What Hospitals Can Do to Deter Attacks on Healthcare Workers

• The fatal shooting at a Pennsylvania hospital is the latest in a long line of violent attacks on healthcare workers, despite calls for federally legislated protection for the industry’s workers. 
• Some states have enacted legislation to protect healthcare workers, but Congress has yet to act at the federal level. 
• Encouraging reporting of workplace violence and following the Joint Commission’s standards are among the ways hospitals can help keep their employees safe. 

The fatal shooting at a Pennsylvania hospital is just the latest in a long line of violent attacks on healthcare workers — despite multiple organizations and industry staff calling for federally legislated protection for the industry’s workers. 

Just last year, a Nursing CE Central blog author threw her support behind the then-reintroduced Workplace Violence Prevention for Healthcare and Social Service Workers Act. 

“This would be a great start in establishing a workplace free of violence. Healthcare and social service workers are on the frontlines caring for our community in their respective roles,” wrote Whitney Finley, RN. “These workers being put in dangerous, violent situations should not be tolerated or accepted as something that is ‘part of the job.’”  

While waiting for more action to be taken at a higher level, hospitals and healthcare workers can consider the following approaches to address and prevent violence. 

Advocate for Federal Legislation to Protect Healthcare Staff

While some states have enacted laws to issue higher penalties for assaulting healthcare works, legislators at the federal level have yet to take action. The American Hospital Association has called on Congress to enact the Safety from Violence for Healthcare Employees (SAVE) Act, which would make it a federal crime to “knowingly assault an individual employed by a hospital while performing their duties, and as a result, interfere with the performance of those duties.” AHA argues that healthcare staff deserve the same federal protections that exist for airline workers.  

Encourage Reporting of Attacks on Healthcare Workers

A 2024 analysis of studies on violence in healthcare settings found several barriers to reporting incidents of violence from both the organizational and worker perspectives. Those include, among other factors: 

• Ambiguity in definitions of reportable offenses. 
• Complexity of the legal system. 
• Lack of management support. 
• Unfamiliarity with reporting methods. 
• Lack of physical injury. 
• Expectations that workplace violence is part of the job. 

Fostering an environment where employees feel like they are heard and action will be taken can bridge the gap while waiting for Congress to act.  

Ensure the Facility Follows the Joint Commission’s Workplace Violence Prevention Standards

The Joint Commission updated its workplace violence prevention standards in 2022, defining such violence as, “An act or threat occurring at the workplace that can include any of the following: verbal, nonverbal, written, or physical aggression; threatening, intimidating, harassing, or humiliating words or actions; bullying; sabotage; sexual harassment; physical assaults; or other behaviors of concern involving staff, licensed practitioners, patients, or visitors.” 

The standards include: 

• The hospital manages safety and security risks, which includes conducting an annual analysis “related to its workplace violence prevention program.” Facilities must then act on any security or safety risks that are found. 
• Staff participate in regularly scheduled education and training. 
• Leadership creates and maintains a “culture of safety and quality.” 

Be Open to Suggestions from Nursing Staff

A nurse in California spearheaded a safety initiative that went from helping her own unit to becoming a systemwide program.  

In addition to creating “Code Gray Bags,” which were kept at nurse stations and included items like restraints and personal protective equipment, she designed “The Gray Dot.” The symbol, according to UCLA Health, is displayed outside of hospital rooms to indicate the possibility of “high-risk situations.” 

“The Gray Dot means ‘See the nurse before entering,’ Amy Castillo, BSN, RN-BC, told UCLA Health. “This allows anybody entering the room – nurses, physicians, staff, people delivering food – to see that patient has been known to be verbally or physically aggressive, or they have the potential.”

The Bottom Line

Incidents of workplace violence against healthcare workers are well-documented. Some state-level legislation has been enacted to issue stricter penalties for those who attack healthcare staff, but federal legislation — introduced multiple times in recent years — has yet to see any movement.  

Hospital leadership and staff can enact their own provisions and prevention measures to help ensure the safety of staff, patients, and visitors.  

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