Policy Brief

Workplace Violence

Jade Henderson

Wilkes University

NSG 505: Health Policy & Politics for Adv. Nursing

Dr. Kwanza Thomas

March 1, 2026

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Workplace Violence

Introduction

In healthcare facilities, workplace violence has become a critical occupation and population health crisis that requires a severe advocacy of the nursing field, especially the Psychiatric-Mental Health Nurse Practitioners (PMHNPs). In the healthcare sector, employees are more likely to encounter workplace violence than any other industry and nurses are more likely to encounter it because of the proximity and constant contact they have with patients (Lim et al., 2022). According to Lim et al. (2022), violence can be verbal, threats, physical or even psychological intimidation and can be experienced in hospitals, outpatient clinics, long-term care facilities, and the community based setting. Workplace violence does not always end with immediate physical harm but also has psychological trauma, burnout, moral distress, attrition of the workforce, and undermined patient care. According to recent nursing research, workplace violence is widespread and underrepresented and it has become normalized, which weakens employee safety and workplace responsibility (Solorzano Martinez & De Oliveira, 2021). Since the PMHNP has a leading role in patient advocacy, systems-level thinking and mental health promotion, this problem should be addressed through organized nursing advocacy at institutional, state, and national levels to ensure safer practice conditions and safeguard both clinicians and patients.

Description of the Health Problem and Existing or Required Health Policy

Workplace violence in the healthcare sector can be described as any physical violence, threat of physical violence, harassment or intimidation along with disruptive behavior at the worksite (Lim et al., 2022). Violence in the healthcare setting is most often initiated by patients or visitors but can also be caused by colleagues or supervisors. The psychiatric and emergency departments suffer this risk especially because patients in acute mental illness, intoxication with substances or in delirium plus the extreme emotional distress involved in these environments (Schablon et al., 2022). Patients and families are frequently in contact with nurses which puts a high-risk for violence. Workplace violence has been related to reduced job satisfaction and higher turnover intentions among nurses due to chronic exposure (Solorzano Martinez & De Oliveira, 2021).

This has affected the policy response which has been inconsistent and disjointed despite the increase in awareness. The Occupational Safety and Health Administration has provided the guidelines on preventing workplace violence in the healthcare and social service environment, but such guidelines are not binding and are advisory (Arnetz, 2022). Lack of a national standard leads to differences in national protection. Additionally, literature reviews have highlighted the importance of formal organizational policies that involve effective reporting procedures, administrative backup and debriefing procedures on incidents to reduce the psychological impact on employees (He et al., 2026). Most institutions are operating on a reactive approach and not a proactive approach without regular policy provisions.

Workplace violence is extremely important to nursing since it directly influences the professional responsibility of safe, therapeutic care. The nurses are unable to promote the patient safety when their own safety is also in danger. The American Nurses Association has continuously supported the view that safe work environment is a fundamental right and professional expectation (Copeland, 2021). The therapeutic engagement and safety balance in the setting of psychiatric care is delicate, in which the PMHNPs handle patients with complex behavioral health requirements.

Lastly, the inability of facilities to handle workplace violence will affect the morale of the staff, destroy the confidence in leadership, and put the therapeutic milieu at risk. Systemic implications of the problem are supported by research, which indicates that environments with high levels of violence are associated with high burnout and reduced quality of care outcomes (Solorzano Martinez & De Oliveira, 2021).

Stakeholders Interested in the Health Problem

There are various stakeholders who are interested in solving the issue of workplace violence in healthcare. Primary stakeholders are nurses and other frontline healthcare professionals since they are the direct ones exposed to violent incidences and are the ones who suffer the psychological and physical effects of the same. The professional nursing organizations have a role in acting as a collective voice for safer work environments and stronger legal protections for nurses (Schimmels et al., 2025). Another group of stakeholders is the hospital administrators and healthcare executives. Even though safety policies are meant to be put into practice by the administrators, there is a need to balance between financial requirements, liability issues and work efficiency. When administration invests in stronger violence prevention efforts, it can make the workplace safer and lower staff turnover but these changes can still face pushback because of various reasons(Lim et al., 2022). State and federal policymakers are key stakeholders since they have the power to either adopt regulatory standards or provide funding for violence prevention programs (Livanos, 2023). Lastly, patients and their families may be stakeholders even though their interests on the matter may differ. The patients enjoy a safe and stable care environment where the clinicians can concentrate all their attention on therapeutic interventions.

Advocacy Plan on This Health Issue

Impact of the Health Problem on Health Policy and Politics

The issue of workplace violence has a major impact on the health policy and political discourse due to the fact that it overlaps with the retention of the workforce, community safety and the performance of the healthcare system. The increasing cases of violence have led to national debates on occupational safety of healthcare workers. Solorzano Martinez & De Oliveira (2021) point out that burnout and turnover due to constant exposure to violence increase nursing shortages, which also impact care accessibility and spending on health. Such workforce implications bring workplace violence beyond an occupational risk to a larger policy-level issue.

Additional policy responses are influenced by political arguments about funding of healthcare, staffing ratios, and services provided to the mentally ill. In a situation where the facilities are staffed insufficiently, the clinicians might not have enough personnel to contain escalating behavioral crises safely. Nursing management research indicates that organizations do not invest in preventative measures when the mandates and accountability structures are not formalized (He et al., 2026). Therefore, violence prevention in the workplace should be a part of the legislative debate on workforce stabilization and reforming the mental health system.

Interventions to be applied in this Advocacy

Advocacy should be aimed at total legislative and organizational change. On the legislative level, PMHNPs should mandate workplace violence prevention standards which would require annual risk assessment, standardized reporting procedures and mandatory staff trainings on de-escalation (Lombardi et al., 2026). Incorporating these requirements in enforceable laws would facilitate uniformity in the protection provided in healthcare systems. The fact that the organization supports and the decreased psychological damage are connected supports the idea that accountability is required and necessary (Solorzano Martinez & De Oliveira, 2021).

At the organizational level, the institutions ought to create interdisciplinary safety committees, which will examine the incident reports, examine the environmental risk factors and propose system enhancements. In psychiatric units, environmental interventions can be secure access points, alarm systems, proper illumination and room design. As Huang & Jiang (2024) indicate, the involvement of leadership and observable dedication to the safety of their staff members is a key factor that determine the organizational perception of support and resilience.

The role of health politics in the implementation of these interventions is significant. Cost analysis and workforce statistics are common responses to policymakers, thus, making advocacy effective by presenting data that prevention lowers turnover and liability costs (Arnetz, 2022). Forming coalitions with labor unions and mental health advocacy groups improves the political strength and ensures that the policies uphold patient-centered values.

Opposition that may be experienced

Healthcare administrators who care about financial aspects can be the key opponents to the idea of total reform of workplace violence. Resource allocation is needed to support environmental redesign, staffing training programs and increased staffing, which some organizations may find to be a burden. Some policymakers may resist regulations if they believe the requirements will increase operating costs (Lim et al., 2022). According to Copeland (2021), stakeholders believe that psychiatric violence is unpredictable and thus unresponsive to any policy.

Lastly, there could be increased stigma to mental health patients once preventive plans are put in place (Edwards & Morris, 2024). Opposition can only be overcome by addressing it with an open line of communication, evidence-based research and cooperative involvement with various stakeholders to ensure that safety programs maintain the dignity and respect of patients.

Conclusion

Workplace violence in the medical sector is a widespread and impactful phenomenon requiring systematic institutional, state and national nursing advocacy. In the case of PMHNPs, the clinical practice, professional well-being and patient safety directly relate to the issue. The exposure to violence at the workplace is associated with psychological distress, burnout and turnover which highlights the urgency of holistic prevention initiatives (Solorzano Martinez & De Oliveira, 2021). Nursing professionals can also make a change happen through research-based advocacy, interdisciplinary collaboration, and involvement in health politics. Treatment of workplace violence is not only the prevention of physical injury, it is to maintain a therapeutic setting and create a better mental health workforce. PMHNPs have an ethical responsibility to protect both patients and staff by supporting clear safety standards and proactive prevention efforts that strengthen the healthcare system.

References

Arnetz, J. E. (2022, April). The Joint commission's new and revised workplace violence prevention standards for hospitals: A Major step forward toward improved quality and safety. The Joint Commission Journal on Quality and Patient Safety, 48(4), 241–245. https://doi.org/10.1016/j.jcjq.2022.02.001

Copeland, D. (2021, April). A critical analysis of the American Nurses Association position statement on workplace violence: Ethical implications. Advances in Nursing Science, 44(2), E49–E64. https://doi.org/10.1097/ans.0000000000000345

Edwards, M. L., MD, & Morris, N., MD. (2024, March 1). How inpatient psychiatric units can be both safe and therapeutic. AMA Journal of Ethics, 26(3), E248–256. https://doi.org/10.1001/amajethics.2024.248

He, J., Yang, J., Yuan, J., Yu, Q., E. Stephano, E., Zhang, W., Li, Y., & Tian, Y. (2026, January). Workplace violence against nurses and Its Association with mental health and turnover intention: A national cross‐sectional study (Y. Oh, Ed.). Journal of Nursing Management, 2026(1), Article 2818047. https://doi.org/10.1155/jonm/2818047

Huang, H., Li, F., & Jiang, Y. (2024). Connor Davidson resilience scores, perceived organizational support and workplace violence among emergency nurses. International Emergency Nursing, 75, Article 101489. https://doi.org/10.1016/j.ienj.2024.101489

Lim, M. C., Jeffree, M. S., Saupin, S. S., Giloi, N., & Lukman, K. A. (2022). Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures. Annals of Medicine & Surgery, 78. https://doi.org/10.1016/j.amsu.2022.103727

Livanos, N. (2023, January). Keeping healthcare workers safe through policy initiatives. Journal of Nursing Regulation, 13(4), 81–83. https://doi.org/10.1016/s2155-8256(23)00033-9

Lombardi, B., Tapen, C., & Fraher, E. (2026, February 4). State laws that address workplace violence in health care settings. Health Affairs Scholar, 4(2), Article qxag022. https://doi.org/10.1093/haschl/qxag022

Schablon, A., Kersten, J. F., Nienhaus, A., Kottkamp, H. W., Schnieder, W., Ullrich, G., Schäfer, K., Ritzenhöfer, L., Peters, C., & Wirth, T. (2022, April 19). Risk of burnout among emergency department staff as a result of violence and aggression from patients and their relatives. International Journal of Environmental Research and Public Health, 19(9), Article 4945. https://doi.org/10.3390/ijerph19094945

Schimmels, J., Iennaco, J., Delaney, K. R., Hauenstein, E., Sharp, D., Brewer-Smyth, K., Kverno, K., Patch, M., Cadena, S., Blaakman, S., Arends, R., & Beeber, L. (2025, May). Protecting our nursing and healthcare workers with comprehensive strategies for preventing violence and promoting safety: An American Academy of nursing consensus paper. Nursing Outlook, 73(3), Article 102425. https://doi.org/10.1016/j.outlook.2025.102425

Solorzano Martinez, A. J., & De Oliveira, G. C. (2021, September). Workplace violence training programs for nursing students: A literature review. Journal of the American Psychiatric Nurses Association, 27(5), 361–372. https://doi.org/10.1177/1078390321994665