RNs encounter workplace violence and abuse at a far higher rate than in any other profession in the United States. Although the topic is uncomfortable, it’s a very real aspect of health care for many professionals. Most nurses have likely experienced an abusive, dangerous, or violent encounter in the healthcare setting at some point in their careers.

Those events can leave a lasting impact—physically, mentally, and emotionally—requiring medical care, psychological counseling, or even job reassignment. Some scars from violent or traumatic encounters can stay with nurses forever, leading to burnout or post-traumatic stress (see article on page 38). Violence in the workplace doesn’t just jeopardize nurses’ safety; its lingering effects can also diminish their ability to provide high quality care for future patients.

Recognize Workplace Violence When You See It 

Workplace violence can come from aggressive patients, confrontational family members, total strangers entering the institution, or even other members of the healthcare team. According to the National Institute of Occupational Safety and Health (NIOSH), workplace violence and abuse can be categorized into four different types

  • Type 1 involves individuals with criminal intent who have no relationship to the business or its employees. 
  • Type 2 involves a customer, client, or patient where the individual has a relationship with the business and becomes violent while receiving services. 
  • Type 3 involves a worker-on-worker relationship and includes employees who attack, threaten, or abuse another employee. 
  • Type 4 involves individuals with personal relationships with the intended target but who don’t have any relationship to the business or institution itself.  

Provide Prevention Programs 

Although the Occupational Safety and Health Administration (OSHA) doesn’t require workplace violence prevention programs at any institutions, it does provide voluntary guidelines for nurses and other healthcare professionals interested in learning more about workplace violence prevention. The guidelines are available from OSHA.

NIOSH provides a free online course, Workplace Violence Prevention for Nurses, to help providers understand the details of violence in a healthcare setting, including prevention strategies at the personal and organizational level. The course also highlights post-event response strategies and further details about prevalence and consequences.  

Advocate for Change 

In March 2019, U.S. Senator Tammy Baldwin (D-WI), member of the Senate Employment and Workplace Safety Subcommittee, introduced the Workplace Violence Prevention for Health Care and Social Service Workers Act. The bill would authorize OSHA to enforce safety standards for all employers, requiring them to write and implement workplace violence prevention plans for healthcare professionals. In the U.S. House, Representative Joe Courtney (D-CT) reintroduced a version of the Workplace Violence Prevention for Health Care and Social Service Workers Act, which would allow OSHA to develop and enforce workplace violence prevention safety standards.  

With support in both chambers of Congress, nurses have a prime opportunity to advocate for change. By sharing stories and experiences of workplace violence, nurses can educate lawmakers about the impact it has on personal well-being and professional practice. As part of its advocacy efforts, ONS is focused on nursing workforce issues, including potentially violent or unsafe environments, and continues to provide nurses the opportunity to connect with elected officials at all levels of government.