A Growing Problem
Observers have noted for some time now that verbal and physical assaults upon medical facility staff members have been on the rise in both volume and volatility. The American Hospital Association (AHA) has recently noted that “For the past decade, the healthcare field has experienced a sharp increase in workplace violence.” According to the AHA, several factors have imposed significant stress on the entire healthcare system; and, in some instances, patients, visitors and family members have attacked healthcare workers, jeopardizing the staff’s ability to provide care.
Furthermore, this notable rise in workplace violence has shown no sign of subsiding. Nearly every day, there is a media report on how some patient or family member assaulted a hospital staff member—sometimes, with a tragic outcome. For example, a Kentucky nurse was recently choked, thrown to the ground, and hit by a patient who later told police she was mad because “staff was taking too long to discharge her from the hospital.” Last year, a Florida physician sustained a concussion, brain contusion and two broken ribs after an alleged attack by a patient’s relative.
From what the AHA say, data supports these news accounts. A Press Ganey survey found that, on average, two nurses are assaulted every hour in the U.S. Similarly, a 2024 American College of Emergency Physicians survey found that 9 out of 10 respondents reported having been attacked or threatened in the past year. This is becoming a serious and even dangerous problem, but what can be done about it?
What to Do?
Hospitals and health systems have long had robust protocols in place to detect, deter and respond to violence against their team members. But, since violence against hospital employees continues to increase, better solutions are needed.
It is eye opening to note that, despite the incidence of workplace violence and its harmful effects on our healthcare system, no federal law currently exists that is designed to protect hospital workers from workplace assault. While the U.S. Congress responded to increases in violent behavior on commercial aircraft and in airports by enacting a federal law criminalizing attacks against those employees, no similar laws have been passed to protect healthcare workers.
Because of the lack of current federal protections against workplace violence in the healthcare setting, the AHA, along with many other hospitals, health systems and clinicians, support the same kind of federal protections that are now afforded to the airline industry. Legislation to do just that has recently been introduced into Congress. Known as the Save Healthcare Workers Act (H.R. 3178/S. 1600), the bill would provide protections similar to those offered to flight crews and airport workers.The bill would make it a federal crime to knowingly assault a hospital worker on the job. It would also establish fines, imprisonment, or both, for such offenses. However, the legislation creates an affirmative defense if the assault results from the perpetrator’s physical, mental or intellectual disability; in other words, if a patient, family member or visitor assaults a healthcare worker because of such a disability, that person could not be prosecuted.
All in all, the Save Healthcare Workers Act is seen by the AHA and many others as a good first step in trying to stem the tide of bad tempers boiling over onto care givers in the facility setting. But questions remain. For example, will patients and their families be aware of this measure, even if passed into law? And even if they have a vague recollection of the passage of this anti-violence law, to what extent would that awareness act as a deterrence when temperatures start to rise and the angry birds start to fly? When patients see red, what is the force with the potential to keep them in check? Obviously, this gets into larger societal issues—some of which will be immune to legislative fixes.
Until such laws are passed and made widely known to the general public, and until societal norms are aligned with the behavioral standards of the last century, it may not be a bad idea for facilities to consider ways to mitigate violence however they can. Signage strategically placed throughout the facility, indicating “Violence Against Staff Will Be Prosecuted,” or similar verbiage, might be a good start. Increasing security presence, especially in those areas where physical attacks have been most noted might be another strategy. It will be up to each hospital to figure it out. Each hospital will need to have their own customized solutions in place to help combat this rise in violence until that time when “peace will guide the planet and love will steer the stars.”