State's health workers deserve protection from violence

Workplace violence is a serious occupational hazard in hospitals and other health care facilities, a fact that has escaped an unsuspecting public. Nationally, nursing assistants employed by nursing homes have the highest incidence of workplace assault among all workers, according to federal data. For women who work in nursing homes, social services and hospitals, the likelihood of being harmed on the job is like that of women working the late-night shift in convenience stores.

To draw attention to these and other hidden risks, the Alliance Against Workplace Violence has designated April as Workplace Violence Awareness Month. On April 28 each year, the unions of the AFL-CIO observe Workers Memorial Day.


In Maryland, health care and social assistance workers made up just 16 percent of the state's workforce but accounted for 62 percent of workplace violence incidents that resulted in at least one day away from work in 2010, the most recent year for which figures are available.

Earlier this year, a broad coalition of stakeholders including workers' unions, the Maryland Hospital Association and advocacy groups came together to address workplace violence in Maryland. The Safe Care Act, legislation that would have strengthened violence prevention at health care facilities, was introduced in the 2013 General Assembly session but withdrawn after stakeholders representing nursing homes and assisted living facilities strongly opposed the measure.


The bill would have improved safety by requiring public and private facilities to establish violence-prevention committees consisting of management and employees; establish a violence-prevention program; produce annual violence assessments, and provide regular training for employees. Workplace Violence Awareness Month calls for greater attention to needed steps such as these.

Opponents of the Maryland legislation representing nursing care and assisted living organizations claimed they already have extensive standards and protocols for dealing with workplace violence that are tailored to the individual environments where they care for patients and residents. Not so. Nursing homes in Maryland are required to develop a personal care plan for residents' health and safety, but not to identify and control workers' assault hazards.

I am distressed that the bill was withdrawn. For more than 20 years, I have worked with numerous health care organizations across the nation to develop programs and policies to reduce workplace violence. This effort supported the passage of state workplace violence prevention laws in Washington and New York. I have conducted federally funded research that has demonstrated the feasibility and impact of developing and implementing a comprehensive violence prevention program, similar to that of the Safe Care Act. Such legislation brings together workers and health care organizations to systematically assess and control the risk of violence to staff and patients alike.

Opponents were also concerned that passage would stigmatize the populations they serve. The public needs to keep in mind that acts of aggression and violence in the health care environment, while unintended by the perpetrators and often due to their underlying pathology or illness, are undeserved by the staff. Exposure to work-related aggression and violence increases the risk of non-therapeutic and negative responses by staff, ultimately leading to diminished quality of care.

Although health care workers must wait another year to be assured that Maryland's elected officials take their safety seriously, it is everyone's responsibility to hold health care facilities accountable. We need to make sure they are safe places to work and receive care. After all, at one point or another, health care facilities are used by all of us.

Nothing new would be demanded of any facility that already has put in place a voluntary workplace violence plan that meets the simple criteria in the Safe Care Act. Its common-sense approach to preventing staff injury and improving patient care is one that employers should embrace for the safety of their staffs.

The Safe Care Act, or a future bill like it, is further needed to improve institutional productivity and patient care. The lack of such a law could potentially diminish the overall strength of Maryland's health care system at a time of rapid expansion and change — a time when trained, empowered health care professionals are more important than ever.

At least nine other states have passed laws that require workplace violence prevention programs in health care facilities. Maryland, a state recognized for its world-class health care institutions, should do the same to protect our health care workforce.


Jane Lipscomb is a professor at the University of Maryland School of Nursing. Her email is