It probably comes as no surprise to learn that violence against nurses frequently occurs on the job. Recent estimates place the rate of physical abuse against nurses as high as three out of every ten patients. The most common violent encounters occur when caring for patients suffering from mental health or substance abuse problems. Studies have shown that of the 25,000 workplace assaults occurring annually, 75% (18,750) occur in healthcare settings. Sadly, only 30% of nurses report their assaults. 

Violence against nurses has become so prevalent that 32 states have deemed physical assaults against nurses a felony, punishable by more than one year in jail or prison. This is a small light on a dark topic as it indicates an increasing awareness of this violent epidemic, and nurses are more likely to have their assault reports taken seriously. 

A recent article by Kristopher Starr, JD, MSN, APRN, CNP, FNP-C, outlines your options following an assault by a patient. We highlight the points here.

• In most states, you are entitled to worker’s compensation benefits if you’re injured at work by an external cause. This does include physical assaults or physical contact initiated against you. 
• The benefits of workman’s compensation usually cover medical care expenses, including psychological or psychiatric treatments, lost wages up to a capped amount, and compensation for any permanent injuries or disfigurements that were sustained. 
• Submission of an adverse event report and seeking medical attention following the facility’s policies provide documented proof of the assault. 
• Submitting a worker’s compensation claim often prevents the injured worker from pursuing legal action against their employer.
• There are rare situations in which this is allowed.
• Reporting the assault to any law enforcement organization at the facility is the first step. This would include talking to a hospital police officer or a constable. 
• The officer or constable will decide if outside law enforcement agencies should be involved. 
• If there is no law enforcement organization at a facility, the assault should be directly reported to the local police department. 
• Request copies of any investigation reports produced by the law enforcement agency handling the assault report. 
• Have a copy of the report sent directly to the facility’s human resources department. 
• The assailant may or may not be arrested.
• This depends on the local prosecution agency, such as the district attorney.
• If nurses press charges, the prosecutor will often attempt to gain a lesser charge so that a conviction by plea can be obtained. 
• This prevents the case from going to trial and ultimately exposing the assailant to more serious charges. 
• It should be noted that a plea agreement does not prevent a victim from receiving worker’s compensation benefits, nor does it waive the right to exercise the right to pursue civil tort litigation. 
• This allows the victim to sue the assailant in “...civil court for personal injury under the common law theories of assault and battery…”. 
• This addresses both physical and psychological harm. 
• The civil tort litigation option requires the victim to hire a personal injury lawyer.
• Once secured, the assailant will be served with a lawsuit wherein they have time to respond to the allegations. 
• The civil court process would continue until mediation, settlement, or trial.
• Be advised that if a victim receives worker’s compensation benefits for an injury, and then pursues litigation for the same injury, the amount of money received from the lawsuit may be affected by the previous claim. 

Mr. Starr notes that worker’s compensation benefits are the most popular of all the options available. This could be secondary to employer pressure on nurses not to take legal action against patients. Please note that an employer cannot prevent a nurse from suing a party or pressing charges without making itself legally vulnerable.