Table 2

Frequency of main themes in provider-generated descriptions of their (A) angry, (B) positive and (C) mental health encounters

Themes and subthemesEncounters
TotalPhysiciansNurses
A. Angry encounters*
Patient behaviour
  Demanding, entitled, or manipulative behaviour50 (53%)27 (54%)23 (52%)
  Verbal or physical abuse towards provider (actual or threatened)34 (36%)18 (36%)16 (36%)
  Frequent/high emergency department utiliser35 (37%)16 (32%)19 (43%)
  Unrealistic expectations (patient expected different or more care than was possible)23 (24%)17 (34%)6 (14%)
  Poor self-care (patient did not manage medical condition or refused necessary treatment)21 (22%)13 (26%)8 (18%)
Issues with family members
  Situations in which a family member directed hostility or anger towards the provider or patient15 (16%)6 (12%)9 (20%)
Hospital or system issues
  Patient care barriers not under direct control of emergency department provider, including issues with colleagues, the emergency department system, hospital, or healthcare in general24 (26%)11 (22%)13 (30%)
Miscellaneous (content not categorised) 6 (6%)3 (6%)3 (7%)
B. Positive encounters†
Relationship with patient and/or family
  Gratitude expressed towards provider52 (55%)28 (56%)24 (54%)
  Patient was cooperative, positive, or understanding19 (20%)15 (30%)4 (9%)
  Other meaningful connection with patient8 (8%)2 (4%)6 (14%)
Success with patient care
  ‘Made a difference’ or advocated for patient37 (39%)18 (36%)19 (42%)
  Felt proud of own abilities13 (14%)9 (18%)4 (9%)
  Felt proud of team/emergency department7 (7%)4 (8%)3 (7%)
Miscellaneous (content not categorised) 4 (4%)1 (2%)3 (7%)
C. Mental health encounters‡
Patient behaviour
  Demanding, entitled, or manipulative behaviour49 (52%)19 (38%)30 (68%)
  Verbal or physical abuse towards provider (actual or threatened)30 (32%)10 (20%)20 (45%)
  Frequent/high emergency department utiliser33 (35%)17 (34%)16 (36%)
  Poor self-care (patient did not manage medical condition or refused necessary treatment)16 (17%)8 (16%)8 (18%)
  Calm, pleasant, thankful22 (23%)13 (26%)9 (20%)
Issues with family members
  Situations in which a family member directed hostility or anger towards the provider or patient6 (6%)6 (12%)0 (0%)
  Situations in which provider experienced sadness for a patient’s family member12 (13%)9 (18%)3 (7%)
Hospital or system issues
  Patient care barriers not under direct control of emergency department provider, including issues with colleagues, the emergency department system, hospital, or healthcare in general36 (38%)21 (42%)15 (34%)
Provider emotions
  Anger, frustration, irritation55 (59%)25 (50%)30 (68%)
  Sadness, helplessness, empathy33 (35%)19 (38%)14 (32%)
  Fear, anxiety12 (13%)5 (10%)7 (16%)
  Positive emotions (appreciation, gratitude)8 (9%)3 (6%)5 (11%)
  Indifference or no emotion mentioned12 (13%)8 (16%)4 (9%)
Miscellaneous (content not categorised) 18 (19%)9 (18%)9 (20%)
  • n=94 (50 physicians, 44 nurses).

  • *Seventy-two stories (77%) were coded into two or more categories.

  • †Forty stories (43%) were coded into two or more categories.

  • ‡Ninety-three stories (99%) were coded into two or more categories.