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Violence at Work: The Untold Risk of Nursing


Patient violence in healthcare is a growing epidemic, but Texas State University is working toward a remedy.

Healthcare workers, especially nurses, have been struggling for years, often in silence, against a troubling increase in patient violence in hospitals, ERs and long-term care facilities throughout the nation. According to U.S. Department of Labor statistics, hospitals now rank second only to law enforcement for frequency of on-the-job violence.

At the Texas State University Round Rock Campus, professor Son Chae Kim, of the St. David’s School of Nursing, says there’s a simple reason many people are unaware of this problem.

“Until recently, a lot of nurses didn’t report it. They believed it was just part of their job,” she says.

A closeup of a nurse's face in scrub cap and surgical mask

Kim is careful to point out that most patients are not violent or abusive, but aggressive outbursts have become all too common.

When nurses don’t feel safe, caregiver morale plummets and nurse turnover increases. That’s a trend that drives quality of care down and costs up.

All St. David’s School of Nursing students receive education on reporting and coping with on-the-job violence, but Kim is also working to create new ways for nurses to protect themselves and their patients.

She designed the Aggressive Behavior Risk Assessment Tool — the ABRAT. The tool is a 10-item patient evaluation checklist aimed at identifying potentially dangerous patients and situations.                                      

The Central Texas Veterans Health Care System (CTVHCS) in Temple is collaborating with Kim and may join in field testing the ABRAT, which also has the potential to improve care for veterans in both Veterans Affairs facilities and community settings, said Dr. Robin Keene of CTVHCS in Temple. 

“We are particularly excited to partner with Dr. Kim to refine and integrate a tool that will help guide nurses in creating evidence-based care environments that reduce risk and enhance resilience in veterans requiring emergency and acute care in hospital settings,” Keene said.


Key Stats:

From the U.S. Department of Labor:

  • More than half of ER nurses surveyed had experienced a violent incident in the previous week. 
  • Healthcare workers are four times more likely to miss work due to injuries from violence on the job.