Prepare for the worst, hope for the best: A qualitative study on workplace violence in healthcare

Purpose

The purpose of the study is to explore how healthcare employees process and cope with workplace violence (WPV) in an effort to improve employee and organizational performance.

Design/methodology/approach

This qualitative study is based on the theories of cognitive adaptation and social exchange. Research and interview questions were developed from these theories to uncover how healthcare workers process and cope with the trauma of violence. Participants gave accounts of verbal, physical and psychological acts of violence perpetrated by patients, patient family members, and colleagues.

Findings

Findings are discussed including WPV experiences, coping with WPV and organizational support to WPV, among others. Detailed preventive and reactive organizational strategies to help employees cope with WPV are recommended. The study offers significant theoretical implications and provides a comprehensive framework for interpreting how employees process, cope with and perceive organizational responses to WPV.

Research limitations/implications

The study advances our understanding of how healthcare workers cope with WPV at different times and informs future research on the resources and support that are needed from employers at different stages of the coping process. The study has several limitations. First, the study relies on interview data that are the perceptions and self-reported data of healthcare workers. Another limitation is that while data saturation was achieved after 11 interviews, this number is modest considering the number of healthcare workers that experience WPV.

Practical implications

Healthcare organizations should adopt a Workplace Violence Prevention Plan (WVPP) that addresses all types, forms and levels of violence, including the threat of terrorism. Selection techniques should be designed to assess candidates' responses to high-stress situations, helping to identify individuals who may struggle with workplace conflict or criticism. Organizations should implement a confidential reporting system and establish a dedicated threat management team (TMT). Healthcare organizations should routinely update their training programs and provide ongoing support to those who have experienced WPV.

Social implications

Organizations have a responsibility to keep their employees safe and secure. Trauma resulting from violence and unsafe conditions not only harms performance but has significant implications for employee mental health and physical well-being. Organizations can and must do more to keep workers safe from deviant, violent and counterproductive work behaviors.

Originality/value

To our knowledge, this is among the few research studies to examine how healthcare workers from both administrative and clinical positions cope with WPV through the frameworks of cognitive adaptation and social exchange.

https://doi.org/10.1108/IJHCQA-05-2025-0062

Haymore, J., Sun, J., & Barber III, D. (2025). Prepare for the worst, hope for the best: a qualitative study on workplace violence in healthcare. International Journal of Health Care Quality Assurance, 1-19 https://doi.org/10.1108/IJHCQA-05-2025-0062.