Nursing Wiki

Workplace Violence in Nursing

Violence against nurses covers physical assault, threats, and verbal abuse by patients, visitors, and colleagues. It is one of the defining working conditions of the job, and it is measured badly, for reasons that are themselves part of the problem.

In a survey of 1,267 nurses conducted between July 2025 and May 2026, 84.8 percent reported experiencing workplace violence in the previous twelve months. Five in six, over one year rather than over a career.

The reporting number

Some 42.5 percent of nurses said their employer changed nothing after they reported an incident.

That finding converts a public safety problem into an employment one. An assault in an emergency department at three in the morning is sometimes genuinely hard to prevent. A report that produces no response is a decision somebody made.

It also explains the chronic under-reporting that defeats every attempt to measure this properly. If more than four reports in ten produce no visible result, the rational conclusion for a nurse at the end of a shift is that the paperwork is not worth twenty minutes. The true incidence is therefore almost certainly higher than 84.8 percent, and any figure drawn from incident logs rather than from asking nurses directly will understate it further.

Where the law stands

Protection depends almost entirely on the state and on the employer.

Federally, no specific standard exists and none is imminent. The occupational safety regulator has had a rule on preventing workplace violence in health care under development for years. It sits in the long-term category, with the target date for even a proposed rule listed as to be determined. That is regulatory language for indefinite.

States are moving unevenly. Utah's requirements took effect in May 2026, New York's in September 2026, and Oregon's arrive in January 2027. Many states have nothing.

Separately from prevention mandates, many states have made assaulting a nurse a felony. Whether such a law means anything in practice depends on whether the employer supports a nurse in pressing charges or quietly discourages it to avoid disruption.

Because the position varies this much, what protections exist at a given hospital is a reasonable question to ask in an interview, and a reasonable factor in deciding where to work.

What already applies, in the absence of a standard

Two obligations bind employers now, and both are widely overlooked in the argument about the missing federal rule.

The first is the general duty clause of the federal occupational safety statute, which requires every employer to provide a workplace free from recognised hazards likely to cause death or serious physical harm. Where violence is a recognised hazard in a setting and feasible steps exist to reduce it, that clause is the enforcement route, and it has been used against hospitals and nursing facilities. It is used sparingly. Across inspections of 107 hospitals and nursing and residential care facilities between 2011 and 2015, the regulator issued 17 general duty citations for failing to address workplace violence. A compliance directive published in 2011 tells inspectors how to respond to complaints of this kind.

The second is accreditation. Since 1 January 2022, hospitals and critical access hospitals accredited by The Joint Commission have had to run a workplace violence prevention programme: leadership oversight, written policies and procedures, a reporting system, collection and analysis of the resulting data, support for staff after an incident, and training. Accreditation requirements are not law, but they reach most hospitals in the country and they are surveyed, which makes them the closest thing to a national floor that currently exists. A hospital that also holds Magnet recognition has committed separately to a protected route for nurses to raise concerns without retaliation.

The practical use of all of this is the same. A nurse asking what an employer is doing is asking about obligations the employer already has, not about a favour.

What nurses say makes a difference

Four things recur, and none of them is a poster.

Prosecution that actually happens. A felony statute is only as strong as the employer's willingness to back the nurse who uses it.

Security measured in response time. Not a number to call, but how long it takes for someone to arrive. That figure exists and can be asked for.

Staffing. Violence is more likely where patients wait longer, where nobody has time to de-escalate early, and where a nurse is alone with a deteriorating situation. This is one reason staffing appears alongside pay in nearly every recent nursing labour dispute. See nurse strikes and bargaining and nurse staffing and patient outcomes.

Reports that lead somewhere visible. The 42.5 percent figure is the one item on this list entirely within an employer's control, and fixing it is what makes the rest of the reporting data trustworthy.

The cost side

Stated plainly, because it is the argument that moves budgets: this is a retention problem with a price attached.

Workplace violence or bullying was named by 12.3 percent of nurses as a reason for intending to leave the profession, and it is one of the documented contributors to nurse burnout. Replacing one registered nurse costs the average hospital about $60,090. A unit losing several nurses a year to an unsafe environment is spending real money on the consequences of not fixing it. See nurse turnover and retention.

It affects hiring directly as well. Experienced nurses talk to each other, and a reputation for leaving staff exposed travels quickly. With wage growth slowed to about 3 percent, employers cannot easily outbid each other, so non-wage conditions increasingly decide where a nurse goes. See registered nurse pay.

The practical measurement for any employer is a single number: what proportion of reported incidents at this organisation produced a change. Not an impression, a count.

Sources

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