One of the questions we have received from our website since beginning our focus on workplace violence in health care is: Why?  

Why is workplace violence (WPV) in health care on the rise, and why is the healthcare industry becoming one of the nation’s most violent fields?  

The answers to these questions, according to the Occupational Safety and Health Administration (OSHA), are the focus of today’s post.

History of Violence

Whether in a large urban hospital or a small rural medical facility, hospital workers frequently work with people who have a long history of violence, are under the influence of drugs or alcohol, or are delirious. One study, published in February 2023, found that people who use drugs “frequent emergency departments at a higher rate than the general population” and “experience a greater number of chronic conditions,” all of which can increase WPV in a health care setting. 

Further, because of a lack of funding for mental health services, severely mentally ill patients with violent tendencies are turning to emergency departments for help. However, these patients would receive better treatment – and likely be less violent – if specialized facilities designed to help them were available.  

Working Alone

Some health care workers work alone, which can be a stressful and dangerous situation. According to OSHA, they face increased risks of WPV from patients, visitors, or intruders for several reasons:

  • Remote locations: Health care workers may have to work in remote areas of the hospital far from security or other staff.
  • Isolation: Workers may be alone with patients during examinations, treatments, or procedures, making them vulnerable to verbal or physical attacks, especially if patients are agitated, confused, or under the influence of drugs or alcohol.
  • Medical procedures: Workers may have to perform tasks that can cause discomfort, pain, or anxiety to the patient. These can trigger violent reactions from patients or their family members if they are present.
  • High activity: This is of particular concern during certain times of the day. According to the Centers for Disease Control and Prevention, “violence often occurs during times of high activity and interaction with patients, such as at mealtimes and during visiting hours.”

Poor Environmental Design

To improve safety, some hospitals needed better designs from the start. Others become cluttered as more equipment, curtains, and partitions are added to work areas. Still others may need better lighting. Whatever the reasons, poor environmental design and poor lighting create hidden areas, making them perfect WPV settings.

Poor Communication Systems

Poor communication systems can lead to life-threatening situations for patients and health care workers. A health care worker who is experiencing a WPV incident, or is fearful one may occur, may find they are unable to contact security due to poor communication systems.


According to the OSHA report, there is a perception that violence is tolerated in health care settings and reporting incidents has no effect. We mentioned this in an earlier blog post: in some cases, hospital administrators discourage health care staff from reporting such incidents. This culture leads to more incidents of WPV.

Inadequate Security Staff

While some larger hospitals have the means to invest in more security personnel, this may not always be true of smaller medical facilities. But what makes the situation worse is that simply adding more staff may not be enough to address the increase in violence in health care settings.

The Big Why and Poor Security Planning

TAL Global finds that many health care administrators have not invested in action plans to address WPV in their facilities. They may believe that hiring more security staff will be sufficient. That may help, but it is not enough.

The first step in creating an action plan requires several assessments. These include the following:

  • A risk assessment to establish the probability an incident may occur and the consequence if it does. 
  • Conducting a facility security assessment to evaluate current security countermeasures and their effectiveness. 
  • Evaluating existing WPV and security policies to determine their appropriateness. 
  • Looking for and reporting security gaps that can help eliminate risks and WPV.

These are just some of the assessments that should be conducted. However, after working with medical facilities around the world, we have concluded that when it comes to WPV and security, no two hospitals are the same.  Creating a customized program is often required to combat WPV.

Ensuring the safety of hospital staff is imperative. As to answering the big why, the first step is to contact a well-established firm specializing in security consulting and risk assessments.

TAL Global is an elite security, consulting, and risk management firm that protects human and physical assets around the globe. For more information email:



© TAL Global, 2019