Violence Against Health & Social Service Workers

Categories: The Insider

Dr. Elbert Goodier III, a urologist in Louisiana, was murdered in his medical office by a patient. Dr. Michael Davidson, a cardiovascular surgeon in Massachusetts, was killed at the hospital by the son of a deceased patient. Theresa Hunt, a mental health caseworker in Pennsylvania, was killed by a psychiatric patient inside a mental health facility. Lara Sobel, a social worker in Vermont, was killed in the parking lot by a client who had recently lost custody of her child. Cynthia Barraca, a registered nurse in California, was murdered by an inmate at a correctional facility. Stephanie Moulton, a counselor in Massachusetts, was abducted and killed by a client at a mental health residential home where she worked. 

These mothers, fathers, grandparents, daughters, and sons who had lost their lives had one thing in common – they were health care and social service professionals who were killed by their own patients or clients. 

But we don’t hear a lot about their stories because workplace violence is a problem that is tolerated and largely ignored even though the statistics are quite alarming. Research has shown that employees working in health care and social service are twice as likely to face job-related violence as other occupations.  

And these statistics don’t even capture the impact on employees who survived the violent acts. They went to work to take care of people in their communities but were shot, stabbed, thrown against walls, suffer brain injuries or broken jaws and hips. Some became disabled and lost their careers or suffer from post-traumatic stress disorder. It shouldn’t be this way. These injuries and deaths are preventable. 

Injured and forgotten 

Workplace violence in the health care and social service sectors has been a huge problem that doesn’t get the attention it deserves. Between 2011 and 2013, there were 24,000 workplace assaults annually, and nearly 75% of those took place in health care and social service settings. 

In 2014, the Bureau of Labor Statistics reported that the employees in these two sectors alone suffered 52% of all the workplace violence incidents. In the private sector, workplace injury rates in the two sectors went up 64% between 2005 and 2014. It’s worse for state workers. Their workplace violence injury rates were nearly 10 times higher than those in the private sector.  

And these numbers come from employer reports. The actual numbers are a lot higher. According to one survey, 85% of incidents were not reported. 

What’s even more disturbing is the fact that their deaths and injuries are preventable. But more than 80% of U.S. employers report no change in their workplace violence preventive measures after a major violent incident.  

Inadequate prevention 

The U.S. has not been successful in preventing workplace violence. The Occupational Safety and Health Administration (OSHA) has stepped up efforts to address workplace violence in health care and social service, using its authority under the General Duty Clause of the Occupational Safety and Health Act, which requires employers to provide workers with a workplace free from recognized hazards that are causing or likely to cause death or serious physical harm. But OSHA's guidelines are voluntary and have not motivated employers to adopt preventive measures. 

Only a few states have workplace violence prevention laws, and some of those only cover state employees, so they do not cover all health care and social service workers in the private sector.  None of them cover federal employees who fall under the jurisdiction of federal OSHA, no matter what state they work in.   

What needs to be done 

Because OSHA guidelines are voluntary, we need a national standard that's enforceable and employers have to follow. That's why on July 12, AFGE and our allies which represent employees in these sectors petitioned the Department of Labor to adopt a comprehensive national standard to prevent workplace violence.  

The standard we're seeking includes the following measures: 

  • OSHA should expand the definition of “workplace violence” to include any threat of violence including those that do not result in injury and any incident that includes the use of a weapon regardless of whether the weapon was deployed. 
  • The new standard should cover all workers in the health care and social service industries, which employ roughly 15 million people and are expected to grow 21% by 2024. Many people are employed in healthcare in positions not directly related to patient care, such as food and custodial services workers. 
  • Employers should be required to develop and implement a written workplace violence prevention program within six months after OSHA has issued the new standard. The written program should include all the standardized procedures proven to prevent and reduce workplace violence. 
  • Employers should provide targeted workplace violence prevention training for all employees, contract workers, and temporary staff. 

“The need is urgent to develop a program standard to protect the 15 million people who risk their safety and well-being every day they go to work to care for the sick, the disabled, the elderly, and the mentally ill,” said AFGE and allies in our petition delivered to Dr. David Michaels, Assistant Secretary of Labor for OSHA. “Workplace violence should not be “just part of the job” for these dedicated individuals, but it is and will remain so until they are protected by an enforceable standard. 

“AFGE represents more than 100,000 nurses, doctors and frontline health care providers across government. Their safety, and the safety of all health care workers, is critically important,” said AFGE President J. David Cox Sr. “We strongly urge the Department of Labor to adopt a national standard for reducing workplace violence across the health care system and ensuring safe working conditions for all health care providers.” 

Besides AFGE, the organizations that signed on to the petition include the AFL-CIO, AFT, AFSCME, CWA, SEIU, USW, and Teamsters, with AFT taking the lead.


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