New legislation, tech look to counter rising healthcare workplace violence

Over a decade and a half as a practicing nurse, state Rep. Tarik Khan of Philadelphia has taken the kinds of blows more often associated with athletic careers.

The former president of the Pennsylvania State Nurses’ Association recalls being headbutted into a concussion by a patient with intellectual disabilities, and attacked by another patient who was frantically seeking opioids – an encounter that left the legislator wearing a permanent knee brace.

“It’s unfortunately very common,” said Khan of healthcare workplace violence. Sobering statistics bear that out: Nationally, healthcare workers suffered nearly three-quarters of all nonfatal workplace injuries due to violence, according to the U.S. Bureau of Labor Statistics. Nurses and their colleagues were five times more likely than all other workers to be punched, kicked, bitten, beaten, choked and assaulted on the job.

A WPXI-TV statewide survey of 500 healthcare workers last year found that 90% of Pennsylvania healthcare workers said they had experienced physical abuse on the job – and a full 50% of them had considered leaving their careers because of violence. 

Incidents like the 2025 mass shooting at UPMC Memorial Hospital in York County – where a patient’s disgruntled family member took hostages in the hospital’s intensive care unit, leaving one victim and the perpetrator dead and seven wounded – only underline the crisis.

The trend, which accelerated during the COVID-19 pandemic, has strained recruitment and retention efforts, intensifying the industry’s already critical labor shortage.

Physical security “has (long) been a problem – but now we’re to the point where physicians, nurses, healthcare workers leave their profession because of the violence,” said Maureen May, a neonatal intensive care nurse at Temple Health who, as the longtime president of the Pennsylvania Association of Nurses and Allied Health Professionals, has led a years-long crusade to address the issue.

Now, Khan and other Pennsylvania legislators are pushing measures to counter the trend – including bills with bipartisan backing that would give healthcare workers more control over their own workplace safety and greater resources to bolster security. Meanwhile, several commonwealth health systems have turned to a digital device that issues a discreet call for backup to provide threatened workers with additional cover.

“For years, I’ve heard from nurses about what they face on the job,” said state Rep. Jason Ortitay, a Republican representing Allegheny and Washington counties and a co-sponsor of the healthcare workers’ support bill. “These are the people who take care of us on our worst days – and they should be able to do that work without fearing for their own safety. Keeping healthcare workers safe isn’t a Republican or Democrat issue. It’s just the right thing to do.”

Measures with momentum

The bill Ortitay referred to, which is championed by May’s state nurses’ union, would require every healthcare facility to devise a violence prevention plan – with input from frontline healthcare staff – and to support workers after security incidents. The measure, which has myriad bipartisan co-sponsors, would also protect workers from retaliation after reporting incidents, and give the state the power to hold facilities accountable for lax security.

“This bill gives health facilities real tools to protect their workers,” affirmed Ortitay, “from violence prevention committees to clear reporting, so incidents don’t get swept aside.”

Nurses support the legislation for giving teeth to “accountability and enforcement,” as May put it. She explained that while many people mistakenly believe that workplace safety is regulated by the Occupational Health & Safety Administration, that federal agency only provides voluntary guidance – as does the Joint Commission, a preeminent healthcare facilities accreditation body. No entity actually enforces those guidelines, May cautioned.

Funding for security is also an issue for healthcare facilities, many of which – especially in rural areas – are already under growing financial strain from declining populations and insurance rates. In response, Khan spearheaded the Hospital Work Safety Grant Program, legislation that would provide state monies for facilities to invest in safety strategies and infrastructure.

A third bill is the Patient Safety Act, which would establish minimum staffing standards for nursing and other healthcare workers. More nurses could obviously translate into better care, but Khan pointed out that simply having more employees around can tamp down flaring tempers – for example, in overcrowded ER waiting rooms – and facilitate earlier interventions.

The idea “is to find ways to just sort of calm things down and lower the temperature,” the Democratic lawmaker explained. “It keeps patients safe; it also keeps healthcare workers safe … There is ample evidence that the Patient Safety Act saves lives.”

“Healthcare providers – we expect them to be on the front lines, taking care of us when we need them,” added Khan, a sponsor or co-sponsor of all three bills. “And it doesn’t work if you show up to the hospital and you don’t have people there because … workers (are) basically being beaten.”

An outbreak of violence

Nurses have been sounding an ever-louder alarm since the pandemic, which strained Americans’ relationship to the healthcare establishment and frayed social norms. The fallout, health workers say, is accelerating violence at healthcare workplaces nationwide.

“Years ago, we would just shrug it off … But we have a very violent society now,” observed May, recalling a recent incident in which an Einstein Health technician had her finger bitten off and spat across the room by an out-of-control patient. “It’s all just escalated. And COVID did not help.”

Kali Gargone, a nurse in the perioperative area at Geisinger CMC in Scranton, affirmed that the pandemic had a coarsening effect on behavior – especially in healthcare settings, which were the backdrop for that era’s most polarizing controversies, such as masks and vaccines.

“Since COVID, we’ve seen a definite increase in violence from patients who are not necessarily confused, and from visitors, too,” said Gargone, the membership chair of the Northeast Pennsylvania Nurses Association and a member-at-large of PASNAP’s executive board.

While nurses “get the brunt of it as the 24/7 bedside workers,” any patient- or visitor-facing healthcare employee is vulnerable, she added. “It’s not a matter of, are you going to suffer either some type of physical or verbal assault; it’s when.”

Much of the current legislation speaks to workers’ desire to wrest some control over workplaces that – driven by marketplace concerns and patient satisfaction scores – increasingly cater to clients rather than advocating for employees, in many nurses’ view.

Gargone related a recent incident at her own hospital in which a visitor repeatedly singled out and threatened a nurse. “The visitor was not asked to leave. They were not reprimanded in any way, and in fact, they were catered to,” she recalled. “Then the nurse was asked, ‘What could you have done to have de-escalated the situation? What could you have done to make them more satisfied?’”

Nurses, she explained, are looking for greater agency over their day-to-day security. For many, the rising unease is exacerbated by security standards that vary widely between hospitals – with some facilities assiduously screening visitors through guarded entrances, metal detectors and backpack checks, and others screening little or not at all.

May said that rising violence was the main issue in last year’s union negotiations for nurses at Butler Memorial Hospital, where lax security had workers spooked. “Nurses there were willing to use their treasury to help pay for a weapons detector,” she noted. “That’s how desperate they were.”

Hands-on security solutions

In Central Pennsylvania, WellSpan Health facilities have reduced rates of workplace violence-related injury by two-thirds by outfitting frontline healthcare staff with a wearable safety device – the literal and figurative linchpin of the health system’s violence prevention initiative.

The equipment, from the Silicon Valley outfit Canopy, was originally developed in partnership with Philadelphia-based Jefferson Health to facilitate faster emergency response through systemwide alerts.

“We’ve made a deliberate decision to address (the workplace violence) trend head-on through proactive, systemwide investments in safety, training and technology,” Patricia Donley, WellSpan’s senior vice president and chief nursing executive, told City & State. “Our focus is not just on responding to incidents, but on preventing them.” The goal, she added, is to make “our caregivers feel safe and supported.”

Canopy and WellSpan Health recently released the results of a case study showing the success of the digital platform, which allows nurses to discreetly push a button alerting colleagues to an escalating situation. Bill White, the health system’s public safety chief, noted that prior to the introduction of the device, frontline staff lacked a reliable method to quickly signal for help.

Canopy’s clinical strategy directors, Ryan Oglesby and Jeanne Venella – both veteran emergency nurses – said the company trains healthcare workers to “press early and press often,” said Oglesby, who is also the immediate past president of the Emergency Nurses Association.

“Oftentimes two other feet and two other eyes entering the room is enough to break the tension,” added Venella, “or to get a staff member to safety by saying, ‘Maybe you could step out for a second,’ or ‘The charge nurse is looking for you’ – something to just defuse the situation.”

While policies and platforms can all be helpful, experts agree that a comprehensive approach is essential to reverse the trend of violent behavior. Most significantly, nurses emphasize, any solution must include input from the frontline caregivers themselves.

“The healthcare workers who are there, who are actually living it every day, who are dealing with violence,” said Khan, “are the ones who are best informed to know – where are the opportunities, where are the strengths in terms of security, and what is needed.”