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Workplace violence in the health care industry

Workplace violence includes any violent act, such as threats or assaults, that disrupts a work site. While it can occur in any environment, some businesses are at higher risk.


The U.S. Bureau of Labor Statistics reported that from 2021 to 2022, the health care and social assistance industry had the highest rates of workplace violence among private sectors.

This trend may be influenced by common conditions in healthcare facilities. The National Institute for Occupational Safety and Health (NIOSH) identified several factors:

  • Working directly with volatile individuals, especially those with a history of violence, certain psychotic diagnoses or under the influence of drugs or alcohol.
  • Dealing with stressed or angry patients and visitors.
  • Lifting, moving and transporting patients.
  • Long wait times and overcrowded waiting rooms.
  • Understaffing and high worker turnover.
  • Unrestricted public access and inadequate security.
  • Lack of staff training and policies for preventing and managing crises with potentially volatile patients.

While these conditions and others' actions may seem beyond our control, there are ways to prevent and prepare for potential violence. One strategy is training workers to spot signs of potential violence in patients, visitors and coworkers, followed by using de-escalation methods. Common indicators include:

  • In patients and visitors: History of violence, overreacting to health-related uncertainty or delays, threatening staff, excessive anger or frustration, blaming others, using abusive language, throwing or punching objects, appearing under the influence of alcohol or drugs, showing or claiming to have a weapon.
  • In coworkers: Making verbal threats, blaming others, being angry, defensive, or paranoid, seeming overwhelmed by problems, abusing alcohol or drugs, shifting towards troubled behavior, becoming involved with weapons.

Developing a formal workplace violence prevention program can also be beneficial.

The program should address the following elements: management commitment and worker participation, worksite analysis and hazard identification, hazard prevention and control, safety and health training and recordkeeping and program evaluation.

Additionally, staff should receive training on how to respond in an emergency, including procedures for emergency communication and notification, de-escalation strategies, lockdowns and evacuation. By committing to safety, both employers and employees can help create a violence-free environment. For more information and training resources on workplace violence, visit OSHA’s website.

Source

Occupational Safety and Health Administration. (2016). Guidelines for preventing workplace violence for healthcare and social service workers.