Healthcare workers are assaulted more than any other workforce in America — five times more often than the average worker, according to Bureau of Labor Statistics data. A quarter of all registered nurses report being physically assaulted on the job each year. Most don't report it. Not because nothing happened, but because decades of hospital culture have told nurses that getting hit, bitten, scratched, or threatened is part of the job. In 2026, at least 20 states have decided it isn't. And a federal bill is waiting on the Senate.

The violence is not hypothetical. At Temple University Hospital in Philadelphia, an internal survey conducted in August 2025 found that 84 percent of registered nurses reported witnessing workplace violence on their unit. Not hearing about it — witnessing it. That is a number that should stop anyone reading it.

The Federal Bills That Could Change Everything

Two federal bills are currently moving through Congress, each targeting a different aspect of the problem.

The Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R.2531 / S.1232), sponsored by Rep. Joe Courtney (D-CT) and Sen. Tammy Baldwin (D-WI), directs OSHA to issue a mandatory standard requiring all healthcare and social service employers to develop and implement a workplace violence prevention plan. The standard would require site assessments, incident reporting, training, and post-incident response protocols. The bill passed the House with bipartisan support. As of April 2026, it is awaiting a Senate vote.

The Save Healthcare Workers Act takes a different approach: criminalization. Under this bill, assaulting a healthcare worker would become a federal felony, carrying up to 10 years in prison — or 20 years if a weapon is involved or the incident occurs during an emergency. This mirrors existing federal protections for airline crews. The bill is bipartisan. It has not yet reached a Senate floor vote.

Both bills have strong backing from the American Nurses Association, National Nurses United, and AFSCME. Both bills have repeatedly stalled. The primary obstacle cited by opponents: an estimated multi-billion dollar implementation cost for employers.

What States Are Doing While Washington Stalls

Frustrated by federal inaction, states have moved independently. As of April 2026, at least 20 states have enacted laws addressing healthcare workplace violence. The range of approaches varies by state:

  • Oregon (Senate Bill 537, effective January 1, 2026): Requires prevention-oriented plans covering hospitals, home health agencies, and hospice settings. Emphasizes prevention over reaction.
  • Utah (HB 380, introduced January 27, 2026): Requires hospitals to implement formal tracking and reporting systems for workplace violence incidents by November 2026, with data sharing to the state health department.
  • New York: New law requires hospitals to establish active violence prevention programs with front-line employee collaboration. General hospitals in high-population areas must have trained security personnel or off-duty law enforcement present in emergency departments at all times.
  • Massachusetts: The House passed legislation addressing healthcare worker violence; a Senate vote is pending.
  • Pennsylvania and Ohio: Both states are advancing bills requiring security plans developed with multidisciplinary input, and mandating that employees trained in de-escalation be present in high-risk departments like EDs and psychiatric units.

This patchwork of state laws represents real progress. It also means nurses in different states have dramatically different levels of protection — and that a nurse working across state lines, or as a traveler, may find the legal landscape shifts under their feet from one assignment to the next.

Who Is Most at Risk

Not all nursing settings carry equal risk. Bureau of Labor Statistics data and nursing surveys consistently identify the same high-risk environments:

  • Emergency departments — highest assault rates, due to acuity, altered mental states, and wait-time frustration
  • Psychiatric and behavioral health units — high rates of patient-on-nurse assault, with unique de-escalation demands
  • ICUs — critically ill patients and high-stress family members create elevated tension
  • Long-term care and SNF settings — cognitively impaired residents and understaffed units combine for chronic risk
  • Home health — nurses isolated from colleagues, working in uncontrolled environments with no security

Across all settings, nurses working night shifts report higher rates of assault than day shift workers. The data is not ambiguous. The question is whether hospitals and legislators are willing to act on it.

Why This Matters for Nurses — Jayson's Take

I worked psych. I worked correctional nursing in a maximum-security facility. I've worked nights in ICUs. Violence against nurses is real, it's routine, and the most damaging thing that has ever been done to nurses on this issue is telling them it's normal.

"It's part of the job" is not a policy. It's a refusal to have one. The reason these federal bills keep stalling isn't because violence against nurses is controversial — it's because the implementation cost lands on hospital systems that spend heavily on lobbying. States are moving because the political calculus at the state level is different. Every nurse reading this should know what protections exist in their state. Check your state's BON website, your hospital's workplace violence prevention policy, and whether your union contract includes specific violence protections. If your hospital doesn't have a formal workplace violence prevention plan, ask why. That question, asked by enough nurses, is its own form of pressure.

The Under-Reporting Problem

Any discussion of violence against nurses has to grapple with what researchers call the under-reporting crisis. Studies consistently find that fewer than half of workplace violence incidents in healthcare are formally reported. Nurses cite several reasons: fear of being disbelieved, fear of retaliation, the administrative burden of filing reports, and a cultural norm that says absorbing violence is what good nurses do.

This under-reporting creates a compounding problem: hospital administrators and policymakers can look at low incident report numbers and conclude that violence isn't a significant issue at their facility. The data is only as good as reporting rates. Until nurses report consistently — and until reporting is easy, anonymous where needed, and free from retaliation — the full scale of the problem remains hidden.

Oregon's SB 537 and Utah's HB 380 both directly address reporting requirements. They treat data collection as a foundational step, not an afterthought. That framing is correct. You cannot solve a problem you aren't measuring.