Antiviolence efforts to protect healthcare workers have been underway with limited success for years, so the latest federal bill in that regard would normally be seen as another well-intentioned, but ultimately futile, effort. However, things are not normal.

In the traumatic aftermath of a school shooting in Florida, students from the school protested and organized national marches. The movement has raised public awareness about gun violence in a way that resonates with advocates for action in healthcare.

“We’re incredibly proud of their efforts, which I believe are heroic,” says Bonnie Castillo, RN, executive director of National Nurses United in Oakland, CA. “The fact that the students themselves are out defending their right to be safe is remarkable. When we look at gun violence, we see it as a public health problem that puts all of us at risk.”

Having successfully fought for a California Department of Occupational Safety and Health (Cal/OSHA) healthcare violence prevention standard in her state, Castillo is lobbying for passage of a recently filed federal bill that would enact similar requirements nationwide. Introduced in March by U.S. Rep. Ro Khanna, D-CA, the Health Care Workplace Violence Prevention Act was co-signed by 12 other members of Congress.

If passed, the law mandates that federal OSHA develop a national standard on workplace violence prevention. Although it has fallen largely silent in the current antiregulatory climate, OSHA issued a request for comment on Dec. 7, 2016, on a workplace violence prevention standard for healthcare settings.1

OSHA cited the passage of healthcare violence prevention regulations by its state-based program in California. The Cal/OSHA program adopted the new standards in 2016, with implementation beginning last year. In doing so, Cal/OSHA became the first state OSHA plan to adopt a healthcare violence prevention regulation.2

At the time of this interview, Castillo says California hospitals were just readying to fully implement the state requirements by an April 1 deadline.

“They are supposed to be ready to operationalize their work plans,” she says. “But we understand with every health and safety regulation that we have fought for and won, we have to have a vigorous enforcement plan as well. We are working with the nurses that we represent to ensure that the hospitals comply with the full intent of the law and all of the regulations.”

Despite the success of the state law, the national regulation faces the same uphill battle that has mired down other efforts for change in healthcare.

“Even prior to the current administration, we have had to fight,” she says. “Primarily because the healthcare industry itself vigorously opposes regulation. There has always been a kind of [political] sympathy for this unregulated model, even across the aisle. But it puts all of us that work in this industry and the public at risk as well.”

The public includes the patients who seek healthcare, and the emerging social justice movement on gun violence could put more pressure on the medical industry to protect caregivers.

“The reason we have been able to overcome some of this in healthcare is that we have been able to get public support from the patients that we serve,” Castillo says. “That’s what we are seeing with these marchers and that is what it is going to take. What is really great is that these students have a collective political voice, and they took it to the streets.”


1. OSHA. Prevention of Workplace Violence in Healthcare and Social Assistance. Fed Reg. 2016-29197. Dec. 7, 2016. Available at:

2. Cal-OSHA. Workplace Violence Prevention in Healthcare. 2016. Available at: