplace violence. I believe that there is a chance for us as nurses to change the current situation by disseminating our research findings and that hope will change the current situation for a better one.