For decades, healthcare workers, especially nurses, believed that verbal and physical from patients and their families were not only possible but acceptable when they go to work.

It’s only been within the past few years that the medical community and more extensive public have taken an interest in reducing the number of assaults in healthcare settings. In 2017, Time’s Up established a branch devoted to protecting health professionals. And at the American Nurses Credentialing Center’s 2019 Magnet Conference, one of the chosen charities was the #EndNurseAbuse campaign. But even with these efforts, many people on the frontlines aren’t aware of which situations in their day-to-day work carry the highest risk for abuse. 

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To fill a sliver of this educational gap, here are the most common types of violence in healthcare settings, per an April 2018 Sentinel Alert from the Joint Commission.

Most Incidents Are Verbal

These include implicit and explicit threats against you or people close to you, name-calling, sexual harassment, and bullying. Physical violence, such as assault, battery, and stalking, are also common, but shootings are rare.

Most Often, Patients or Visitors Abuse Workers

According to the National Crime Victimization Survey, healthcare workers have a 20% higher chance of being victims of workplace violence than other workers.

Many incidents are not recognized as violence.

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Workplace violence in healthcare is grossly underreported, partly because its victims are uncertain about what constitutes violence. It’s common to justify such actions with the aggressor’s mental state. Another factor: people think it’s just “part of the job,” even though it doesn’t have to be.

Inpatient Psychiatric Settings and EDs Have the Most Recorded Incidents

That said, virtually all types of healthcare settings have recorded incidents of violence at some point.

Violence Is Incredibly Common in Long-Term Care Settings

These environments, especially residential ones, are less controlled and present different challenges. 61% of home care workers report violence annually.

Most Often, Aggressors Have Altered Mental Status

Dementia, delirium, substance intoxication, or decompensated mental illness are frequent drivers. Other than this characteristic, there aren’t many similarities among aggressors; there’s no conclusive evidence linking healthcare violence to any demographic groups or urban versus suburban versus rural settings.

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Other Common Factors Associated With Violence in Healthcare Settings Include:

• Stress, for example, due to long wait times, crowding, being given bad news, etc.

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• Lack of policies and training for security and staff to de-escalate patients or other visitors

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• Gang activity

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• Domestic disputes among patients or visitors

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• Presence of firearms or other weapons

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• Inadequate security or mental health personnel on-site

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• Understaffing

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• Staff working in isolation or situations where they have no escape route

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• Poor lighting and other factors restricting vision

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• No access to emergency communication

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• Unrestricted public access to hospital rooms and clinics

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• Lack of community mental health care.

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If you are a victim of abuse at work, either physical or verbal, notify leadership, internal security, and law enforcement, if necessary. You should also file an incident report with your employer, which can help prevent it from happening again.