Institutional Silence and Informal Coping: A Qualitative Descriptive Study of Nurses’ Experiences of Workplace Violence in Three Hospitals in Riyadh, Saudi Arabia
TL;DR
In participants’ accounts, informal coping absorbed harms that organisational systems did not address, and hospital managers could use these findings to check whether reporting, post-incident follow-up, training, staffing, and security arrangements work in practice.
Abstract
Background/Objectives: Saudi evidence on workplace violence (WPV) against nurses is largely survey-based. This study explored how nurses in three Riyadh hospitals experienced and coped with WPV, the institutional factors shaping their responses, and the improvements they proposed. Methods: In this qualitative descriptive study, 17 purposively recruited registered nurses from a tertiary government, a specialised government, and a private hospital took part in face-to-face semi-structured interviews (January–March 2026). Data were analysed using reflexive thematic analysis and reported according to COREQ. Results: The findings describe participants’ experiences and are not prevalence estimates. Four themes were constructed: (1) everyday exposure to violence and its cumulative burden; (2) coping through personal strategies and peer support; (3) institutional silence and gaps in organisational protection; and (4) balancing self-protection and therapeutic care. Participants described relying on personal and peer resources where they perceived institutional protection as insufficient. Their priorities for improvement, reported separately, centred on de-escalation training, simpler reporting, timely post-incident support, and leadership accountability. Conclusions: In participants’ accounts, informal coping absorbed harms that organisational systems did not address. Hospital managers could use these findings to check whether reporting, post-incident follow-up, training, staffing, and security arrangements work in practice. Participants’ proposals require evaluation.