Psychiatric Nurses and Technicians Report High Rates of Exposure to Trauma Involving Patients

Nurses and psychiatric technicians at a private psychiatric hospital reported significantly higher rates of exposure to trauma—witnessed or experienced—than those in roles requiring lower direct patient care, according to a report in Psychiatric Services.

 

Physical violence toward inpatient health care workers accounts for a significant percentage of all nonfatal workplace violence. The risk is especially high in psychiatric settings because of involuntary admissions, with nursing staff exposed to high rates of verbal aggression, property destruction, and sexual violence.

 

Despite extensive research, differences in violence exposure across disciplines remain unclear. The current study aimed to examine not only rates of violence exposure across disciplines in an acute inpatient psychiatric setting but also the impact of such exposure on staff well-being.

 

• In a cross-sectional survey conducted at a 274-bed inpatient psychiatric hospital in Texas, 142 staff members reported their experiences of violence and related emotional impacts using the Staff Workplace Experiences Questionnaire.
• Those in moderate and high direct care roles reported witnessing or experiencing an average of 9.38 and 12.98 events, respectively, compared with 6.15 events among those in low direct care roles.
• Those in high direct care roles reported an average of 5.6 traumatic events that they experienced themselves, compared with 2.4 among those in low direct care roles.
• On average, those in moderate and high direct care roles reported being more likely to feel at least somewhat unsafe or very upset because of a traumatic event during their work in the hospital.

Self-reports may be influenced by recall bias or by underreporting due to fear of reprisal. Staff who were most affected by workplace violence may have been either more motivated to complete the survey, thereby inflating exposure rates, or less likely to participate because of distress. Additionally, the survey was conducted at the beginning of the COVID-19 pandemic, a period marked by heightened stress, staffing instability, and increased illness acuity in inpatient psychiatric settings.

 

“This study highlights the disproportionate burden on high direct care roles and the need for trauma-responsive, equitable organizational support,” the researchers wrote. “Support for staff well-being is essential for workforce sustainability and high-quality psychiatric care.”

 

“Ramifications of a Patient’s Physical Assault on Inpatient Ward Psychiatrists”

 

Stephanie Emhoff, et. al. Trauma on the front lines: violence exposure across disciplines in an inpatient psychiatric hospital. Psychiatric Services. Published August 6, 2026. doi:10.1176/appi.ps.20250602