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Caring at a cost: workplace violence and my exit from nursing

Kate Morin, BSN
Conditions
January 21, 2024
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In 2013, I graduated with a BSN, drawn to nursing by a love for science and a passion for helping others. The promise of good pay, job security, and growth opportunities was a marketing pitch so convincing I never thought to question it. Before my first clinical experience, I vividly recall having to attend a self-defense class. At the time, it struck me as both odd and somewhat amusing that we were being trained for an eventuality that seemed so remote. It felt as unnecessary as flight safety demonstrations—more of a formality than a practical necessity.

Although I was undoubtedly naive, it wasn’t completely irrational to be unaware of the epidemic of violence within health care, an epidemic that occurs behind closed doors, far from the scrutiny and awareness of the outside world. I couldn’t have known, for example, that I was about to enter a field that experiences more incidents of non-fatal violence than any other profession. Or that up to 80 percent of my future colleagues had been assaulted at some point in their careers.

Expectations vs. reality

Before I graduated from nursing school, I was working as a nursing assistant when I was assigned to be a “sitter” for a young man who was recovering from a stroke (a sitter stays exclusively with one patient due to the risk of them harming themselves or others, often due to confusion, agitation, or physical limitations). As I began my shift, I learned he was confused and violent and had injured the previous assistant. I was counting on the nurse’s support, but after a brief greeting, she shut the door behind her, leaving me alone in the room with him all night.

I didn’t have a work phone—I didn’t even know the nurse’s name. I just remember his constant rage, erratically jumping out of bed, screaming, and throwing items around the room. Every minute of the 12 hours crawled by, with me trying not to breathe too loudly for fear of provoking another outburst. Although he never physically hurt me, the fear from that experience stayed with me. The threat of violence was not a distant, improbable notion as I had previously thought; it was a very real, palpable danger lurking just a hair’s breadth away.

I convinced myself that things would improve as I transitioned to an ICU nurse, yet, to my dismay, I quickly discovered that the level of danger and vulnerability I faced remained unchanged. I recall another patient I cared for who, in the throes of alcohol withdrawal, had broken out of restraints and punched a nurse in the face. His room was in such a remote corner of the unit that I remember doubting if anyone would be able to hear me if I screamed. Again, I left that shift physically unscathed but psychologically rattled.

I wasn’t always as “lucky,” having sustained multiple kicks and hits over the years. But frankly, I considered myself fortunate, especially compared to the horrifying stories of nurses being taken hostage, permanently maimed, or even killed. I easily understood how these situations could happen since, in many hospitals, security measures are disturbingly inadequate. Security guards are often stationed in distant emergency rooms, leaving staff defenseless as they wait for help to arrive.

Hospitals respond to the surge in violence against health care workers by distributing bags of lavender, offering yoga classes, or installing massage chairs in break rooms. These measures fall drastically short of safeguarding health care providers and do little to address the trauma of facing persistent violence and intimidation.

After almost a decade as an ICU nurse, the pre-shift anxiety became increasingly unmanageable. I found myself having to arrive at work 20 minutes early so I would have time to be sick in the bathroom before starting my shift. At the time, the abnormality of this behavior barely registered, but in hindsight, I find myself questioning whether these were manifestations of PTSD.

Writing a new future

While workplace violence, or the looming threat of it, wasn’t the sole reason for my departure from nursing, it undeniably played a large role in my decision to step away. The relentless undercurrent of fear and apprehension was a stark contrast to the ideals that once drew me to the profession and ultimately became a decisive factor in re-evaluating my career path.

Instead, I began working as a freelance writer, using my health care experience to write about topics I was passionate about. In one of my first roles, I was making less than $10,000 a year—yet, instead of being discouraged, I was overjoyed. It wasn’t lost on me that I had a decade of experience in one of the most in-demand fields in the world, and I was working a job that put me firmly below the poverty line. But the fact that I didn’t care says everything that needs to be said about the state of nursing in this country.

With time, I successfully carved out a new path for myself, building a business and establishing a fulfilling career in writing. Yet, many of my friends and colleagues remain in health care, grappling with the very challenges that once plagued me. When they share their struggles, I often find myself at a loss for words—advice seems futile in the face of administrative indifference and a lack of substantive legislation to protect and retain health care workers.

My story is not unique. The epidemic of violence against health care professionals has persisted for decades and is only getting worse. It both infuriates and saddens me to witness how a workforce brimming with highly educated, compassionate, and self-sacrificing individuals is treated as disposable and replaceable, not deemed worthy of basic protections against harm. Now, more than ever, there is a need for systemic change to value and safeguard our health care frontline workers before more are hurt, traumatized, or compelled to abandon their professions entirely.

Kate Morin is a medical writer and nurse.

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