Violence Against Nurses: A Major Issue in Healthcare


Workplace violence for healthcare workers – including nurses – is on the rise. Here’s what nurses need to know about the hot-button topic.

Workplace violence against nurses has significantly increased in the past decade or so, with some studies suggesting a 110% spike in the rate of violent injuries against healthcare workers in the last 10 years.

According to the National Institute for Occupational Safety and Health (NIOSH), there are 4 types of workplace violence in the healthcare field:

• Type I: The perpetrator has criminal intent and has no relationship to the business or its employees

• Type II: A customer, client, or patient becomes violent when receiving care or services

• Type III: employee-to-employee violence

• Type IV: Personal relationship violence1

Even though workplace violence is still underreported in the healthcare setting, laws are starting to be enacted, and nurses are taking to social media to bring light to the issue. We recently asked our audience on Oncology Nursing News what the hottest topic in nursing is, and multiple readers said safe staffing.

Workplace Violence Is Underreported

In the field of nursing, violence from patients or visitors toward nurses — which falls under Type II – is the most common type. But despite this being the case, many nurses do not report these attacks that they face.

“Nurses fail to report such episodes for many reasons. Profit-driven corporate models and a management focus on patient satisfaction can deter reporting,” said Edith Brous, MS, MPH, JD, RN, a nurse attorney in New York who focuses on litigation and licensure matters affecting healthcare professionals.

Brous continued, “Management structures that are reluctant to hold patients responsible for inappropriate conduct can cause a learned helplessness in which nurses become convinced that reporting does not affect change. Reporting mechanisms might be too complex or time-consuming for nurses who have many competing demands. Differing classifications for violent incidences create inconsistencies in capturing data.”

Additionally, Brous also mentioned that nurses might excuse violent behavior because their patients are ill.

“Most disturbingly, some nurses do not report [workplace violence] because they believe it is part of their job,” Brous said.

Finding Solutions

The U.S. Department of Labor Occupational Safety and Health Administration (OSHA) published guidelines for healthcare and social service workers. They recommend that each institution develops a written workplace violence prevention program, reports are documented and investigated in a timely manner, all workers have training on workplace violence, and more.

“Specifically, a workplace’s violence prevention program should have clear goals and objectives for preventing workplace violence, be suitable for the size and complexity of operations, and be adaptable to specific situations and specific facilities or units,” the guidelines state.2

Additionally, more than 30 states now have increased penalties for assaults of nurses. Ohio requires hospitals to post warnings about violent behaviors, and Hawaii passed a resolution encouraging leaders in healthcare to establish standards of conduct and policies for managers and employees to reduce workplace bullying and promote healthful and safe work environments.3

Brous emphasized that nurses should never accept violence as a part of the job, and should always report altercations they face.

By speaking up and establishing laws and institutional policies, hopefully the epidemic of violence against healthcare workers will diminish over time.

Read more: Bullying on the Oncology Unit: Nurses Are at Risk


  • Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health (NIOSH). Occupational Violence. Updated March 28, 2018. Accessed August 6, 2019.
  • Occupational Safety and Health Administration. Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. U.S. Department of Labor Occupational Safety and Health Administration. 2016.
  • The American Nurses Association. Workplace Violence. Updated June 2019. Accessed August 9, 2019.

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