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The escalating violence in health care workplaces: a critical problem facing the nation’s health care system

Harry Severance, MD
Physician
June 2, 2023
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The recent shootings at an Atlanta medical facility that left one dead and four seriously wounded are just the most recent, widely published event documenting the accelerating violence occurring in the nation’s health care workplaces.

Violence within our health care workplaces has been a steadily rising and critical problem over the past decade – now further fueled by issues such as fallout from the COVID pandemic – including a political-issue-motivated demonization of health care workers, the expanding opioid crisis, and increasing difficulties in patient access to health care.

A 2022 Association of American Medical Colleges (AAMC) report notes that health care workers are five times more likely to suffer workplace violence than workers in any other industry. The report continues, noting that “the Bureau of Labor Statistics reports that the rate of injuries from violent attacks against medical professionals grew by 63 percent from 2011 to 2018, and hospital safety directors say that aggression against staff escalated as the COVID-19 pandemic intensified in 2020. In a spring survey by National Nurses United, the nation’s largest union of registered nurses, 48 percent of the more than 2,000 responding nurses reported an increase in workplace violence — more than double the percentage from a year earlier.”

Some say that the numbers have now risen to 75 percent of all workplace assaults occurring in health care workplaces – again confirming health care as the most unsafe job type in this country – even more so than the police or military! Nurses at the Atlanta medical facility shooting site reported to interviewers that they fear returning to work.

Health care workers are now fleeing their violent and toxic workplaces. 4 to 5 million workers (that’s around 20 percent of the current U.S. health care workforce) have left health care over the last two years – and this exodus continues. Of the main reasons voiced by workers who continue to exit the health care workplace – the dangers of abuse, assaults and death are among the predominant motivations, (the risk of dying just because you show up for work). In my own work as a career mentor – I am now hearing increasing numbers of health care professionals, doctors, nurses, and mid-levels, wanting to explore other non-clinical work options – reporting that their families now fear them going to work – and want them to find a safer job.

Hospital stability is also increasingly affected by this rising violence and increasing worker exodus.   Recent reports show that over 630 U. S. hospitals are at extreme risk of closure. One of the chief reasons reported for these imminent closures is the inability to find adequate numbers of doctors, midlevels, and nurses to staff critical hospital service lines, thus these facilities can no longer provide the essential services necessary to maintain their cash flow!

Thus, the end result of this uncontrolled workplace violence is an increasing lack of access by patients to timely and critical health care.

Various health care workplace violence bills have appeared in front of Congress over the past several years, but they have thus far failed to win enough support to be acted upon.

One reason for inaction may be a lack of public awareness of this issue. Health care workplace violence events are not widely reported – except for extreme examples such as the recent Atlanta shootings – where deaths and/or weapons are involved. In comparison – almost any violence on an airplane gets videoed and released online – often before the plane even lands – and airplane violence almost never involves weapons – TSA screens them out. But, in health care workplaces, videos are not allowed due to patient privacy issues – thus, the public rarely, if ever, sees or hears of these events. Would increased recognition move the needle on action?

However, right now – the result of current inaction from all sectors and the continued unchecked acceleration of violence in the health care workplace will only result in more health care workers leaving for safer jobs – in a country where almost any other job is now safer than health care – thus increasing hospital and medical facility closures, with a result of further disruption of the entire health care system and further worsening of all patient access to timely medical care.

Harry Severance is an emergency physician.

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