Date of Conferral





Public Policy and Administration


Mark DeVirgilio


Assaults on emergency department nurses by patients are higher than any other occupation in the private sector. Professional nursing organizations have lobbied for penalty enhancement laws that increase the categorization of assaulting a nurse on duty from a misdemeanor to a felony. As of 2015, 32 states have implemented these laws. Yet, low assault reporting rates by nurses remains a problem, and little is known about whether penalty enhancements improved reporting rates. The purpose of this correlational study was to evaluate the impact of penalty enhancement laws on self-reporting of assault on emergency department nurses in 6 Mid-Atlantic cities. Constructs from organizational culture theory and rational choice theory were tested to determine if actions taken by nurses after assaults were influenced by the organizational culture within the hospital, by the rational choice actions of the individual nurse, or both. Data were obtained through online surveys of 107 emergency department nurses. Data included demographic information, workplace violence experiences, individual actions, and institutional actions. These data were analyzed using multiple regression. Findings indicate that rational choice actions were a significant predictor of nurse reporting behaviors of patient assaults (p <.001). Organizational practices, age, gender, and state penalty enhancement laws were not significant predictors of nurse reporting behaviors of patient assaults. Implications for social change include the development of policies and strategies to improve reporting of assaults in emergency departments. In addition, results may be used to increase awareness of policymakers on the perceived effects of penalty enhancement laws on emergency department nurses.