Workplace Violence in Nursing: How to Support Yourself and Your Team

Nursing is one of the most trusted professions, but it’s also one that faces the most risks.

From emergency rooms to home care visits, nurses regularly face verbal abuse, threats, and physical harm while doing their jobs. Many accept this risk quietly, believing it's something they’re expected to accept, but safety shouldn’t depend on how much risk a nurse is willing to carry.

We outline the causes of workplace violence in healthcare, what to look out for, and how to create a culture where nurses feel safe, supported, and heard.

Why workplace violence in nursing must be addressed now

Workplace violence against nurses has reached an unacceptable level across North America. In the U.S., nurses face three times the rate of workplace violence injuries compared to workers in other industries. Nearly half of all nonfatal workplace violence injuries happen in healthcare, even though the sector makes up just 10% of the workforce.

In Canada, it’s no better. A 2021 Ontario Nurses’ Association survey found that almost 70% of nurses had experienced or witnessed physical violence at work. Many deal with verbal abuse, threats, and intimidation on a daily basis.

The personal impact is real. Nurses report anxiety, burnout, physical injury, and PTSD as consequences of repeated incidents. In a 2023 Nurses National United survey in the US, six in ten nurses said they had either left, changed roles, or considered leaving the profession due to workplace violence. And it’s taking a toll—not just on retention and morale, but on the quality of care itself.

It’s no longer enough to quietly manage these risks shift by shift. It’s time to treat workplace violence as a system-level problem—with system-level solutions. Nurses, managers, and health systems need to speak openly, take clear action, and build the structures that protect everyone involved in care.

3 key factors contributing to workplace violence in nursing

Among the factors that contribute to high levels of workplace violence in nursing, the three most significant risks are: the high number of patients and visitors, a lack of nurses and hospital structure, and the pervasive belief that this workplace violence is normal.

1. Patient and visitor factors

Many violent incidents start with distress, not malice. Patients may be in pain, confused, or frightened, especially those dealing with dementia, brain injuries, mental illness, or substance use. In these moments, even routine care can trigger aggression, especially when fear and confusion are involved.

Family members and visitors may also act out when they feel powerless or frustrated, particularly during long waits or after receiving difficult news. Nurses, often the most visible point of contact, are frequently the first to absorb this tension.

2. Organizational and environmental factors

When staffing is stretched thin, care is delayed, stress rises, and situations are more likely to escalate. Nurses have less backup, and patients have fewer touchpoints for reassurance or redirection.

Safety tools and clear protocols also play a critical role. Without panic buttons, mobile alerts, or accessible duress systems, it’s harder to respond quickly. And when the reporting process is unclear or cumbersome, many incidents go unlogged, leaving patterns unrecognized and risks unaddressed.

3. Systemic and cultural factors

In too many workplaces, violence is seen as part of the job. This mindset leads to underreporting, silence, and burnout. When incidents aren't followed by action or support, trust breaks down, and the weight of staying safe falls unfairly on individuals.

Leadership response matters. A clear zero-tolerance policy, backed by consistent follow-through and staff engagement, sets the tone. Without it, accountability slips, and the burden of managing unsafe conditions falls on nurses themselves.

In both the U.S. and Canada, nursing unions and public health bodies have called for stronger prevention standards and clearer reporting expectations. But real cultural change begins at the unit level—with consistent support, honest conversations, and systems that back up words with action.

Addressing workplace violence: what can be done?

Foster a culture of safety and openness

Real change starts with honest conversations, especially about things we’ve been told to ignore.

• Build space into daily huddles and team meetings to raise safety concerns.
• Make it clear that all incidents should be reported, whether it’s a raised voice, a verbal threat, or physical aggression.
• Encourage nurses to speak up without fear of being blamed or ignored. When leaders listen and take visible action, teams feel supported and more willing to speak out again.

Invest in training and preparation

Training helps nurses feel more confident and prepared to respond and prevent violence.

• Offer regular de-escalation training that focuses on early signs of aggression and communication strategies to reduce tension.
• Run drills for situations like aggressive patient encounters or code white scenarios. These rehearsals build muscle memory and reduce response time.
• Include violence prevention in onboarding for new hires so that safety is part of the culture from day one, and follow up with ongoing training throughout the year.

Equip staff with the right safety tools

No one should have to rely on shouting for help when something goes wrong. The right tools make it easier to respond quickly and stay safe.

• Provide wearable healthcare panic buttons and mobile emergency alerts, especially in higher-risk units or during overnight shifts. Nurses need a discreet safety device to call for backup when they’re alone or under threat.
• Use digital reporting platforms that make it easy to log incidents in real time. These reports help surface trends before they become problems, so teams can adjust and prevent harm.
• Evaluate physical spaces with safety in mind. Prioritize clear exits, visibility, and secure environments where staff can retreat if needed.

Strengthen leadership response and accountability

What happens after an incident, and how leadership reacts, sends a strong message to the rest of the team.

• Ensure your zero-tolerance policies are visible and actionable, not just posted but regularly reinforced in meetings and training.
• When something occurs, follow up promptly with those involved. Provide support, communicate any next steps, and ensure that proper documentation is completed.
• Involve staff in unit walk-throughs, risk assessments, and policy updates so they see their concerns being taken seriously and help shape the solutions.
• If it’s a repeated occurrence, you should consider presenting the case for a safety solution to leadership. 

How nurses can stay safe and supported

All nurses and healthcare workers deserve to feel safe and supported at work. Leaders must protect, train, and support their teams by responding decisively to safety needs. 

Encourage nurses to recognize early warning signs

Most violent incidents don’t start suddenly. They build up. 

It might be a change in tone, an abrupt shift in body language, or someone ignoring your boundaries when they hadn’t before. These small moments are often the first warning signs of escalating behaviour. 

Just as nurses are trained to recognize clinical changes in patients, they should also be supported in identifying early signs of agitation or distress. Leadership can reinforce the importance of trusting those observations and encourage staff to speak up when something feels off. Creating space for early intervention helps reduce risk before a situation reaches a critical point.

Know and use the resources available

Every nurse should know what tools they have to stay safe. That includes how to trigger an alert, whether it’s a panic button, intercom, or mobile app, as well as how to file a quick incident report afterward. If your team is working alone or in a remote area of the hospital, make sure they are checked in using a lone worker system. These technologies aren’t just boxes to tick. They’re there to back your team up when it matters most. 

Also, encourage them to take a few minutes each shift to locate the nearest exits and note the location of your duress tools. In an emergency, seconds matter, and knowing where support points are can make a real difference.

Support mental health after an incident

The impact of workplace violence is not always visible. Even when an incident seems minor, it can leave lasting effects on mental and emotional wellbeing. Healthcare workers need time and space to process what happened, and they need to know that support is available.

At Aware360, we believe that no one should carry it alone or push through without support.

Resources like Employee Assistance Programs, peer support teams, and trauma-informed care services play an important role. Encouraging staff to use them helps normalize the response to stress and reinforces that recovery is part of staying safe at work.

Reactions such as fear, anger, or fatigue are common after a difficult event. What matters is that teams feel supported in acknowledging those reactions. Leadership presence and follow-up are key to creating that environment.

Foster a culture where speaking up is safe

Healthcare workers are more likely to report risks when they know their concerns will be met with action, not judgment. Creating a culture where staff can speak openly about safety starts with consistent support from leadership.

When nurses bring up issues, those concerns should be taken seriously. These patterns are often early indicators of deeper systemic problems and deserve immediate attention.

Leaders can help by listening closely, following up promptly, and closing the loop on concerns that are raised. It’s also important to make sure staff are included in safety rounds and policy updates. Their firsthand experience helps shape solutions that actually work in practice.

The more supported staff feel after speaking up, the more likely they are to raise concerns in the future. That trust is what builds a safer environment for everyone.

How Aware360 helps protect nurses on the frontlines

No one should feel alone in a high-risk moment. With Aware360, healthcare teams stay connected, supported, and ready to respond—wherever care takes them.

That’s what Covenant Health, a home healthcare and hospice provider in East Tennessee, prioritized when they equipped their nursing staff with Aware360’s AlertGPS solution. Their team often works alone in unfamiliar environments, visiting patients in homes that may be remote or unpredictable. With wearable devices that include an SOS button and real-time location monitoring, their staff can now discreetly signal for help and get immediate support if a situation turns unsafe.

The result? Nurses report feeling more confident and protected on the job. Managers know where their teams are and can respond quickly if someone needs help. It’s a simple, reliable layer of support that travels with them wherever care happens.

If you’re exploring new ways to support your nursing team, whether they’re in facilities, on the road, or working solo, we’d be happy to show you what’s possible.

Book a demo to see the tools we’ve built with frontline workers in mind.