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A prevalent shared theme revealed basic mistrust that hospital administration would respond to reported patient violence. Sixty nine percent of Registered Nurses completed the pre-questionnaire and 50% completed the post-questionnaire. Pre- and post-education surveys were constructed, distributed, and analyzed to determine changes in nurse knowledge and perceptions related to patient aggression. Definitions, literature, statistics, hospital policy and reporting process, and a Crisis Prevention Intervention (CPI) link were easily accessed by ED staff. ED staff were provided education to manage, mitigate, and minimize patient aggression via a bulletin board. Support from Occupational Safety and Health Administration (OSHA), The Joint Commission, and the Emergency Nurse Association was aimed at protecting nurses physically and emotionally from patient violence through education, empowerment, and encouraging hospital administrative support. Nurse surveys indicated daily anticipation of physical harm, a sense of helplessness from lack of administrative support, and emotional stress related to acts of patient violence. Patient verbal and physical abuse directed at nurses is generally viewed as an acceptable job risk by the general public, hospital administrators, and nurses. Survey and questionnaire responses from 18 nurses in a Midwestern hospital ED revealed mindsets and perceptions of short and long term effects of potential and realized patient violence situations. Patient violence in the Emergency Department (ED) is common, varied, and has lasting effects on nurses.