Healthcare providers' neurobiological response to workplace violence perpetrated by consumers: Informing directions for staff well-being

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Aims: To examine the neurobiological response experienced by healthcare workers when exposed to workplace violence perpetrated by consumers, with a view to informing future training and self-care strategies for staff well-being. Background: Considerable work has been undertaken internationally to identify the causes of workplace violence and to develop legislation and guidance for reducing the risk in healthcare. However, there is a gap in understanding workers' innate neurobiological response to workplace violence, and how to prepare staff to recognise the professional and self-care implications of such a response. Design: This explanatory study was part of a larger descriptive study. Methods: Individual and group interviews were conducted with managers, directors, health/safety staff, nurses and educators (n = 99) from rural and metropolitan health services in Australia. Inductive thematic analysis was conducted, followed by in depth analysis to answer the question: what neurobiological response could be occurring when healthcare workers experience workplace violence? The analytical framework was informed by polyvagal theory. Results: With the increased risk of threat to physical and personal safety in the workplace, healthcare workers may experience activation of the fight, flight or freeze response, affecting their wellbeing and performance at work and at home. Participants recognised a need to care for themselves and understand their own reactions, so that they could better address the needs of consumers. Conclusions: Education for health care workers should include knowledge of the neurobiological responses to threat, and techniques to increase their capacity to identify, and manage their responses. An understanding of trauma-informed care for staff, will enable them to recognise the cumulative effects of workplace violence, and identify strategies to manage their well-being. Relevance to clinical practice: Information about the body's neurobiological response to stressors that threaten physiological and psychological safety can assist healthcare providers to better understand how to respond to workplace violence and aggression.

Original languageEnglish
Pages (from-to)42-48
Number of pages7
JournalApplied Nursing Research
Publication statusPublished - 1 Oct 2018


  • Defense cascade
  • Healthcare
  • Occupational
  • Polyvagal
  • Qualitative research
  • Resilience
  • Stress response
  • Trauma
  • Violence
  • Workplace

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