Efforts to protect medical professionals from violence in health care settings appear to be lagging despite multiple federal and state efforts.
The federal H.R. 2584, which would establish the Safety From Violence for Healthcare Employees (SAVE) Act, was introduced in April 2023 and now has 116 cosponsors, spurring companion legislation in the Senate. The legislation would create criminal penalties for assaulting or intimidating hospital staff, modeled after laws related to assaulting an airline worker.
Proponents have been calling for swift action, but the legislation has stalled, in part, because of language differences between the House and Senate versions of the bill. The American Nurses Association, for example, supports the Senate version because it focuses more on preventive measures than penalties for crimes that have already occurred.
State efforts are all over the board, with some states putting in place safety standards for health care workers and others proposing legislation. More than two dozen states have worked on the issue with mixed results.
Health care violence surged during the pandemic, but the problem existed long before, experts say.
“We’re seeing an increase in workforce violence in the health care setting pretty much year over year from 2014 to 2024,” said Bill Bower, Chicago-based executive vice president and healthcare vertical leader for Gallagher Bassett Services Inc.
Before joining Gallagher in 2021, Mr. Bower was chief risk officer at Northwestern Memorial Hospital in Chicago, and he said that organization experienced increased incidents of workplace violence consistent with what has been seen industrywide.
Jane Muir, a postdoctoral fellow at the University of Pennsylvania, said she recently studied clinicians working in emergency departments to learn more about employee experience with workplace violence.
“Many of the clinicians in the study told me, ‘We’re just not culturally the same as we used to be in emergency departments,’” Ms. Muir said of post-pandemic medical settings.
While doctors have also been victimized – a January poll by the American College of Emergency Physicians found that 91% of emergency room doctors say they or a colleague were threatened or attacked within the prior year – nurses find themselves more frequently subjected to violent acts.
“Nurses are on the front lines of all those assaults because they’re the ones who are triaging patients, they’re the ones who are delivering the majority of direct patient care,” Ms. Muir said.
The American College of Emergency Physicians says documented incidents of violence against health care staff have run the gamut from verbal death threats to physical assaults.
The American Nurses Association says that while it has not seen any significant increase in health care worker violence from 2023, the issue continues to be a problem for nurses, nursing assistants, aides and vocational nurses.
“The sheer volume of nurses that provide hands-on or direct care puts them at risk because they work closest to patients and their families,” said Ruth Francis, the ANA’s senior policy advisor.
Workplace violence can sometimes lead to the filing of workers compensation claims, more often related to physical injuries than mental injuries, Mr. Bower said.
In July, the Journal of the American Medical Association published a study showing a slight drop in the number of Michigan nurses planning to leave the profession in 2023 compared with the year prior.
The study said improved working conditions and a slight reduction in cases of abuse and assaults at work could be a factor in the decline.
While the development is viewed as positive, experts say insurers and risk managers are not in the clear because current levels of violence continue to be at rates higher than they were pre-pandemic.
In addition to legislative action, regulators are tackling the issue, with a U.S. Department of Labor spokesman saying the agency is scheduled to issue a notice of proposed rulemaking on health care workplace violence in December.
Absent a specific safety standard, employers “still have a legal obligation to protect workers who have experienced acts of workplace violence or are aware of threats, intimidation or other indicators of potential for violence at work,” a DOL spokesman said.
