Healthcare workers are accustomed to dealing with people on some of their worst days. Patients may be frightened, frustrated, in pain, confused, or angry. Family members may be anxious or upset. While difficult interactions are sometimes considered “part of the job,” threatening or violent behavior should never be treated that way.
OSHA defines workplace violence broadly. It can include physical violence, harassment, intimidation, threats, and other threatening or disruptive behavior. In healthcare, that means workplace violence does not begin only when someone is physically assaulted.
Threatening a receptionist, intimidating a nurse, aggressively confronting an employee, throwing objects, blocking an employee from leaving a room, or making a worker fear for their safety are behaviors that should be taken seriously. Even when no physical injury occurs, these incidents can provide important warning signs and opportunities for prevention.
Healthcare presents unique risk factors. Employees routinely interact with patients and visitors, sometimes work alone, handle emotionally charged situations, and may encounter individuals experiencing behavioral health crises, impairment, or other conditions that increase the potential for unpredictable behavior. Long wait times, inadequate staffing, unrestricted public access, poor lighting, isolated work areas, and lack of employee training may further increase risk.
So, what should healthcare employers be doing?
Start by evaluating the workplace. Consider where and when employees may be most vulnerable. Reception and check-in areas, isolated treatment rooms, parking areas, after-hours operations, and locations where employees work alone may require additional safeguards.
Next, make reporting easy and expected. Employees should know whom to contact when they feel threatened, observe concerning behavior, or believe a situation is escalating. Employees should also understand that reporting a threat or near miss is important even when no one was injured. Reviewing these events can help employers identify patterns and correct hazards before a more serious incident occurs.
Depending on the workplace and identified risks, preventive measures may include panic buttons, improved lighting, controlled access, security measures, buddy systems, changes to room layouts, or procedures for obtaining assistance when a patient or visitor becomes threatening.
Training is another critical component. Employees should understand the organization’s workplace violence prevention procedures, warning signs of escalating behavior, appropriate de-escalation techniques, emergency response procedures, and when to remove themselves from a situation and seek assistance. Supervisors should also understand how to respond when an employee reports a concern.
Most importantly, workplace violence prevention should be part of the organization’s overall safety culture—not simply a response after an incident occurs.
Healthcare employees should not have to accept threats, intimidation, or violence as “part of the job.” Recognizing the risk, encouraging reporting, reviewing incidents and near misses, and implementing reasonable safeguards can help healthcare organizations create safer environments for employees, patients, and visitors.