Expressing frustration with what they say are increasing incidents of violence at work, doctors at the Virginia College of Emergency Physicians are urging federal lawmakers to support a U.S. Senate bill that would give greater protections to health care workers . 

“I have been assaulted by patients hundreds of times —  have been punched, kicked, spit on, and had objects thrown at me and weapons pointed at me. All this from the patients whose lives I’m trying to save,” one doctor who has worked as an emergency physician for three decades wrote in a letter to Sens. Mark Warner and Tim Kaine, Democrats from Virginia. 

The emergency physician, who goes unnamed in the letter, isn’t alone. The Bureau of Labor Statistics says that 70 percent of private sector workers who “experienced trauma from nonfatal workplace violence” in 2019 worked in health care or related social assistance roles, making them five times more likely to be injured by violence at work than others. 

S.4182, the Workplace Violence Prevention for Health Care and Social Service Workers Act, would direct the Department of Labor to create enforceable standards to ensure health care and social services workplaces implement violence prevention, tracking and response systems. A companion bill in the House was passed in 2021. In 2019, the Virginia General Assembly passed legislation making it a Class 1 misdemeanor to threaten to injure or kill health care workers. 

State-level trends track national data, according to Toni Ardabell, chief of clinical enterprise operations at Inova, a major health care provider in Northern Virginia with 18,000 employees and more than 2 million patients a year. In 2021, 648 physical workplace violence incidents were reported within their hospital system and Ardabell assumes many minor incidents go unreported. By one NIH estimate, almost 90 percent of incidents are not formally reported. 

Ardabell cited the breakdown of the state’s mental health system as another possible factor in rising incidents of violence. Understaffing and overcrowding at publicly-funded psychiatric care hospitals have increasingly forced patients to stay in local emergency rooms instead of at state facilities, where they may not receive adequate care. Some private hospitals have dedicated mental health units where patients can receive proper care.

“What we are not equipped to deal with is the extremely physically abusive mental health patients,” Ardabell said. “The state closed beds in mental health institutions where these patients should be, and so there is not a real good solution for these patients right now.”

It is also common for family members of patients to take their anger out on workers. The highest concentrations of violence take place within emergency and behavioral health departments, with nurses in the ER being four times more likely to be assaulted than those in other departments, but Ardabell emphasized that there is no typical situation.

“The situations can really be all over the map. It could be a confused patient that hits someone in their confusion, it could be someone who purposely hits someone because of their anger,” Ardabell said. 

In the meantime, ER doctors continue push for better working conditions “The physical and verbal abuse and violence toward all ED staff is out of control. This bill is a decent start, but we need even more,” read another letter.

(Editor’s Note: The article was edited and re-published with permission by the Virginia Mercury.)