Workplace violence against nursing students and nurses: an Italian experience

Background: Nurses and nursing students are exposed to workplace violence. Objectives: To compare the characteristics and effects of violence in nursing students and nurses in order to assess the phenomenon and take preventive action. Methods: A retrospective survey was conducted in three Italian university schools of nursing. At the end of a lecture, 346 out of 349 students agreed to fill in a questionnaire that included domains on violence, mental health, job stress and organizational justice. This group was compared with 275 nurses from a general hospital (94.2% participation rate). Results: The prevalence of subjects reporting at least one upsetting episode of physical or verbal violence during their lifetime activity in clinical settings was 43% in nurses and 34% in nursing students. Nurses reported more physical assaults (OR 2.89, CI95% 1.35-6.18), threats (OR 2.84, CI95% 1.39-5.79) and sexual harassment (OR 2.3, CI95% 1.15-5.54) during the previous 12 months than students. Nurses were mostly assaulted or harassed by patients or their relatives and friends (“external” violence), whereas students often reported verbal and also physical violence on the part of colleagues, staff and others, including teachers, doctors and supervisors (“internal” violence). Verbal violence was associated with high levels of psychological problems, as measured by GHQ-12, in both students and nurses. Verbal violence was also associated with high job strain, low social support and low organizational justice, but only among nursing students. Conclusion: Preventive action is urgently needed to control patient-to-worker and worker-to-worker violence in clinical settings.