How do We Reduce Violence against Nurses?

By Marti Slay

How do We Reduce Violence against Nurses? | Alabama State Nurses Association;; Sarah Wilkinson-Buchmann, DNP, RN; Alabama Law Code: 13A-6-21

Nurses at the ASNA conference hold the signs that are posted in clinics alerting patients that violence against nurses is a felony.

Workplace safety is not a concern unique to healthcare institutions, but it is important. And as incidents of violence increase, it's most often nurses who are the victims.

"Nurses spend more time with patients than any other sector in healthcare," said Sarah Wilkinson-Buchmann, DNP, RN, president of the Alabama State Nurses Association (ASNA). "That makes them the natural target when patients take their anger out in violent ways. Patients who are naturally stressed about a health problem may feel frustration, which could be exacerbated by a long waiting time or other difficulties, but there is a proper way to address that frustration, and taking it out on the healthcare worker who is trying to provide a service isn't the right way."

Wilkinson-Buchmann ultimately sees policy as the long-term answer. "This begins with the opportunities that are provided within our state for access to care. It goes back to our legislature and policy formation," she said. "11 rural hospitals have closed in Alabama, and that trend is going to continue. People don't have insurance and don't have coverage. It's too expensive for them to see a private physician when they can't pay the bills, so they flock to the ERs in vast numbers, which leads to frustration."

While the biggest issue is concern for the safety of healthcare workers, Wilkinson-Buchmann said the problem of violence also needs to be addressed in order to avoid worsening the nursing shortage. "We are approaching a shortage of nurses by over 30 percent for next year so this is hardly a time to deter people from entering the profession over fear of their safety," she said. "We need to keep as many nurses as possible. The ASNA is looking to do everything we can to protect our nurses and allow them go about patient care safely. That benefits not only the nurses, but the safety of patients as well."

One such effort has been to place signs in clinical waiting areas to remind everyone that it has been a felony in Alabama to assault a healthcare worker since 2006.

When the ASNA surveyed Alabama nurses last year, they found that most nurses weren't aware that violence against them was a felony. If the nurses didn't know, the ASNA found it reasonable to conclude that patients and even hospital administrators didn't know either. They decided it was time to launch a public awareness campaign.

In the last legislative session, State Representative April Weaver and Senator Greg Reed sponsored a joint resolution to have signs posted in clinical waiting areas, in hopes of reminding patients and healthcare workers alike of the law. The signs read, "We respect you. Please respect our staff. Assault of a healthcare worker is a FELONY. Alabama Law Code: 13A-6-21."

Weaver, the only nurse currently serving in the Alabama legislature, has worked with the ASNA on legislation in the past, and she agreed to co-sponsor the resolution. "I have worked in situations that were very volatile, especially in emergency rooms," she said. "I certainly understood the concern of the nursing association and agreed to carry that legislation for them."

The resolution was well received and passed without problem. Wilkinson-Buchmann credited Weaver for her help. "We couldn't have done it without Representative Weaver or Senator Reed," she said.

Now the signs have been printed and the ASNA is beginning to distribute them to hospitals and clinics throughout the state. They are appearing at UAB and Huntsville Hospital and will soon be visible in more institutions.

"This initiative is gaining momentum," Wilkinson-Buchmann said.

Wilkinson-Buchmann hopes more nurses will join Representative Weaver in the process of making policy decisions. "Nurses need to be included in decision making, and not simply dictated to," she said. "We are the ones who provide most of the care and have the birds-eye view of what's going on in our facilities. Nurses need to be involved not only in policy formation, but in boardroom decisions as well."

For more information or to get copies of the signs for your institution, contact the Alabama State Nurses Association at