Workplace Violence Prevention

Violence in emergency departments has reached epidemic levels and emergency nurses are particularly vulnerable. In fact, the health care industry leads all other sectors in the incidence of nonfatal workplace assaults, and the emergency department is a particularly vulnerable setting. It’s currently a felony to assault an emergency nurse in 31 states, and we’re working hard to make it a felony in all 50 states.

ENA believes emergency nurses have the right to education and training related to the recognition, management, and mitigation of workplace violence. The mitigation of workplace violence requires a “zero tolerance” environment instituted and supported by hospital leadership.

The resources below were designed to help emergency nurses conduct and participate in research and quality improvement initiatives aimed at preventing, mitigating, and reporting workplace violence.


No Silence on ED Violence

According to surveys by the American College of Emergency Physicians and the Emergency Nurses Association, almost half of emergency physicians report being physically assaulted at work, while about 70 percent of emergency nurses report being hit and kicked while on the job. Furthermore, the vast majority – 80 percent – of emergency physicians say violence in the emergency department harms patient care. Similarly, emergency nurses report that the harmful consequences of experiencing a violent event at work interfere with the delivery of high-quality patient care.


No Silence on ED Violence Logo

The frequency of violent attacks on nurses, physicians and patients in our nation’s emergency departments is unconscionable and unacceptable. For medical professionals, being assaulted in the emergency department must no longer be tolerated as “part of the job.”

In an effort to meaningfully minimize these attacks and protect emergency department professionals, ENA and ACEP launched a new campaign called “No Silence on ED Violence.” This joint effort aims to support, empower and provide the resources our respective members need to effect safety improvements at their workplace, while engaging state and federal policymakers, stakeholder organizations and the public at large to generate action to address this crisis.

Join Us

Online Education

Workplace Violence Prevention Course
Workplace Violence in the ED is an overarching problem. To better prepare you, ENA's updated Workplace Violence Prevention online course educates nurses, managers and staff who work in the emergency care setting how to recognize and mitigate all types of violence, including incidents precipitated by consumers/visitors, intruders, employees, and management. Free for ENA members!


Position Statement: Violence and Its Impact on the Emergency Nurse

ENA recognizes emergency nurses are at significant occupational risk for workplace violence and emergency nurses have the right to personal safety in the work environment.

Guiding Principles: Mitigating Violence in the Workplace  
ENA and the American Organization of Nurse Executives (AONE) created these guiding principles to assist nurse leaders in systematically addressing measures to manage and reduce violence against healthcare professionals. The guiding principles include steps to systematically reduce lateral, as well as patient and family violence in the workplace.

Toolkit for Mitigating Violence in the Workplace 
ENA and the American Organization for Nursing Leadership created a toolkit to provide a step-by-step approach to mitigating violence in the workplace.

Research and Articles

Nothing Changes, Nobody Cares: Understanding the Experience of Emergency Nurses Physically or Verbally Assaulted While Providing Care
Journal of Emergency Nursing, January, 2014 
This qualitative study was designed to better understand the experience of emergency nurses who have been physically or verbally assaulted while providing patient care in US emergency departments. The findings are consistent with existing literature but with an added contribution of clearly identifying an underlying cultural acceptance of violence in the emergency department, as well as a distinct lack of cue recognition.

Emergency Department Violence Surveillance (EDVS) Study(2011)
ENA initiated a workplace violence surveillance study to collect data on a quarterly basis via an online survey from emergency nurses on the occurrence of violence toward nurses and the processes used to respond to workplace violence. This two-year report represents analysis of eight consecutive rounds of data collected approximately three months apart. As no other dataset exists that is as large or comprehensive in its focus on emergency nurses, we are continuing to provide this data, despite its age, as a benchmark for future research and mitigation initiatives.

Violence Against Nurses Working in US Emergency Departments
JONA: Journal of Nursing Administration, July/August 2009
A total of 3,465 emergency nurse ENA members participated in a cross-sectional study aimed at investigating emergency nurses' experiences and perceptions of workplace violence, the types of and frequencies of assaults, and the contributing factors to workplace violence.