Healthcare Crisis Unveiled: Alarming Levels of Workplace Violence Against Nurses in Saudi Arabia

Documents 84% Verbal Abuse Rate and 40% Non-Reporting of Incidents—With Urgent Call for Systemic Reform in Healthcare Safety Protocols

A landmark study published in Evidence-Based Nursing Research has exposed the shocking reality of workplace violence against nurses in Saudi Arabia—documenting what researchers describe as "an epidemic of underreported violence that threatens both healthcare worker safety and patient care quality."

Conducted at Dammam Medical Tower, one of Saudi Arabia's largest healthcare facilities, the research reveals that 84.3% of nurses experience verbal abuse while on duty, yet only 28% consider workplace violence a "very serious" problem—a disconnect that experts warn could be putting both healthcare workers and patients at risk.

The Hidden Crisis in Plain Sight

The comprehensive study, led by Dr. Sara Mohammed Aljanabi of King Abdul-Aziz University, surveyed 300 nurses to assess their perceptions of workplace violence—a problem that has reached crisis levels in Saudi healthcare facilities despite government efforts to address it.

"Our findings reveal a disturbing pattern where violence has become normalized in healthcare settings," explains Dr. Aljanabi, lead researcher. "When nearly half of all nurses don't report violent incidents, and only 18.7% believe their employer is very concerned about their safety, we're facing a systemic failure that demands immediate attention."

The research documents a series of violent incidents that made headlines in 2018:

• May 4, 2018: A Filipino technical nurse stabbed with a sharp instrument in Al-Medina
• July 10, 2018: Saudi nurse Nayef Mahdi Al Yami fatally shot at King Salman Hospital
• August 20, 2018: A doctor and two nurses subjected to verbal and physical violence in Alahsaa

"These high-profile cases represent just the tip of the iceberg," notes Dr. Naglaa El Seesy, co-author of the study. "For every reported incident, our research shows there are multiple unreported cases—creating a dangerous culture of silence that prevents effective intervention."

The Reporting Gap: 40% of Nurses Stay Silent

• Perhaps most significantly, the research documents a critical reporting gap that undermines safety efforts:
• 40.3% of nurses who experienced violence did not report any incidents
• 55.3% were not knowledgeable about proper reporting procedures
• Only 48.6% reported that management was supportive and tried to find solutions

"The lack of reporting isn't indifference—it's often fear, lack of confidence in the system, or the belief that nothing will change," states Dr. Amal Sijeeni, the study's third author. "When nurses don't trust that reporting will lead to meaningful action, they stop reporting altogether."

The study particularly highlights how workplace violence directly impacts patient care:

1. 38.3% of nurses indicated violence affected their ability to concentrate on the job
2. Only 35.0% were offered relief time after violent incidents
3. Patients and their relatives emerged as the most common perpetrators

The Day Shift Danger Zone

The research reveals unexpected patterns in when violence occurs:

• 46.3% of nurses reported violence occurred during day shift (contrary to expectations that evening/night shifts would be more dangerous)
• 39.0% reported violence during evening shift
• Only 10.7% of nurses felt they had "much control" over their safety in the workplace

"This challenges the assumption that violence is primarily a night shift problem," explains Dr. Aljanabi. "The busier daytime environment with more patient interactions and family visitors creates unique vulnerability that requires targeted interventions."

The Roadmap to Safer Healthcare

Based on their findings, the researchers developed a comprehensive action plan for healthcare administrators:

1. Clear Policy Implementation

38.3% of nurses identified "clear policy and procedures addressing violence" as the most feasible solution—a recommendation that aligns with Saudi Arabia's legal framework where "violence against health care worker is punishable by imprisonment up to ten years and financial penalty up to 1,000,000 Saudi Riyal."

2. Training and Education

1. 33.7% of nurses suggested "training on legal rights about violence" as critical, with researchers recommending:
2. Mandatory workplace violence prevention training
3. Integration of violence concepts into orientation courses
4. Regular interprofessional educational courses on improving work conditions

3. Reporting System Overhaul

The study calls for a complete redesign of reporting mechanisms to address the current system's failures, including:

• Simplified reporting procedures
• Guaranteed confidentiality
• Clear follow-up protocols
• Transparent communication about outcomes
• Global Implications for Healthcare Safety

The findings carry significance beyond Saudi Arabia's borders, offering valuable insights for healthcare systems worldwide:

Hospitals with comprehensive violence prevention programs see 37% fewer incidents

Facilities that address violence as a patient safety issue (not just staff issue) achieve better reporting rates

The normalization of verbal abuse often precedes physical violence, making early intervention critical

"With healthcare workers facing unprecedented stress since the pandemic, this research provides the evidence-based foundation for making healthcare workplaces safer," states Dr. El Seesy. "When nurses feel safe, patient outcomes improve across the board."

The Call to Action

The study concludes with an urgent call for systemic change:

• Healthcare administrators must move beyond reactive responses to implement proactive safety measures
• Clear policies must be developed and consistently enforced
• Violence must be addressed as both a staff safety and patient care quality issue
• Regular monitoring of violence incidents and reporting rates should become standard practice

"Our research shows that violence against healthcare workers isn't inevitable—it's preventable," emphasizes Dr. Sijeeni. "The solutions exist; what's needed now is the commitment to implement them consistently across all healthcare settings."

As healthcare systems worldwide grapple with staffing shortages and burnout, this research provides both the evidence and implementation framework needed to transform healthcare workplaces from environments where violence is normalized to settings where safety is non-negotiable—proving that when healthcare workers are protected, everyone benefits from higher quality, more compassionate care.