Voice of the President | November 2026
There is a challenging contradiction at the heart of healthcare: We ask nurses to create an environment of safety, compassion and healing for every patient while too many nurses do not always feel safe themselves, due to workplace violence (WPV).
Workplace violence remains a persistent public health and workforce safety concern in healthcare. Workers in the Bureau of Labor Statistics Health Care and Social Assistance sector accounted for nearly three-quarters of all nonfatal WPV cases involving days away from work, job restrictions or transfer during 2021-2022, the most recent period for which WPV-specific data are available. These findings highlight the disproportionate burden of WPV experienced by healthcare workers and the continued need for evidence-based prevention strategies.
It’s important to remember that behind many of these incidents is a nurse. A nurse who was assaulted while trying to deliver care. A nurse who was verbally threatened by a patient or family member. A nurse who begins to question whether the emotional and physical toll of the work is sustainable.
Nurses are especially vulnerable because of their close and continuous contact with patients and families. They are often in the environment when emotions and situations escalate and are among the first to experience threatening behavior, verbal abuse or physical violence.
The impacts of workplace violence extend beyond the individuals directly involved, creating ripple effects that affect the overall well-being of witnessing colleagues, their teams and the entire workforce. Over time, the physical and emotional toll can undermine psychological safety and diminish job satisfaction and engagement, as well as result in higher rates of absenteeism and turnover.
As nurse leaders, we have a responsibility to continue advocating and working collaboratively with colleagues to change that experience. Many of us have been on the receiving end of WPV at some point in our careers and have witnessed its effect on colleagues, teams and organizations.
AONL is a leader and strong voice in finding both organizational and policy solutions to protect healthcare workers. AONL advocates for the Save Healthcare Workers Act to provide federal protection for healthcare workers against violence and intimidation.
Ten years ago, AONL and the American Hospital Association collaborated to launch Hospitals Against Violence (HAV), an initiative to share examples and best practices on combating workplace and community violence. #HAVhope is now celebrated annually as a national day of awareness. AONL has also collaborated with the Emergency Nurses Association to develop guiding principles and a toolkit of resources to mitigate violence in the workplace.
No healthcare worker should ever have to fear for their safety while caring for patients and families. We cannot accept workplace violence as just part of the job.
Nurse leaders are critical in helping to shape systems in which violence is taken seriously, addressed promptly and reported consistently. They are examining patterns of WPV-related incidents; identifying high-risk situations and locations, appropriate staffing and care models, security resources, and appropriate education and training; and establishing clear expectations for respectful behavior. Nurse leaders are also helping build psychologically safe environments where nurses feel free to speak up and share their concerns.
This issue of the Voice explores strategies to prevent WPV, support nurses and healthcare workers who experience violence and create psychologically safe cultures where people feel supported, heard and protected.
Kyle Riley and Erik Martin share a phased approach to addressing an increase in pediatric patients requiring both medical and behavioral health treatment. Nurse leaders formed an interprofessional team to enhance behavioral health safety due to a corresponding rise in WPV. The team identified best practices and evidence-based strategies, including the introduction of a multidisciplinary behavioral health huddle three times a week and the formation of a Behavioral Emergency Response Team to help nurses and staff proactively identify and respond to patient behaviors to prevent escalation.
One unique collaboration is helping small, regional organizations access workforce violence prevention training. Amer Patel and Sarah Beebe examine a partnership between a rural hospital in Idaho and a medical liability insurer to expand access to high-quality training through a dual-modality model that combines individual virtual reality de-escalation practice with team-based interprofessional, actor-based simulation.
Morgan Wood and colleagues discuss the importance of demonstrating support to victims of violence. Through the E-SAVE (Employee Support After a Violent Event) team, affected employees receive prompt on-site, trauma-informed support, allowing patient care to continue. Kevin Langkiet shares his organization’s efforts to strengthen support services by outlining who would support affected employees through the reporting, recovery and legal processes.
Cultural change is an important part of violence prevention. Sharon Stemm and Andrew Harding share their organization’s efforts to strengthen workgroup culture to create a psychologically safe environment.
The violence we are seeing in hospitals and health systems reflects broader challenges in our society, because the behaviors do not stop at the hospital or care delivery doors. Yet, no healthcare worker should ever have to fear for their safety while caring for patients and families. We cannot accept WPV as just part of the job. Addressing this ongoing crisis will require continued commitment, advocacy and action from all of us. Creating safe environments for those who provide care is not optional. It is fundamental to supporting nurses and other healthcare workers, strengthening the workforce and ensuring the highest quality care for the patients and communities we serve.