'Many of us don't feel safe': Emergency doctors urge Congress to help with violence

Many emergency doctors and nurses don’t feel safe on the job.

Nine out of 10 emergency doctors say they or a colleague were a victim of violence in the past year, according to a 2024 survey of the American College of Emergency Physicians.

Dr. Patsy Chenpanas, president of the Oregon chapter of the American College of Emergency Physicians, says the violence in the emergency department is a national problem, and it’s getting worse.

“Providers are always worried and stressed about being assaulted while they're just trying to do their jobs,” she tells Chief Healthcare Executive®.

Scores of emergency doctors have gone to Washington, D.C. this week to meet with lawmakers and legislative staff to draw attention to the issue.

They are also pushing Congress to pass the Save Healthcare Workers Act, a measure that would make it a federal crime to attack employees of hospitals and healthcare organizations. Some states have similar laws, but groups representing doctors and hospitals have pushed for a federal law as well.

“The workplace conditions are becoming hazardous to the point that … I think many of us don't feel safe at work, and we want to come to work,” Chenpanas says. “The thing is, we want to be there. We want to take care of our patients.”

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‘That level of stress’

The American College of Emergency Physicians and several other organizations issued a joint statement denouncing violence aimed at healthcare workers. Other groups joining the statement include the American Hospital Association, the Children’s Hospital Association and the American Nurses Association.

“Workplace violence erodes the safety and dignity of health care environments, directly contributes to workforce burnout and turnover, and compromises the quality of care for patients,” the groups said.

Doctors and nurses who work in emergency departments generally agree that while violence has been a problem for years, they are seeing more assaults, threats and aggressive behavior from patients and families.

There are a number of factors contributing to the problem, doctors and hospital leaders say. Hospitals are seeing more patients in emergency departments, and some of those patients are staying in the emergency room for longer periods due to a lack of available beds.

“The wait times are already long, the resources are very limited, so there's already frustration when people arrive to the emergency department,” Chenpanas says. “And then with limited resources, it's getting harder in the era of boarding and crowding to do our jobs.”

“The amount of people that are seeking emergency care has just been on the rise ever since the pandemic, and it has not stopped. And so there's just kind of a perfect storm right now, with all of these factors contributing to workplace violence being on the rise,” she says.

The level of violence in hospital emergency departments also has an impact on patient care.

“There's that level of stress, there's physical injury, which actually limits you from being able to provide care for patients,” Chenpanas says. “So if you are physically injured, you have to stop providing care and get care yourself.”

She says that situation happened in her own emergency department when a colleague was assaulted.

“He couldn't do his job any further because .. he became the patient, unfortunately, himself,” she says.

She says the violence also takes a toll on other patients waiting for treatment in the emergency room.

“As a patient in the emergency department, you're now witnessing someone else get assaulted in front of you,” Chenpanas says. “And so I wouldn't want my family or friends being in a department to seek care for their medical illness or injury, and then have to be in a situation that's dangerous as well. So I don't want patients to witness that, to feel unsafe while they need to be there.”

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Leaving the field

For some doctors and nurses, the constant threat of violence in the emergency room simply becomes too much, and they end up walking away. And she says that’s a factor in turnover in the emergency department.

“Some of our healthcare workers unfortunately have to take time off due to workplace violence and then never come back because the amount of stress, the psychological injury, and just the moral injury …. feelings that you carry with you after being assaulted for just trying to do your job and help people. That never goes away, and some people feel that that's too much to bear, so they don't come back,” Chenpanas says.

“It's actually leading a lot of providers to just leave the field altogether, and you already have a shortage of nurses and doctors, especially in certain areas,” she says.

Hospitals need to have security and metal detectors, Chenpanas says. She also points to the value of hospitals placing signs warning that violence against staff is unacceptable and will be prosecuted.

In airports, she says, “That messaging is very apparent. It is not apparent in a hospital or an emergency department, and I think it should be just to tell people and discourage people from wanting to assault a healthcare worker.”

Such signs also send a message to staff that hospital leadership is looking out for them.

“That sort of support from the hospital is so valued by its employees,” Chenpanas says.

“I think that as an institution, it just makes sense to want to try to foster an environment where everybody can feel safe,” she says. “It's not just about the people who work there. As a patient, if you see the signs also discouraging violence, then you feel better about having to be there and coming there to seek care as well.”

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