Attacks on healthcare workers more common than you might think

If you have been to a clinic or a hospital recently, you may have noticed newly posted signs that read: “We respect you. Please respect our staff. Attacking a healthcare worker is a FELONY.” These signs are now required to be posted at entrances and in patient waiting areas of healthcare facilities in the state because of a bill passed by the Arkansas General Assembly in 2023. Co-sponsored by Sen. Kim Hammer, R-Benton, and Rep. Lee Johnson, R-Greenwood, the bill was rare in that it was passed with strong bipartisan support.

If you’re like me and thought the types of incidents addressed by the bill and its required notice were also rare, then you’d be wrong. According to a Press Ganey analysis of the National Database of Nursing Quality Indicators, on average more than two nursing personnel were assaulted every hour in a single quarter in 2022, with the assaults coming not only from patients but also family members, visitors, and other co-workers.

That’s an alarming rate, but it’s also likely lower than the actual rate due to underreporting. Some healthcare workers do not report attacks because they expect or accept that violence is a part of the job or the work culture. Unfortunately, there have also been policy barriers that have made it difficult or risky to report attacks. The new Arkansas law addresses one of these, allowing healthcare workers who have been attacked to list a work address instead of a home address when filing a police report or complaint.

Physical attacks of healthcare workers are on the rise in the U.S., and there have been very disturbing instances of gun violence against healthcare workers, sometimes resulting in death. This phenomenon, combined with a rise in threats and verbal abuse toward healthcare workers, is bound to have an effect on the willingness of workers to continue to be on the frontlines of our healthcare system and for students to enter the pipeline.

Indeed, it is having that effect, according to a recent study by the Centers for Disease Control and Prevention, which noted that the percentage of health workers who reported feeling threatened or harassed by patients or others at work more than doubled between 2018 and 2022 to 13.4%. The increase in threats or harassment has been linked to higher rates of anxiety, depression, and burnout, according to the study. Ultimately, this cascades into high turnover rates, reductions in hours worked, or healthcare workers leaving the profession altogether, meaning that hospitals are forced to close departments, delay treatments or procedures, or fill vacancies at much higher costs.

It may sound alarmist, but the signs are compelling. Results from the 2022 National Nursing Workforce Survey show that about 800,000 registered nurses, roughly 20% of the workforce, said they were likely to leave nursing by 2027. It’s a similar story with doctors. According to a survey conducted in early 2022, 25% of primary care clinicians expected to leave primary care within the next three years.

This planned exodus will only compound existing primary care doctor shortages faced by Arkansas, particularly in rural areas. An analysis by the Arkansas Center for Health Improvement released in December noted that more than one-third of Arkansans live in health professional shortage areas, and six of the state’s counties have only one full-time primary care doctor apiece.

Although we remain hopeful that there is a pipeline to backfill a very needed workforce, the same pressures experienced by current clinicians are also impacting medical and nursing students. According to the “Clinician of the Future 2023: Education Edition” report, 60% of student survey participants worried about their mental health, and 23% of U.S. medical and nursing students were thinking about quitting their studies.

Fortunately, healthcare professional and industry groups have been raising awareness about these concerns and launching initiatives to address healthcare worker harassment, violence, and burnout. In 2022, the U.S. surgeon general issued an advisory on health worker burnout and resignation with recommendations for changing workplace culture, eliminating barriers to and encouraging seeking care for mental health and substance use disorders, and protecting the safety and well-being of workers, including protection from violence, threats and harassment.

The legally required notice that you will now see in clinics and hospitals across the state should serve as a signal that we should double-down on efforts to protect our health workers so they will continue to enthusiastically answer their call as healers, and so others will follow eagerly in their footsteps.

Editor’s note: Craig Wilson, J.D., M.P.A., is the director of health policy for the Arkansas Center for Health Improvement, an independent, nonpartisan health policy center in Little Rock. The opinions expressed are those of the author.