Is Workplace Violence Affecting Your Nursing Staff? A Simple Questionnaire Can Help
"Learn how a new questionnaire assesses workplace violence against nurses, offering a crucial tool for prevention and support."
Workplace violence in healthcare is a widespread and troubling issue, particularly affecting nursing professionals. From physical assault to verbal abuse and sexual harassment, nurses often face a range of aggressive behaviors that can lead to significant psychological, emotional, and even physical consequences. Recognizing and addressing this violence is crucial for protecting the well-being of nursing staff and ensuring the delivery of quality patient care.
Many healthcare facilities lack the necessary tools to accurately measure and assess the extent of workplace violence. The absence of validated instruments makes it difficult to identify the specific types of violence occurring, understand their impact on nursing staff, and develop effective prevention and intervention strategies. This gap in assessment capabilities underscores the urgent need for practical and reliable methods to evaluate workplace violence in healthcare settings.
A recent study focused on developing and validating a questionnaire designed to assess workplace violence experienced or witnessed by nursing staff. This questionnaire aims to provide a standardized and comprehensive tool for healthcare facilities to evaluate the prevalence and nature of violence in their workplaces, ultimately contributing to safer and more supportive environments for nurses.
A Persisting, Underreported Crisis Among Nurses
U.S. Bureau of Labor Statistics data for the two-year period of 2021–2022 show that the Health care and social assistance sector recorded the highest counts and annualized incidence rates for workplace violence of any private industry sector, including 41,960 total nonfatal cases requiring days away from work, job restriction, or transfer. The American Nurses Association notes that, according to BLS figures, health care and social service workers are 5 times as likely to suffer a workplace violence injury as workers overall, and 1 in 4 nurses reported being physically assaulted in a 2019 ANA survey. National Nurses United's 2025–26 Workplace Violence Survey—based on data collected from 1,267 RNs working in 28 states and D.C. between July 2025 and May 2026—confirms the problem persists, building on rates that have been surging nationally since the onset of the Covid-19 pandemic. Because these incidents are underreported, the already alarming rates may be considerably higher than official statistics suggest.
Why Safety Training Alone Falls Short
The conventional response to workplace violence in health care has centered on safety training, yet a review in the Journal of Advanced Nursing argues that addressing the problem requires a comprehensive approach beyond safety training alone. Active nurses' participation in intervention design and enhanced managerial support are essential for creating effective solutions, the review emphasizes. A systematic review published in PMC likewise notes that nurses may be subject to all kinds of workplace violence due to their frontline position in healthcare settings, which complicates any single-intervention strategy. Consensus papers have also called for strengthening the legislative and regulatory environment around workplace safety and bringing nurses' voices to the policy that directly affects their well-being.
From Shared Concept to Documented Rise
Foundational work includes the 2021 concept analysis by Al-Qadi, which applied Walker and Avant's eight-step method to clarify the concept of workplace violence in nursing and propose an operational definition of the concept. The analysis frames workplace violence and discrimination against healthcare workers as global, universal phenomena, with violence at work recognized as a serious and growing problem. Timeline reporting from nursejournal.org documents the rise in violence against nurses and the recent incidents to make headlines, alongside the steps healthcare centers can take to provide a safer workplace. A review in RN Journal nonetheless concludes that workplace violence in nursing is a systematic problem that threatens the safety, mental health, and retention of healthcare workers, and that past efforts have not been sufficient to reverse the rising rates.
A Questionnaire to Assess Workplace Violence: What It Measures
The questionnaire developed in this study is structured to capture various forms of workplace violence experienced by nursing staff. It goes beyond simply asking whether violence has occurred; it delves into the specifics of each incident, providing a more detailed understanding of the issue. Here’s a breakdown of what the questionnaire assesses:
- Physical Violence: Examines incidents involving physical force, such as assaults, pushing, or hitting.
- Verbal Abuse: Assesses experiences of yelling, insults, and disrespectful language.
- Sexual Harassment: Identifies unwanted behaviors of a sexual nature that create an offensive or hostile environment.
- Other Types of Violence: Allows staff to report any other forms of violence not covered in the previous sections.
- Prevention and Reduction: Gathers insights on existing measures and suggestions for improving workplace safety.
Toward a More Holistic View of Violent Events
A 2024 review in Nursing Outlook identifies important knowledge gaps in the literature: studies often focus on one type of violence—primarily patient-to-nurse physical events—while ignoring verbal threats or staff-on-staff events, which prohibits a holistic assessment of workplace safety. Many studies also do not address whether the nurse reported the incident to their employer, a critical omission for understanding the true scope of the problem. Writing in Health Affairs Scholar in 2026, a commentary frames workplace violence against nurses as an urgent patient safety issue, arguing that in hostile and dangerous work environments, patient safety and healthcare quality inevitably suffer. Together these pieces suggest the next wave of research must measure a broader range of violent events and track their reporting to support effective prevention.
Shared Responsibility vs. Employer Duty
The American Nurses Association's position statement frames workplace violence prevention as a shared responsibility, stating that employers across the health care continuum, including academia, have an ethical, moral, and legal responsibility to provide a healthy and safe work environment free from workplace violence. This framing highlights a recurring tension in how the problem is addressed: some guidance emphasizes the employer's duty, while practical resources such as Betternurse's overview of causes, laws, and prevention teach individual nurses the signs to watch for and the steps they can take to stay safe. The ANA statement emphasizes that nurses and employers must share and sustain a culture of respect, implicitly acknowledging that training individual workers alone will not resolve the crisis. Legal protections exist, but perspectives in the field differ on where the primary duty to prevent violence should rest, and critics note that such positions have not on their own reversed rising rates.
Measuring the Problem Across Settings
Direct comparisons across settings and studies are difficult because researchers and organizations define and measure workplace violence differently—some count only physical assaults while others include threats, verbal abuse, or staff-on-staff incidents. Exposure also appears to vary meaningfully by clinical environment, shift, and patient population, so a statistic that holds for one hospital may not transfer cleanly elsewhere. Published rates should therefore be treated as approximate and context-dependent rather than universal benchmarks. For most facilities, consistently tracking their own incidents over time is likely more informative than relying on figures drawn from other settings.
The Value of This Questionnaire: Creating a Safer Environment for Nurses
This newly developed questionnaire offers a valuable tool for healthcare facilities committed to creating a safer and more supportive environment for their nursing staff. By providing a standardized and comprehensive method for assessing workplace violence, the questionnaire enables facilities to:
Violence, Engagement, and the Nurse's Central Role
A 2025 analysis published in PMC examined the relationship between workplace violence and work engagement in nursing professionals, finding that violence in the workplace has become a phenomenon of growing concern and that nurses are one of the most exposed groups to this type of abuse. A concept analysis of workplace violence applies the concept analysis method to demystify the factors at play in the violence to which nursing staff are subjected, with the underlying intention of preventing such violence. Qualitative work published in Workplace Health & Safety concludes that workplace violence in health care is a multifaceted interplay of events with the nurse involved in all aspects of the process. The authors suggest these findings can be used by occupational health nurses in education and policy development, underscoring the practical payoff of research that reaches beyond description.
Policy as the Next Frontier
A consensus paper published in Nursing Outlook explores the current legislative and regulatory environment affecting workplace safety in organizations employing nurses and providing patient care. The work is aimed at mitigating the risk and occurrence of violence in the healthcare workplace, ensuring the protection of both the nursing and healthcare workforce and the public through policy recommendations. By bringing nurses' voices to the policy that affects their well-being, this consensus approach points toward legislative and regulatory change as a key frontier for the coming years. The trend is toward translating evidence on workplace violence into enforceable, cross-cutting protections rather than leaving safety to individual facilities alone.
Violence Within a Larger System
Nurses do not experience workplace violence in isolation; the problem sits within broader systemic conditions such as staffing levels, workplace culture, reporting practices, and pressures that have intensified in recent years. Formal data on these system-level dynamics remain limited, so conclusions in this area should be treated as provisional rather than settled. Still, the recurring observation across the literature is that no single training program or policy change has reversed the trend on its own. Durable improvement will likely require coordinated change in organizational practice, regulation, and the way incidents are measured and reported.
Lived Experience and Documented Incident
A qualitative study of nurses' lived experiences, published in PubMed, reports that workplace violence against nurses is a growing concern within the health care industry, contributing to increased stress, burnout, and higher staff turnover, and it examined the scope and impact of that violence based on nurses' recollections. A case study of the UCLA Medical Center 6 West unit in California, conducted by National Nurses United, recorded 37 violent incidents and seven violence-related injuries to employees during the study period from January 1, 2019 through May 7, 2024. A first-person account published by the American Association of Critical-Care Nurses recounts the author's experience with workplace violence and points to a rapid evidence review in the Journal of Emergency Nursing finding that programs promoting nurse awareness, de-escalation, and hands-on techniques are extremely valuable. Together these sources show both the human toll of violence and evidence-based tools for responding to it.
<ul><li><b>Identify the prevalence and nature of violence:</b> Pinpoint the specific types of violence occurring and understand their frequency.</li><li><b>Understand the impact on nursing staff:</b> Assess the psychological, emotional, and physical consequences of violence on nurses' well-being.</li><li><b>Develop targeted prevention and intervention strategies:</b> Implement evidence-based measures to reduce the risk of violence and support affected staff.</li></ul>
Ultimately, this questionnaire represents a crucial step towards fostering a culture of safety and respect in healthcare settings, ensuring that nurses can focus on providing quality patient care without fear of violence.