The raised profile of healthcare workers in the pandemic is giving momentum and political traction to address a longstanding problem: Violence.

The Workplace Violence Prevention for Health Care and Social Service Workers Act of 2021 recently passed the U.S. House of Representatives and is now in the Senate.1 The bill was reintroduced after withering on the vine in 2019. It would direct the Occupational Safety and Health Administration (OSHA) to require violence prevention programs in hospitals and other healthcare settings.

OSHA began promulgating a standard2 after the epidemic level of violence in healthcare — primarily from patients to providers — was revealed in a 2016 report by the Government Accountability Office (GAO). The GAO found “healthcare facilities experience substantially higher estimated rates of nonfatal injury due to workplace violence compared to workers overall.”3

There are few data published on violence against healthcare workers during the pandemic. Some incidents have occurred — particularly after mask-wearing became politicized — but the early cancellation of elective procedures and the banning of visitors meant fewer potential perpetrators of violence. A NIOSH study published in 2018 revealed violence is increasing in healthcare.3

The bill calls for annual training, some of which may fall to employee health professionals, to include “identified workplace violence hazards, work practice control measures, reporting procedures, recordkeeping requirements, response procedures, anti-retaliation policies, and employee rights.”

Some have questioned mandating programs and the effects of such mandates on hospitals in terms of compliance, notes Ron Kraus, MSN, RN, EMT, president of the Emergency Nurses Association.

“I can sympathize with that, but my argument is that this has been going on way too long,” he says. “Nurses are getting abused. Healthcare workers are getting assaulted. I don’t know how to make it clear, but people who don’t work in healthcare don’t realize what is happening. I tell friends and neighbors if you went to a restaurant and your steak wasn’t done right, you wouldn’t assault the server or the chef. That’s not acceptable. Why should it be acceptable to assault healthcare workers?”


  1. 117th United States Congress. Workplace Violence Prevention for Health Care and Social Service Workers Act. HR 1195. April 19, 2021.
  2. Groenewold MR, Sarmiento RFR, Vanoli K, et al. Workplace violence injury in 106 US hospitals participating in the Occupational Health Safety Network (OHSN), 2012-2015. Am J Ind Med 2018;61:157-166.
  3. Occupational Safety and Health Administration. Prevention of workplace violence in healthcare and social assistanceFed Reg 2016-29197, Dec. 7, 2016.
  4. Government Accountability Office. Additional efforts needed to help protect health care workers from workplace violence. GAO-16-11. March 17, 2016.