Violence at work--all too common in health care
This is going to be short...I am getting over a terrible cold
Hi Everyone,
Sorry for the pause between newsletters. I had a terrible cold last week that started two weekends ago, and still doesn’t feel completely gone. Arthur is now sick, too, and we spent the weekend sniffling, coughing, being mildly irritated and irritating (though not with each other), and using up throat lozenges by the bagful (only a slight exaggeration). I am better and he is getting there, but if you have been flattened recently by an annoying illness, I feel your pain. I had forgotten how unpleasant colds can be because mine lately have been mild.
New column in Cancer Nursing Today
Well, this column isn’t new anymore because…I haven’t been feeling good, but it’s new to all of you, maybe. And unfortunately it’s an evergreen topic that won’t be going away anytime soon: health care workers being attacked on the job. It’s fair to call this problem an epidemic as it is ubiquitous, and everyone who works in health care is at risk, not just nurses. Post-Covid, patients are angry, and the prospect of not being able to pay for health care due to Republican cuts to the Affordable Care Act subsidies, and to Medicaid, are surely not helping. Nor is the fact that health care premiums are getting costlier for many people, while health insurance seems to cover less and less for many of us.
The column describes how I recently was attacked on the job: a patient spit in my face and then scratched my arm, drawing blood. The patient was elderly and unaware of what she was doing—I think. But in the end her being conscious, or not, of hurting me, didn’t change how terribly unsettling the whole experience was. It is upsetting and scary to be physically hurt at work when the whole point of the job is to care for others. Being hurt by someone I was there to help felt, to me, like a strange form of moral injury. I was expected to take care of someone who had purposefully and aggressively, if not intentionally, injured me, and that expectation put my on-the-job altruism and my valuation of my own physical safety, completely at odds with each other. That conflict between caregiving and safety poses a professional and moral conundrum for all those who work in health care, and I try to tease out some of the subtleties of the problem in the column below.
Start the column here and then click on the violet button to finish reading at Cancer Nursing Today.
Being Attacked on the Job is Not Nurses’ Work
April is Workplace Violence Awareness Month, and I got attacked by a patient at work this April. I work in an outpatient clinic, and an elderly patient with severe cognitive impairment spit in my face when I first approached, and then clawed my left arm, leaving parallel, bleeding, four-inch scratches. The patient’s violent behavior, combined with cognitive impairment, made doing a complete exam impossible and left us unable to address the issue that brought the patient to the clinic in the first place. The only thing the patient’s visit accomplished was to leave me physically injured and psychically disturbed by what happened.
As many nurses already know, I am far from alone in being hurt by a patient. According to the 2026 State of Nursing Survey from nurse.org, over the past year 27% of nurses were physically assaulted at work, and 56% were threatened or had aggressive language directed at them. Physicians also encounter violence on the job: 91% of emergency department physicians either witnessed or were victims of violence last year, according to an article in Medical Economics. Also, most nurses (and possibly other staff, too) tend not to report acts of violence at work, so the actual number of incidents is probably much higher than reported.
Until next time…
Stay well, everyone! More soon when I’m fully recovered.
Hugs to all,
Theresa
More examples: PTSD and/or physical injury (back, etc) on the job sometimes lead to an inability to stay in that job. Part of the so called "nursing shortage" is when the facility does not protect nurses from violent patients or by providing a Hoyer lift so that nursing staff end up with injuries that prevent them returning to work. A CNA was unable to heal from a wrist injury from a violient patient so that she was unable to work again. Many nursing staff have decided that facilities can't pay nursing staff enough to put our future employability at risk like that. I worked on a floor that was under construction, i.e., that did not meet OSHA safety requirements, so that I had to take sick time for vibrational stress and then later go on light duty, and eventually find a new employer. Facilities are excellent at not listening to or believing the nurse's report of cause and effect, and so deflecting financial responsibility for the nurse's injury. When the CNA and other staff are unable to get a violent patient's cooperation with care, the nurse is ultimately responsible for that patient receiving the CNA care so the nurse ends up spending more time with a violent patient than non-violent patients.
In hospice, we were sent into homes that were physically unsafe for the patients and also for the hospice staff. One nurse sustained such a severe tibial fracture from loose entry steps that the nurse would have been unable to work at all if she hadn't gotten fired to deflect blame. After her injury, our supervisor sent the nurse for a drug screening implying that her injury was caused by her being drunk or high. Since hospice staff spend work days intentionally dehydrated for lack of bathrooms, she was unable to produce urine to comply with the drug screen so she was fired. Ironically, her on the job work injury that was a sign of her commitment and loyalty to her patients was turned against her to prevent her employer being held liable for sending staff into an unsafe home. I was the next nurse to be sent to the home with the loose front steps so I took photos to support my former coworker, and I bought wood and screws. The patient and her husband were living in that unsafe home because they were in a bad way financially. They didn't have money for repair supplies but the patient's husband was handy and was eager to repair the stairs for their own safety needs. When my boss's boss asked me directly if that home was physically unsafe, I named that it was very unsafe, and then gradually I had to give notice because of the ramifications of my boss being furious at me from not letting them gaslight me.
I’m sorry you and Arthur are sick and even more sorry that you were attacked by a patient. That must have been so frightening and upsetting. Our culture loves to minimize the awfulness of dementia—calling a second childhood, for example—but often dementia patients can be aggressive, and I wish we could be honest about that. Honesty might help protect medical professionals like you.