Workforce Violence Requires Legislative Support

September 22, 2022 by Alec Stone MA, MPA, ONS Government Affairs Director

The truth is that violence against healthcare workers (https://nurse.org/articles/workplace-violence-in-nursing-and-hospitals/) will always be a major concern for the profession, especially in emergency rooms. However, there are steps that individuals and healthcare systems can take to help keep the environment as safe as possible but also allow nurses the ability to report the events. New laws are in the process of being enacted and harsher penalties are enforced against those that harm healthcare workers. Nurses are there to save our patients—not each other.

Nurse.org, 2022

Health care is a hazardous professional industry. As a calling more than a career, providers understand the risks associated with patient interactions. Florence Nightingale’s environmental theory of nursing (https://www.google.com/books/edition/Notes_on_Nursing/DxRbAAAAQAAJ) calls for nurses to tailor a patient’s surroundings to their treatment plan, and that includes creating a safe space for patients and providers alike.

Workplace Violence Is Escalating

According to the Occupational Safety and Health Administration (OSHA), healthcare workplace violence takes many forms (https://www.osha.gov/sites/default/files/OSHA3827.pdf), including verbal threats or physical attacks from patients, family members who may become abusive or even an active shooter, domestic disputes, coworker bullying, and much more. OSHA added that patient-provider interactions are innately stressful, especially if patients have severe pain, mental health conditions, drug misuse disorders, or a history of violence.

The U.S. Bureau of Labor Statistics reported that 73% of all nonfatal workplace injuries and illnesses from violence in 2018 occurred in healthcare workers (https://www.bls.gov/iif/oshwc/cfoi/workplace-violence-healthcare-2018.htm). The pandemic only exacerbated those reports, particularly for frontline workers like nurses, who are already experiencing elevated stress, trauma, and burnout from caring for patients with COVID-19. In a 2021 National Nurses United survey, respondents reported significant increases in workplace violence. More must be done to directly protect nurses from increasing workforce assaults and attacks.

Policymakers Step In With Support

The urgency and severity of the situation called for immediate reform, and policy leaders and the nursing community have introduced legislative and regulatory recommendations to better support patients’ and providers’ mental and physical health.

When the emotional toll of burnout from COVID-19 led a physician to take her own life, the U.S. Congress passed the bipartisan Dr. Lorna Breen Health Care Provider Protection Act in March 2022. The act’s explicit purpose is to develop (https://www.congress.gov/bill/117th-congress/house-bill/1667) “programs to promote mental health and resiliency among health care providers,” and it led to a legislative effort to stem the tide on the growing hostile conditions in health care.

In April 2021, the U.S. House of Representatives passed the Workplace Violence Prevention for Health Care and Social Service Workers Act (https://www.congress.gov/bill/117th-congress/house-bill/1667), which would require the US Department of Labor to make “employers within the healthcare and social service industries to develop and implement a comprehensive workplace violence prevention plan.” Although the bill has not yet passed the U.S. Senate, activists are promoting the need to guarantee healthcare workers and the institutions in which they work understand and provide those plans.

Finally, in June 2022, the U.S. House introduced the Safety From Violence for Healthcare Employees (SAVE) Act (https://www.congress.gov/bill/117th-congress/house-bill/7961), which outlines actions to stop the “problem of assault and intimidation against hospital employees” The House bill described the situation as “serious, widespread, and interstate in nature” and that it warranted federal assistance. The bill would provide millions of dollars in funding for institutions to develop resources to combat violence and the opportunity to curtail future incidents. But the legislation session’s end is rapidly approaching, and few hold out hope the SAVE Act will become law.

ONS Perspective

The proposed bills are not quick fixes, nor will any federal legislation be able to prevent all violence in the healthcare journey. A gunshot, a car crash, and a cancer diagnosis create moments of distress that alter patients’ and families’ perception of and reaction to situations. Frontline workers are aware of the potential risks when they dedicate themselves to patient-centered care.

According to the Joint Commission, “healthcare workers must be alert and ready to act (https://www.jointcommission.org/-/media/tjc/idev-imports/topics-assets/workplace-violence-prevention-implementing-strategies-for-safer-healthcare-organizations/sea_59_workplace_violence_4_13_18_finalpdf.pdf) when they encounter verbal or physical violence—or the potential for violence—from patients or visitors who may be under stress or who may be fragile, yet also volatile.” Ultimately, nurses and other healthcare providers must advocate for their own safety and well-being. But advocates are raising awareness of the situation’s severity in the hopes that preventive measure may diminish the dangers to clinicians’ lives while they work to save their patients’ lives.


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