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The statistics are shocking but not surprising. At least 60% of health care workers will experience workplace violence with nurses and doctors receiving the brunt. While 25% will experience physical violence, 45% non-physical violence: verbal abuse, threats, and sexual harassment. The effects may be minor. But experiencing workplace violence can lead to missed work, lost income, physical and mental injury, disability, and death.

The figures above are likely low due to underreporting. Workers are hesitant to report violence for several reasons:

  • Conditioned to believe it’s “part of the job”
  • Reporting processes are time-consuming, cumbersome, and re-traumatizing
  • Employer focus on profit and patient experience 
  • Historic non-action
  • Fear of retaliation from perpetrator or employer

Vulnerable Nurses 

Nurses’ dedication and compassion make them especially vulnerable to violence by patients or visitors. They are often in close contact with patients who have mental health or substance abuse challenges. They care for their patients despite warning signs and known violent history. Patients, in turn, are often stressed, scared, and can easily become agitated. Nurses have a reputation for sticking it out in the worst of times, Finally, they are compelled to “do no harm” and prioritize patient safety above their own. 

Workplace Violence Prevention

Health care organizations are beginning to understand the scope of the problem and respond. But we have a long way to go before health care workers can feel safe and sound at work. Occupational Safety and Health Administration (OSHA) does not currently require employers to implement workplace violence prevention programs but encourages it. Its guidelines include 5 core elements: 

  • Management commitment and employee participation
  • Worksite analysis and hazard identification
  • Hazard prevention and control
  • Safety and health training
  • Record keeping and program evaluation


Under the proposed bill H.R. 1309, the Department of Labor would require health care employers to develop and implement a comprehensive plan for protecting their workers from workplace violence. On November 21, 2019, H.R. 1309 was passed in the US House of Representatives and received by the US Senate for review. 

Nurses should not be afraid at work. If everyone works together, we can turn this tide. Nurses contact their state senator and urge them to pass H.R. 1309. They should encourage their employers to proactively develop workplace violence protection. Most all, nurses must support one another and encourage reporting to help end this crisis. 


ANA: Workplace Violence

OSHA Worker Safety in Hospitals Guidelines

Silent No More Foundation

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Shawna Kratochwill, BSN, RN
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