Aug 10, 2023 - Health

Hospitals and clinics are now among America's most dangerous workplaces

Number of nonfatal occupational injuries and illnesses resulting in time away from work
Data: Bureau of Labor Statistics; Chart: Tory Lysik/Axios Visuals

Health care workers are increasingly being assaulted or shot on the job, making hospitals and clinics among the most dangerous workplaces in America.

The big picture: Violence was a serious problem before COVID-19 — the field suffered more nonfatal injuries from workplace assaults than any other profession, even law enforcement, per the Associated Press — and pandemic stressors like backlash against public health measures have made matters worse.

  • The combustible situation not only can disrupt patient care but help fuel alarming levels of burnout among the pandemic-fatigued health care workforce.
  • "We saw a great big uptick in violence," said National Nurses United vice president Cokie Giles, noting that inadequate staffing also contributes to frustrations.
  • "It used to be people had a respect for what was done in hospitals and the people who worked in those hospitals. That's not there anymore," Giles said.

Context: About 3 in 4 nonfatal workplace violence injuries involved workers in health care and social work in 2020, the most recent year for which statistics are available.

  • The frequency of injuries from workplace violence in health care has risen almost every year since 2011, reaching 10.4 per 10,000 full-time workers in 2018, up 62% from 6.4 per 10,000 in 2011, per the Bureau of Labor Statistics.
  • That trend likely continued upward during the COVID pandemic. A review published in Public Health last month concluded the pandemic "exacerbated the scale of the problem" around the world, estimating that nearly 8 in 10 health care workers were involved in an assault or other violent incident during the health crisis.
  • A study in the American Journal of Emergency Medicine last year found a link between higher local COVID case rates and violent incidents involving patients in Mayo Clinic's emergency department in Rochester, Minnesota. They also found an increase in violent incidents in the department overall during the pandemic, compared to before the crisis.
  • Researchers point to unprecedented stress from the pandemic, the way it wore on on individuals' mental health and home life, and flaring political tensions as likely factors. Health care workers also point to staffing shortages that can lead to backups and poorer outcomes among patients.

What's happening: Headlines across the U.S. in the past year depict a profession under assault, increasingly subject to gun violence that's plaguing large swathes of American life.

  • Scripps Health found at least one staff member is attacked on the job every day across its health system, according to Fox 5 San Diego.
  • A recent survey of health care workers from Premier and the federal Agency for Healthcare Research and Quality found that 40% experienced workplace violence in the last two years.

State of play: Hospitals are stepping up efforts to identify security risks, training staff on violence prevention and calling in counselors to de-escalate tense situations, according to the Association of American Medical Colleges.

  • They are also beginning to invest in AI technology to help detect guns entering buildings, Fierce Healthcare reported.
  • But arming hospital security guards, such as with handguns or tasers, has been controversial, sparking debate about whether that actually makes patients less safe.

What to watch: There are ongoing efforts in Congress and statehouses to make health care settings safer.

  • A bill introduced by Sen. Tammy Baldwin (D-Wis.), would require all health providers to implement a plan to prevent and protect their employees from violent incidents.
  • The Joint Commission, the main accreditation organization for U.S. hospitals, last year added a workplace violence standard meant to "guide hospitals in developing effective workplace violence prevention systems."

Go deeper: Listen to the Axios Today podcast, where host Niala Boodhoo and Tina Reed talk about the escalating violence in America's doctors offices and hospitals, and what health care workers are saying about what they're experiencing.

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