Violence Against Nurses: A Timeline and a Blueprint for Increased Workplace Safety
Our Integrity Network
NurseJournal.org is committed to delivering content that is objective and actionable. To that end, we have built a network of industry professionals across higher education to review our content and ensure we are providing the most helpful information to our readers.
Drawing on their firsthand industry expertise, our Integrity Network members serve as an additional step in our editing process, helping us confirm our content is accurate and up to date. These contributors:
- Suggest changes to inaccurate or misleading information.
- Provide specific, corrective feedback.
- Identify critical information that writers may have missed.
Integrity Network members typically work full time in their industry profession and review content for NurseJournal.org as a side project. All Integrity Network members are paid members of the Red Ventures Education Integrity Network.
- Healthcare workers, especially those working in the emergency department, experience high rates of workplace violence.
- Addressing the issue of patient-to-staff physical assaults can be as simple as implementing screening processes, which have been shown to decrease assault incidents.
- In one case, the rate of 0.265 patient-to-staff assaults per 1,000 patient visits decreased to 0.146 per 1,000 patient visits.
In October 2023, emergency room nurse Tristin Kate Smith took her own life after what she described as abuses she experienced at her work. The 28-year-old openly titled her final note, "Letter to my abuser," in which she detailed the times she saw colleagues get hit, criminally charged, and exploited.
Sadly, Smith is not an outlier. According to the World Health Organization, up to 38% of health workers experienced physical violence at some point in their careers. In addition, nurses die by suicide more frequently than people in the general population.
A 2018 American College of Emergency Physicians survey found that workplace abuse topped 70% for emergency room (ER) nurses. (Note: Nurses were not asked the same question for the 2022 survey).
Violence against nurses is on the rise, but this does not have to be the reality. In this report, we give a timeline of recent incidents of violence against nurses. Finally, we provide some solutions for how healthcare centers can respond to increase workplace safety.
Violence Against Nurses: A Recent Timeline
The following events are recent incidents of violence against nurses to make national headlines. It is not an exhaustive list of all occurrences.
Potential Solutions for Workplace Violence Against Nurses
What is the best way to address workplace violence against nurses? One possibility is to enact laws that will protect hospital staff.
For example, North Carolina passed a new law that requires hospitals with emergency departments to have a law enforcement officer on-site at all times. The new state law takes effect in 2025.
In April 2023, the governor of Kansas signed a bill that increased penalties for individuals who commit battery towards a healthcare provider.
But how can healthcare institutions enact their own violence prevention plans? According to Sheila Mallett-Smith, the clinical nursing director at LA General Medical Center, any hospital or healthcare facility looking to design and implement its assault prevention plan should include some key elements:
- Identify patient risk characteristics at the facility and in literature
- Early screening to identify patients at risk of aggression/violence
- Alert system to flag patients who have physically assaulted staff on previous visits
- Training staff on de-escalation techniques, injury prevention, and assault prevention strategies for patients identified at risk upon arrival
- Behavioral response team of experts in de-escalation and restraint application
- Workplace Violence Committee to monitor, track, trend and adjust strategies to reduce and sustain reduced verbal and physical assaults
- Implementation of procedures to mitigate common triggers of violence
- Strong and visible leadership support for zero violence
- Policies and procedures that support aggression/violence reduction
Mallett-Smith is also the first author of a 2023 article in the Journal of Nursing Care Quality, in which the authors present the effectiveness of an assault intervention initiative used in the emergency department.
Prior to the implementation of the workplace violence prevention model, there was a rate of 0.265 incidents of physical assaults for every 1,000 patient visits by patients towards staff.
After the utilization of "Plan-Do-Study-Act" prevention systems, which incorporated risk for violence screenings (RVST) of adult patients in the emergency department, the rate of assaults decreased to 0.146 per 1,000 patient visits.
Some states have implemented workplace violence policies.
In October 2023, Massachusetts lawmakers held a hearing on legislation requiring hospitals to design and implement policies that would better prevent violence against healthcare workers.
Part of the bill required employers to perform annual risk assessments and identify factors that threaten worker safety (e.g., time of day, staffing levels).
Mallet-Smith S, et al. (2023). Implementation of an Assault Prevention Quality Improvement Initiative in an Urban Emergency Department. Journal of Nursing Care Quality
Preventing violence against health workers. (2023). WHO
Page last reviewed on November 19, 2023
You might be interested in
Nurse Strike Update: The Latest on Nursing Strikes and Labor Disputes Around the Country
Nursing Shortage Solutions: States Propose New Measures to Support Nurses
NurseJournal.org is an advertising-supported site. Featured or trusted partner programs and all school search, finder, or match results are for schools that compensate us. This compensation does not influence our school rankings, resource guides, or other editorially-independent information published on this site.
Are you ready to earn your online nursing degree?
Whether you’re looking to get your pre-licensure degree or taking the next step in your career, the education you need could be more affordable than you think. Find the right nursing program for you.