Kim Da S, Byon Ha Do
School of Nursing, The University of Virginia, 202 Jeanette Lancaster Way, PO Box 800782, Charlottesville, VA, 22903, United States, 1 434-243-3973.
MedStar Georgetown University Hospital, Washington, DC, United States.
Asian Pac Isl Nurs J. 2025 Jun 18;9:e67029. doi: 10.2196/67029.
Type II (client-on-worker) workplace violence (WPV) between patients and nurses is an ongoing safety and health challenge in health care. However, little is known about the experiences of racial and ethnic minority nurses specifically in a profession in which most individuals identify as White. During and after the COVID-19 pandemic, type II WPV against certain minority groups increased, which suggests that underrepresented racial and ethnic minority nurses may have unique experiences with type II WPV inflicted by patients, their family members, or visitors.
The aim of this study was to (1) explore the lived experiences of racial and ethnic minority nurses who have faced type II WPV from patients in the hospital setting, and (2) assess the emotional and physical effects of type II violence among racial and ethnic minority nurses.
Semistructured individual interviews were conducted with racial and ethnic minority nurses. The research team recruited participants through snowball sampling. Nurses were eligible to participate if they (1) were ages 18 years and older, (2) were currently working as a registered nurse in a hospital in the United States or had previous experience in this role, with the experience dating no earlier than March 2020, when the COVID-19 pandemic began, (3) had experienced WPV from patients, their family members, or visitors at some point during their career, and (4) identified as a racial and ethnic minority. Interviews were conducted between February 2023 and March 2023. A qualitative descriptive approach was used to analyze the findings.
A total of 10 nurses from racial and ethnic minority groups were interviewed: 5 Asian, 2 Latina, 2 African American, and 1 Middle Eastern nurse. Violence experienced by the nurses fell under 2 categories: macroaggressions and microaggressions. Macroaggressions included physical violence, verbal abuse, and sexual violence. Microaggressions were subtle and often unconscious and unintentional comments, interactions, or behaviors relating to the participants' race. All nurses (10/10) reported experiencing racial microaggressions and considered them very harmful. Microaggressions left a negative impact on these nurses in terms of their self-esteem, the nurse-patient relationship, and their job performance. However, many participants did not speak up about microaggressions to either the perpetrator or management because they feared that their experiences would be dismissed. Minimization and normalization of microaggressions were common themes among participants. In total, 90% of participants (9/10) expressed that they do not feel supported in the hospital as nurses of underrepresented minority groups.
Microaggressions are a form of WPV. "Micro" implies small, but the consequences of microaggressions are additive and detrimental. Racial microaggressions negatively impact nurses in terms of their personal well-being, job performance, and ability to deliver quality patient care. Given this, more policies, procedures, and resources must be in place to support racial and ethnic minority nurses in the hospital setting.
患者与护士之间的II型（客户对工作人员）工作场所暴力（WPV）是医疗保健领域持续存在的安全与健康挑战。然而，对于种族和少数族裔护士的经历，尤其是在一个大多数人认同为白人的职业中的经历，我们知之甚少。在新冠疫情期间及之后，针对某些少数群体的II型WPV有所增加，这表明代表性不足的种族和少数族裔护士在遭受患者、其家庭成员或访客施加的II型WPV时可能有独特的经历。
本研究的目的是（1）探讨在医院环境中遭遇患者II型WPV的种族和少数族裔护士的生活经历，以及（2）评估II型暴力对种族和少数族裔护士的情绪和身体影响。
对种族和少数族裔护士进行半结构化的个人访谈。研究团队通过滚雪球抽样招募参与者。护士符合以下条件即可参与：（1）年龄在18岁及以上；（2）目前在美国医院担任注册护士或曾有过该职位的工作经历，且该经历不早于2020年3月新冠疫情开始之时；（3）在其职业生涯中的某个时候曾遭遇患者、其家庭成员或访客的WPV；（4）认同自己为种族和少数族裔。访谈于2023年2月至2023年3月进行。采用定性描述方法分析研究结果。
共访谈了10名来自种族和少数族裔群体的护士：5名亚洲护士、2名拉丁裔护士、2名非裔美国护士和1名中东护士。护士们经历的暴力分为两类：宏观侵犯和微观侵犯。宏观侵犯包括身体暴力、言语虐待和性暴力。微观侵犯较为微妙，通常是无意识和无意的与参与者种族相关的评论、互动或行为。所有护士（10/10）都报告经历过种族微观侵犯，并认为其非常有害。微观侵犯在自尊、护患关系和工作表现方面给这些护士带来了负面影响。然而，许多参与者既没有向施暴者也没有向管理层提及微观侵犯，因为他们担心自己的经历会被忽视。对微观侵犯进行淡化和正常化是参与者中的常见主题。总体而言，90%的参与者（9/10）表示作为代表性不足的少数族裔护士，他们在医院中感觉不到支持。
微观侵犯是WPV的一种形式。“微观”意味着微小，但微观侵犯的后果具有累加性且有害。种族微观侵犯在个人幸福感、工作表现以及提供优质患者护理的能力方面对护士产生负面影响。鉴于此，必须制定更多政策、程序和资源来支持医院环境中的种族和少数族裔护士。
