Workplace violence in healthcare is a growing concern that affects not just the safety and well-being of healthcare workers but also the overall quality of patient care. While the healthcare environment should be a place of healing, it is, unfortunately, one of the most common settings for incidents of workplace violence.
Effective measures, such as those outlined in the Workplace Violence Prevention for Health Care and Social Service Workers Act, are essential to address and mitigate these risks. This blog explores the latest statistics, providing insight into the severity of the problem and offering strategies for creating a safer healthcare environment.
Overview of Workplace Violence in Healthcare
Workplace violence in healthcare is an issue that demands urgent attention. OSHA defines workplace violence as “any act involving harassment, physical violence, intimidation, or other disruptive behavior that poses a threat or occurs at the worksite”.
In healthcare, workplace violence is categorized into four types:
- Type 1 involves criminal intent where the perpetrator has no legitimate relationship to the business.
- Type 2 is client-on-worker violence, the most common in healthcare settings, where patients or their family members perpetrate the violence.
- Type 3 is worker-on-worker violence, often seen as bullying or harassment among colleagues.
- Type 4 involves personal relationships, where the violence spills into the workplace from outside.
Healthcare Workers Are Highly at Risk for Workplace Violence
Historically, healthcare workers have faced significant risks of violence due to the nature of their work. Over the years, data shows a worrying trend: healthcare workers accounted for a majority of nonfatal workplace injuries resulting from violence.
According to the Bureau of Labor Statistics, healthcare and social assistance workers are five times more likely to experience workplace violence injury compared to employees in other industries. The frequency of incidents involving patients is particularly alarming in areas like emergency departments and psychiatric units, where stress levels are high and patient behavior can be unpredictable.
Despite ongoing efforts to implement workplace violence prevention strategies, such as de-escalation training for healthcare providers and security measures, the problem persists. Healthcare settings continue to see a rise in both physical assaults and verbal abuse, affecting not only the safety but also the mental health and job satisfaction of health workers.
As we delve deeper into the statistics on workplace conflict in healthcare, it’s clear that more robust and widespread workplace violence prevention measures are essential.
Statistics on Violence in Healthcare
Workplace violence remains a critical issue in healthcare, affecting health care workers across various settings. Despite ongoing efforts in workplace violence prevention, incidents of violence continue to rise, with severe consequences for the safety and well-being of those on the front lines.
The following statistics shed light on the prevalence and impact of workplace violence in the healthcare sector, emphasizing the urgent need for enhanced protective measures and support systems aimed at preventing violence in healthcare.
Data on Incidents and Frequency of Violence
- Between 2016 and 2020, there were 207 fatalities caused by workplace violence within the health care and social assistance industry (BLS, 2021).
- In 2020, health care and social assistance workers had an incident rate of 10.3 per 10,000 full-time workers for injuries caused by assaults and violent acts by others. The rate was notably higher for workers in nursing and personal care facilities, at 21.8 per 10,000 full-time workers (BLS, 2021).
- Annually, there are 13.2 physical assaults per 100 nurses and 38.8 non-physical violent events (threats, sexual harassment, verbal abuse) per 100 nurses (Minnesota Nurses’ Study) (Nachreiner, N.M. et al., 2007).
- Health care workers accounted for 73% of all nonfatal workplace injuries and illnesses due to violence in 2018, demonstrating the high impact of workplace violence on this sector (BLS, 2021).
- A significant 97% of nurses have witnessed some form of workplace violence over the past two years, including acts of verbal abuse, intimidation, harassment, and physical assaults (Hennepin Healthcare Survey, 2022).
- In 2018, the rate of nonfatal occupational injuries and illnesses due to intentional violence in the private health care and social assistance sector was 10.4 per 10,000 full-time workers. This is significantly higher compared to the overall rate of 2.1 per 10,000 across all industries (BLS, 2018).
- Specific to hospitals, the rate increased to 12.8 per 10,000 full-time workers (BLS, 2018).
- Health care and social service workers are five times more likely to experience workplace violence-related injuries compared to workers in other sectors. Since 2011, the incidence rate of workplace violence injuries among health care workers has continued to rise (BLS, 2018).
- From 2011 to 2018, there were 156 workplace homicides involving health care workers, averaging about 20 per year. The most common perpetrators of these homicides were relatives or domestic partners of the injured workers (BLS, 2018).
- More than one-third (36%) of emergency physicians have been assaulted multiple times in the past year, indicating that repeated assaults are a significant issue in emergency departments (ACEP, 2022).
- Among those who have been assaulted six or more times in the past year, 59% report being assaulted several times each month. Alarmingly, 36% of these physicians face assaults on a weekly basis, and 4% experience daily assaults (ACEP, 2022).
- 85% of emergency physicians reported that a patient has threatened to return and harm them or other emergency department staff, a slight increase from 2018. The same percentage of male and female physicians (85%) reported experiencing these threats (ACEP, 2022).
- In Q2 2022, more than two nursing personnel experienced workplace violence every hour. This frequency translates to approximately 57 assaults per day in health care settings (Press Ganey, 2022).
- On a monthly basis, hospital workers experienced roughly 1,739 assaults. Over the course of a quarter, about 5,217 assaults were reported against nursing personnel (Press Ganey, 2022).
- Nearly half (48%) of hospital nurses reported an increase in workplace violence, reflecting a significant rise from 30.6% in September 2021 (National Nurses United, 2022).
- The reported increase in workplace violence among hospital nurses shows a nearly 57% jump since September 2021 (National Nurses United, 2022).
- Compared to March 2021, there is a 119% increase in the number of hospital nurses reporting a rise in workplace violence.
- 85% of emergency physicians believe that violence in emergency departments has increased over the past five years, with 45% stating it has greatly increased. Notably, none of the physicians believe that the rate of violence has decreased, which is a significant shift from 2018, when fewer physicians reported a great increase in violence (ACEP, 2022).
- 75% of physicians reported that they have observed an increase in violence against healthcare professionals over the years, while only 25% have not noticed this trend (MDLinx, 2023).
Impact on Healthcare Workers and Institutions
- Nurses who experienced violence reported higher levels of work stress and felt that violence was an expected part of the job (Hennepin Healthcare Survey, 2022).
- Only 47% of nurses report violent incidents to their employers, often due to time constraints, insufficient staffing, and perceived inaction from management (Hennepin Healthcare Survey, 2022).
- More than half of the nurses surveyed (53%) had seriously considered leaving their positions or exiting the nursing profession altogether due to the violence they experienced (Hennepin Healthcare Survey, 2022).
- In 2018, workplace homicides in the private health care and social assistance sector accounted for 4% of the total workplace homicides. However, these homicides constituted less than 1% of the 5,250 total workplace fatalities that year across all industries (BLS, 2018).
- 70% of emergency physicians who experience physical assaults report that their hospital administration or healthcare security responded to the workplace violence incident (ACEP, 2022).
- Male physicians are more likely to receive a response from hospital administration or healthcare security following an assault, with 72% of male victims reporting a response, compared to 64% of female victims. This discrepancy suggests potential differences in how assaults are perceived or addressed based on the gender of the physician (ACEP, 2022).
- The most frequent action taken by hospital administration or security after a physical assault is placing a behavioral flag in the patient’s medical chart, which occurs in 29% of cases (ACEP, 2022).
- Arrests following physical assaults have become less common, with only 16% of physicians reporting that the patient was arrested, a decline from 21% in previous years (ACEP, 2022).
- Among those reporting “other” responses to assaults, 45% indicated that the hospital’s reaction is often minimal. Common actions include escorting the patient off the premises or restraining them, but many physicians note that in some cases, nothing is done at all (ACEP, 2022).
- Several physicians have observed that hospital administration tends to intervene primarily to “de-escalate” situations using verbal de-escalation strategies in a manner that appeases the patient or their family rather than supporting the physicians or staff involved in the assault (ACEP, 2022).
- Some physicians report being discouraged from pressing charges against their assailants, with concerns that pursuing legal action could negatively impact the hospital’s reputation (ACEP, 2022).
- One-third (33%) of physicians who have been assaulted suffer injuries as a result, with no difference between male and female physicians. This marks an increase in injury rates since 2018 (ACEP, 2022).
- Two-thirds (66%) of assaulted physicians report being assaulted within the past year alone, highlighting the ongoing and frequent nature of these incidents (ACEP, 2022).
- Few emergency physicians (9%) report missing part or all of a shift due to injuries sustained during an assault, though this is an increase from 5% in 2018 (ACEP, 2022).
- Female physicians are slightly more likely to miss work due to assault-related injuries, with 11% reporting missed shifts (ACEP, 2022).
- 89% of emergency physicians agree that violence in the emergency department negatively impacts patient care, an increase from 77% in 2018. This impact is most commonly seen in the form of emotional trauma, loss of productivity, increased wait times, and reduced focus, all of which have reportedly increased since 2018 (ACEP, 2022).
- 53% of physicians experience emotional or psychological trauma as a result of workplace violence (MDLinx, 2023).
- 47% of physicians report that violence negatively impacts their ability to perform their job effectively and care for patients (MDLinx, 2023).
- 43% of physicians suffer from career impacts, such as low morale or the need to move their practice due to workplace violence (MDLinx, 2023).
- 29% of physicians find that violence leads to difficulties in their professional or personal relationships (MDLinx, 2023).
- 22% of physicians state that they experience no negative effects from workplace violence (MDLinx, 2023).
- 8% of physicians face legal or financial problems as a result of violence in the workplace (MDLinx, 2023).
- 6% of physicians endure physical injuries due to workplace violence (MDLinx, 2023).
Statistics on Causes and Contributing Factors
Understanding the underlying causes of workplace violence is essential for developing effective workplace violence prevention strategies. Various factors contribute to the increasing number of workplace violence incidents experienced by health care workers, from patient and family interactions to systemic issues within healthcare facilities.
By analyzing these contributing factors, we can identify key areas for workplace violence prevention efforts and work toward creating safer environments for all health care professionals.
High-Stress Environment and Long Working Hours
- Chronic understaffing is the primary risk factor for an unsafe working environment, according to 75% of nurses (Hennepin Healthcare Survey, 2022).
- Emergency department crowding remains a critical factor, with a mean score of 3.70 in 2022, slightly down from 3.95 in 2018, ranking fourth in both years (ACEP, 2022).
- Emergency department boarding, ranked fifth in 2022, has a mean score of 4.55, a slight decrease from 4.82 in 2018, indicating its ongoing significance among risk factors in emergency care settings (ACEP, 2022).
- The issue of people seeking prescription opioids has become more prominent, with a mean score of 5.30 in 2022, up from 4.18 in 2018 (ACEP, 2022).
- The COVID-19 pandemic, though not present in the 2018 data, emerges as a significant factor contributing to violence, with a mean score of 6.07, ranking it seventh in 2022 (ACEP, 2022).
Patient and Family Interactions
- 62% of nurses believe that violence in healthcare settings poses a significant risk to patient safety and health (Hennepin Healthcare Survey, 2022).
- From 2011 to 2018, workplace homicides involving healthcare workers were most frequently committed by a relative or domestic partner, accounting for 45 fatal injuries (BLS, 2018).
- From 2011 to 2018, there were nine fatal injuries caused by acquaintances, emphasizing that even familiar individuals can contribute to workplace violence in healthcare settings (BLS, 2018).
- In emergency departments, almost all physical assaults against emergency physicians are committed by patients. However, around 31% of these assaults are carried out by the patient’s family or friends, demonstrating the significant risk posed by individuals close to the patient (ACEP, 2022).
- Emergency physicians identify psychiatric patients and those seeking drugs or under the influence of drugs or alcohol as the primary perpetrators of these assaults, accounting for 42% and 40% of incidents, respectively. There are virtually no differences between male and female physicians in the reasons attributed to these assaults (ACEP, 2022).
Systematic Issues Within Healthcare Facilities
- 65% of nurses feel that hospital executives have not provided adequate training or resources for workplace violence prevention or to address workplace violence effectively (Hennepin Healthcare Survey, 2022).
- From 2011 to 2018, 21 healthcare workers were fatally injured by a co-worker or work associate, highlighting the dangers of internal conflicts and the need to address workplace violence (BLS, 2018).
- From 2011 to 2018, 18 healthcare workers were fatally injured by other clients or customers, demonstrating the potential risks involved in direct interactions with patients and their families (BLS, 2018).
- From 2011 to 2018, 9 healthcare workers were killed by robbers, pointing to the risks of criminal acts targeting healthcare facilities (BLS, 2018).
- Men working in emergency departments are more likely to report having been physically assaulted at work compared to their female counterparts, with 58% of men reporting physical assaults versus 50% of women (ACEP, 2022).
- In 2022, the top factor contributing to violence in emergency departments is the lack of adequate punitive consequences or responses toward the attacker, with a mean score of 2.66, slightly higher than the 2.64 mean in 2018 (ACEP, 2022).
- Behavioral health patients are the second most significant factor, with a mean score of 2.87 in 2022, up from 2.62 in 2018 (ACEP, 2022).
- The absence of adequate protective mechanisms for physicians and staff ranks third, with a mean score of 3.36 in 2022, an increase from 3.20 in 2018 (ACEP, 2022).
Other Statistics
- Male physicians are more likely to be assaulted by a patient’s friends, family members, or other visitors compared to female physicians. This disparity underscores the different experiences of workplace violence among male and female healthcare providers in high-pressure environments like emergency departments (ACEP, 2022).
- Female physicians are more likely to have experienced a single assault in the past year, while male physicians are more likely to have been assaulted between two and five times during the same period (ACEP, 2022).
Types of Assaults
- Verbal assaults, including threats of violence, are the most common, reported by 64% of emergency physicians. Physical assaults, such as being hit or slapped, are reported by 40% of physicians (ACEP, 2022).
- Male physicians are more likely to be spit on (34%) or punched (34%) than their female counterparts, with 26% of female physicians reporting being spit on and 20% reporting being punched (ACEP, 2022).
- Inappropriate comments or advances from patients or visitors are reported by 88% of emergency physicians, up from 85% in 2018. Female physicians are particularly affected, with 96% experiencing these behaviors compared to 83% of male physicians (ACEP, 2022).
Types of Workplace Violence Experienced by Healthcare Professionals
- 96.1% of healthcare professionals experienced verbal abuse or intimidation in the workplace, making it the most common type of violence they face (MDLinx, 2023).
- Discrimination is also a significant issue, reported by 31.4% of healthcare professionals (MDLinx, 2023).
- Sexual harassment affects 21.6% of healthcare professionals, highlighting the prevalence of this serious issue in healthcare settings (MDLinx, 2023).
- Physical assault and stalking are reported by 13.7% of healthcare professionals, indicating the physical dangers present in these environments (MDLinx, 2023).
- Cyberbullying impacts 11.8% of healthcare professionals, showing that digital harassment is a growing concern (MDLinx, 2023).
- Vandalism is the least common but still notable, with 5.9% of healthcare professionals experiencing it (MDLinx, 2023).
Coping Mechanisms Following Workplace Violence Incidents
- 75% of healthcare professionals cope with violence by discussing their feelings with family and friends (MDLinx, 2023).
- 70% of healthcare professionals focus on wellness and self-care as a coping mechanism (MDLinx, 2023).
- 52% of healthcare professionals choose to discuss their feelings with colleagues after experiencing violence (MDLinx, 2023).
- 40% of healthcare professionals take time off work to recover from violent incidents (MDLinx, 2023).
- 40% of healthcare professionals engage in hobbies or other interests as a way to cope.
- 15% of healthcare professionals seek professional help outside of work to deal with the effects of violence (MDLinx, 2023).
- 5% of healthcare professionals take advantage of employer-offered support and counseling services following violent incidents (MDLinx, 2023).
