Ethnicity and exposure to workplace violence for hospital-based and community nurses


Supervisor: Stephani Hatch

Non-accademic partner: NHS England

As the NHS is suffering its worst ever staffing crisis, a number of non-UK studies have found that a key detrimental factor in recruitment and retention is workplace violence (Alameddine et al. 2015; Wolf et al., 2018). This issue is particularly pertinent for nurses, who are at greatest risk of workplace violence (Pich et al., 2010; Spector et al., 2014) and are also one of the staff groups in the shortest supply with 40,000 vacancies currently in the NHS. 14% of NHS staff in England are exposed to physical violence from patients, relatives or members of the public (Workforce Race Equality Standard, 2018). What we don’t know, however, is how rates of violence vary across ethnic groups. With rising crime rates in London (Metropolitan Police Service, 2019) and increasingly overburdened hospitals, nurses face additional challenges of treating victims or perpetrators of violence from their own communities. At an individual level, workplace violence can lead to depression and anxiety, absence from work, loss of good working relationships with colleagues and avoidance of the workplace (Nabb, 2000; Al-Sahlawi et al., 2003; Ryan et al., 2008; Ünsal Atan et al., 2013; da Silva et al., 2015). This, in turn, contributes to poor recruitment and retention, particularly in specialised areas which struggle to retain experienced nurses, such as emergency care, critical care and mental health. This project aims to understand the nature and impact of workplace violence on the mental and physical health of hospital-based and community nurses across ethnic groups, and the barriers to reporting these incidents, with implications for improving the recruitment of nursing students, work performance, and retention of qualified nurses. The project partners with NHS England Workforce Race Equality Standard (WRES) and builds on the Wellcome Trust funded Tackling Inequalities and Discrimination Experiences in health Services (TIDES) study (, which investigates how discrimination experienced by both patients and healthcare practitioners may generate and perpetuate inequalities in health service use. Using a mixed-methods design to analyse TIDES data and follow up those who consented to be re-contacted, this project aims to: 1. Explore witnessing or experiencing violence across ethnic groups both in and outside the workplace in terms of context, type, frequency, severity and perpetrator (Study 1). 2. Examine the impact of workplace violence on mental and physical health, job satisfaction, work performance, and intention to stay in the profession and how it varies across ethnic groups (Study 2). 3. Explore what procedures are in place for reporting violent incidents and what are the barriers and facilitators to reporting (Study 3)