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Violence in healthcare is on the rise. How do you keep yourself safe?

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Injuries to employees who work in healthcare were 4x more common than in other industries.  More than 70% of nurses and physicians in the emergency department had witnessed or experienced a physical assault while working.

Covid hasn’t made these numbers better.  In fact, many nurses are noticing an increase in violence across all departments.  No matter where you work, it is important to know what to do in a violent situation.

Preparation is key to preventing violence.  Take any classes available on de-escalation to learn skills on how to decrease patient anxiety and limit the likelihood of violence.  Be aware of your surroundings and make sure to always have an exit strategy, no matter what happens in the room. If the patient displays verbal or physical aggression, use the buddy system and make sure you have a clear path to the exit at all times.

Make sure you know your hospital policies on what you are allowed to do or say to violent patients or visitors.  You should also know how to contact security or call for help in any location you are working.

The biggest thing nurses can do to help stop violence is to report it.  The International Association for Healthcare Security and Safety (IAHSS) estimates that only 30% of violent episodes are reported.  Your hospital leadership can’t change things it doesn’t know about.  The government won’t put laws in place to protect workers if there isn’t evidence that violence in healthcare is a problem.

Many nurses underreport because they feel it is part of the job, are concerned about retaliation from management, or the belief that nothing will be done.  Violence is never a part of nursing, even in psychiatric or emergency departments where patients are more likely to become physically and verbally aggressive.

What has become normal is dangerous and shouldn’t be tolerated by nursing staff.  You have the right to file a report and to press charges if the violence was physical. Sounding the alarm early and often can help hospitals implement better security and stronger policies to prevent violence and provide training.

Some other options include flagging violent patients in the electronic health record system and adopting a zero-tolerance policy.  If a critically ill patient becomes violent, the proper use of restraints and multiple sitters is important to keep staff members safe.

Finally, consider learning some self-defense skills, which may be useful inside or outside the hospital.  Be aware that some hospitals have policies in place that may prevent you from using certain self-defense techniques.  Still, when faced with a violent patient, using self-defense and losing your job may be preferable over life-threatening injuries.  You have rights as a nurse, help bring some attention to this issue by reporting the violence you experience!

Amanda Ernst, DNP, RN, CEN

Amanda Ernst, DNP, RN, CEN


Amanda is an ER nurse with 10 years of healthcare experience. She currently works as a nurse educator and as an adjunct professor for several schools. She also works as a freelance healthcare writer in her spare time. Amanda thinks the greatest thing about nursing is the endless possibilities and opportunities to learn. What have you learned today?


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