Aggressive and provocative behaviour towards medical staff. Results of an employee survey of the emergency services at the Charite-University Medicine Berlin

Emergency areas in hospitals are particularly and, due to more stress and crowding, increasingly exposed to violence and aggression by patients and their relatives. There is a lack of empirical data on frequency, types and extent of violence in emergency areas in Germany. In all, 698 quantitative questionnaires were distributed to personnel (nursing, doctors, midwifes and others) of predefined specific areas dealing with emergencies [emergency departments (ED), delivery rooms, outpatient clinics] of a large university hospital. Personally experienced verbal or physical aggression during the last 6 months was inquired. In addition, the questionnaire evaluated whether the staff felt prepared to deal with escalating situations. The return rate was 51.3 %; 77.4 % of the completed questionnaires were handed in by employees of the EDs. A total of 95 % of responders were exposed to verbal aggression in the last 6 months before the examination, around one third (33%) to physical aggression. The extent of verbal aggression was similar for doctors and nursing staff, whereas almost every second nurse (46 %) but "only" every fifth doctor (22 %) reported physical violence during this period. Every fifth employee (21 %) sustained an injury (34 % of nurses, 7 % of doctors), of which around one third (34 %) were reported as mental injuries. On average, 43 verbal and 8 physical aggressions per responding person were reported during the last 6 months. Around 70 % reported not feeling adequately prepared for escalating situations. The experience of aggression and violence is a relevant problem for staff of the inquired emergency areas. The majority of employees do not feel well prepared for escalating situations. Our results suggest the initiation and evaluation of adequate measures like in-house training programs for professional de-escalation.