Please upgrade your browser

Workplace violence:  Healthcare workers are often a target — what would you do?

April 18th, 2018 | Posted in Advocacy 101, Professional Skills

As a patient advocate, you may often find yourself in a hospital, clinic or physician’s office and you need to know the workplace violence plan for each facility. Don’t rely on healthcare staff to always know what to do.

In September, a man in a room with a patient who had been in a Minnesota hospital for two days pulled a gun and twice struck the woman he was visiting before running down a hospital hallway brandishing the gun.

Staff initiated the hospital’s “Active Threat” alert, which was broadcast over the hospital’s announcement system, and many sheltered in place until police arrived, as trained. No one else was injured and the man was later arrested. But investigators with the Centers for Medicare & Medicaid Services cited the hospital because a nursing assistant and many other staffers were not aware that the hospital had recently changed procedures and at first did not know how to respond.

About three-quarters of workplace assaults happen in the healthcare or social service sector, according to the federal Occupational Safety and Health Administration (OSHA). Violence-related injuries are four times more likely to cause healthcare workers to take time off from work than other kinds of injuries, according to the Bureau of Labor Statistics (BLS).

While hospitals and other healthcare facilities are supposed to protect workers from the hazards of violence under OSHA’s General Duty clause, OSHA has said it is considering creating a separate standard for healthcare to address the unique circumstances in that workplace that often results in violence.

And on April 17, The Joint Commission (TJC), one of the largest accrediting organizations for healthcare, issued a Sentinel Event Alert calling for better protection of healthcare workers from physical and verbal abuse.

Statistics show that Emergency Departments and inpatient psychiatric units where patients are being cared for related to substance abuse, intoxication, dementia or altered mental states are the most common areas for violence in healthcare. However, no area of healthcare is immune.

There are many factors contributing to violence, according to TJC’s Sentinel Event Alert, but some include:

  • Stressful conditions, such as long wait times or crowding in the clinical environment or being given “bad news” related to a diagnosis or prognosis
  • Lack of organizational policies and training for security and staff to recognize and deescalate hostile and assaultive behaviors from patients, clients, visitors, or staff
  • Domestic disputes among patients or visitors
  • Inadequate security and mental health personnel on site
  • Unrestricted public access to hospital rooms and clinics
  • Lack of community mental health care


TJC, CMS and other accreditors require all healthcare organizations to have an emergency plan, and that should include how to deal with active shooters and other security incidents.

If you are employed by or spend significant amounts of time in a healthcare organization, ask for information about its emergency plan so you will know how to keep yourself and any patient you are with safe in the event there is a security incident.

The Sentinel Event Alert also includes tips and resources for healthcare organizations in dealing with workplace violence.

In addition, the Department of Homeland Security offers online training on being prepared to react in the event of an active shooter or other such active threat. That training, a video, fact sheet and more information can be found at — A.J. Plunkett ( and Matt Vensel (