Despite recent drops in overall violent crime in the U.S., violent crime is on the rise in key segments of society. One such segment is health care. Today, health care workers are estimated to be five times more likely to experience workplace violence than employees in other industries, according to the American College of Surgeons.
Emergency departments are high-risk environments where tensions run high, mental health and substance use crises intersect with medical emergencies, and security measures are often insufficient. Ninety-one percent of emergency physicians reported an increase in violence in the emergency department in 2023, a poll by the American College of Emergency Physicians found. Eighty-two percent of nurses reported experiencing at least one type of violence in the workplace in 2023, according to a report by National Nurses United.
In February, two health care workers were attacked by a patient with a knife at Provident Hospital’s emergency room on the South Side. One of these victims was an emergency medicine physician who was stabbed in the chest and had to be transported to a local trauma center.
In the same week, a gunman entered a University of Pittsburgh Medical Center hospital in York, Pennsylvania, killing a police officer and wounding a physician, a nurse, a custodian, and two other police officers. In the weeks prior to these incidents a patient attacked three ER health care workers with a knife in Halifax, Nova Scotia, Canada. These events are clear examples of the statistics demonstrating a growing epidemic of violence directed at health care workers.
Physicians, nurses and staff put themselves in harm’s way every day to serve and protect the public welfare. Exposure to blood and infectious agents is one such threat. However, such risks are mitigated through training, protective gear and system protocols to meet these threats. Sadly, such systems of protection against violent crime in the hospital are lacking. The rise of violence in emergency departments, hospitals and clinics represents a new threat which requires innovation and new strategically designed systems of protection.
The Illinois College of Emergency Physicians stands firmly in support of stronger protections for health care workers and urgent action to address this crisis. The problem is complex, requiring many solutions.
More security, building upgrades, incident reporting
One solution that the college has put forward in collaboration with state Sen. Laura Fine and state Rep. Natalie Manley are SB 2294 and HB 3435 respectively.
Both bills would strengthen existing laws to protect emergency physicians, nurses and emergency department workers from violence or threats of violence while at work. Specifically, the bills would require hospitals to meet threshold standards for preparing and preventing potential acts of violence, including provisions for security and facility upgrades.
More importantly, they would require hospitals to document and report violent incidents annually to the Illinois Department of Health detailing occurrences, injuries and security plan updates. Because hospitals are not required to report such incidents, the scope of health care violence is not fully appreciated. These bills would bring data for key stakeholders to use in determining next actions.
These bills are a great beginning, but the growing problem of violence in health care settings will require a multifaceted, comprehensive response. Violent incidents in the ER often stem from untreated mental illness and substance abuse disorders. Another possible solution will be the expansion of mental crisis intervention programs and investment in programs that combat substance abuse.
Emergency room physicians, nurses and staff are firmly committed to their professions and their patients. They deserve to come to work free from fear so they can focus on their jobs of saving lives and caring for others. Patients equally deserve to have health care environments free from violence.
Ensuring that Illinois emergency rooms and hospitals are free from violence is an essential component of high quality health care delivery that patients, physicians, nurses and health care workers deserve and expect. We can and must do better.
Will Sharp, MD, Ph.D., FACEP is president of the Illinois College of Emergency Physicians.
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