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

Background: Workplace violence (WPV) is a persistent challengein 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.