Running header: WORKPLACE VIOLENCE

Using Legislation to Mitigate Workplace Violence in Healthcare

Michelle Stimson
Ferris State University

WORKPLACE VIOLENCE

Abstract
Workplace Violence is an escalating problem in healthcare. Violent assaults against healthcare
workers are on the rise (United States Department of Labor [USDL], 2014). Emergency nurses
are particularly vulnerable to workplace violence (Gacki-Smith et al., 2009; Wolf, Delao, &
Perhats, 2014). In several states, nurses have gained protection from workplace violence through
legislative efforts (Emergency Nurses Association [ENA], 2013). Laws protecting police
officers and emergency personnel against assault while performing their job-related duties are a
commonplace throughout the United States. Nurses in the State of Michigan believe they are
entitled to the same level of protection (Michigan Nurses Association [MNA], 2014). Why
nurses in the State of Michigan are attempting to obtain that level of protection and how
workplace violence has impacted healthcare is discussed.

WORKPLACE VIOLENCE

Using Legislation to Mitigate Workplace Violence in Healthcare

Workplace violence (WPV) in healthcare is a serious and growing problem. According to
the Emergency Nurses Association (ENA), workplace violence in healthcare occurs 3.8 times
more often than in any other private industry (Emergency Nurses Association [ENA], 2010). In
2010, the Bureau of Labor Statistics reported that healthcare and social assistance workers were
victims of approximately 11,370 assaults (U.S. Department of Labor [USDL], 2014). That
accounts for a 13 percent increase in reported assaults since 2009 (USDL, 2014). Emergency
nurses are particularly vulnerable to WPV (Gacki-Smith et al., 2009; Wolf, Delao, & Perhats,
2014). Several states have passed legislation making it a felony to attack or batter a nurse while
performing their job-related duties (ENA, 2013). The State of Michigan has entertained similar
legislation (Michigan Nurses Association [MNA], 2014). This paper will discuss that legislation,
why WPV is a problem in healthcare; particularly for emergency nurses, and what position
different stakeholders have taken on the issue.
Workplace Violence is a Healthcare Problem
Workplace violence is defined as "any act or threat of physical violence, harassment,
intimidation, or other threatening disruptive behavior that occurs at the work site" (USDL, 2014).
It includes emotional and/or verbal abuse (Wolf et al., 2014). In healthcare, it is the most
common cause of missed work days due to a non-fatal injury (Wolf, et al., 2014). Thirty-five to
80 percent of hospital staff have endured a physical assault while providing patient care (GackiSmith et al., 2009). Patients and their family members are the most common perpetrators of
WPV in healthcare and emergency nurses are particularly vulnerable (Gacki-Smith et al., 2009;
Gillespie, Gates, Kowalenko, Bresler, & Succop, 2014). According to Wolf et al. (2014), over 70
percent of emergency nurses have experienced physical or verbal assault while providing patient
care. Even though these statistics are alarming, it is assumed that many incidences go unreported
(Gacki-Smith et al., 2009; Wolf et al., 2014).

WORKPLACE VIOLENCE

Twenty-four hour accessibility, lack of adequate security measures, high stress situations,
cramped spaces, long wait times, psychiatric emergencies, and patients under the influence of
drugs and alcohol make emergency departments (EDs) especially vulnerable to violence (GackiSmith et al., 2009; Wolf et al., 2014). Crowding in EDs is worsening. Emergency departments
have decreased in number since 1995 along with inpatient beds (Nolan, Fee, Cooper, Rankin, &
Blegen, 2015). At the same time, ED visits have increased from an average of 23,119 to 30,388
per ED annually (Nolan et al., 2015). The availability of inpatient psychiatric beds has declined
sharply (Nolan et al., 2015). One out of every eight patients seen in an ED involves a psychiatric
condition (Nolan et al., 2015). Gillespie et al. (2014) found an increase in physical assaults and
threats when staff cared for patients with psychiatric conditions. Reduced inpatient beds for
medical and psychiatric patients, added to overall decreased ED capacity, has led to increased
ED crowding, further increasing opportunities for WPV against nurses.
Nurses are negatively affected by WPV. It not only leads to physical damage, but to
psychological damage as well (Gacki-Smith et al., 2009; Wolf et al., 2014). Nurses report fear of
returning to work, working alone in areas such as triage, and caring for patients that trigger
painful memories (Wolf et al., 2014). Symptoms of post-traumatic stress disorder (PTSD) may
also occur (Gacki-Smith et al., 2009; Wolf et al., 2014). Emergency nurses leave the profession
as a result (Wolf et al., 2014). Not only do long term physical and psychological consequences
to WPV exist, but it also leads to nurse burnout, staff turnover, and impaired delivery of safe and
effective patient care (Wolf et al., 2014).
Patients and employers are adversely affected by WPV as well. Decreased productivity,
workers compensation claims, legal liabilities, and fines by regulatory agencies can be costly
(Gillespie et al., 2014). Nurses are frontline caregivers for many health consumers. Threatening
or assaulting a nurse can lead to compromised care and poor patient outcomes (Gillespie et al.,

WORKPLACE VIOLENCE

2014). For these reasons, WPV in healthcare must be addressed. A multipronged approach is
needed to eliminate it, however, legislation protecting nurses against WPV can play a role in
making Michigans healthcare settings safer for everyone.
Workplace Violence Legislation in the State of Michigan
Legislation protecting healthcare workers, including nurses, against WPV resides at the
state level. Currently, while emergency medical service personnel such as police officers,
firefighters, and paramedics are protected against WPV in the State of Michigan, nurses are not
(MNA, 2014). In 2013, legislation was introduced to the Michigan Legislature making it a
felony to assault a healthcare professional while performing their job-related duties (MNA,
2013). A healthcare professional is defined as "an individual who is employed by a hospital,
health system, or health care provider, and whose duties involve the provision of direct patient
care and require licensure, certification, or other regulation under the Public Health Code or
supervision by another person who is regulated under the Code" (Michigan Legislature, 2013a).
Senator Goeff Hansen (R-34) introduced Senate Bills 0250 and 0360 (Michigan
Legislature, 2013a, 2013b). They are amendments to the Michigan penal code and carry a fee,
jail time, or both (Michigan Legislature, 2013a, 2013b). These Bills extend similar protection to
nurses that many professionals in other hazardous professions interacting with the public already
receive. Senate Bills 0250 and 0360 overwhelmingly passed the Senate on June 12th, 2013
(MNA, 2014). Afterwards, they were referred to the Michigan House of Representatives where
they sat in the Committee of Criminal Justice (MNA, 2014). Since no action was taken on them
during that time, the bills "died" while in committee (MNA, 2014).
Mandated WPV prevention regulations are lacking in healthcare (Gacki-Smith et al.,
2009). Currently, the Occupational Safety & Health Administration (OSHA) does not require
employers to adopt specific preventative measures (USDL, 2014). The standards are voluntary
and are not strictly enforced. Workplace violence in healthcare is recognized by state legislators

WORKPLACE VIOLENCE

around the country as an issue that needs addressed legally. Thirty-four states have passed
legislation making it a felony to attack or commit battery against an emergency nurse (Trotto,
2014). The ENA and Michigan Nurses Association (MNA) support this type of legislation
(ENA, 2010; MNA 2014). Like firefighters and police officers, nurses cannot simply walk away
from their job-related duties. On an interesting note, it is a felony to attack a police officer in
every single state across the United States (Trotto, 2014).
Wolf et al. (2014) researched the experiences of emergency nurses victimized by WPV.
Themes of a justice system unwilling to pursue charges against perpetrators, lack of support from
public officials, and feelings of frustration and anxiety were consistently found. Nurses felt
vulnerable and unsafe at work as a result (Wolf et al., 2014). Many WPV incidents are
underreported (Gacki-Smith et al., 2009; Wolf et al., 2014). This is attributed to inconsistent
handling by law enforcement and low conviction rates (Gillespie et al., 2014).
In my opinion, assaulting a healthcare worker, including a nurse, while they are
performing their job-related duties should be a felony. Nurses do not have the ability to refuse
care to patients in an emergency setting. This exponentially increases their vulnerability to
violence. Linda Reetz, the Director of Emergency Services for Sparrow Health System, believes
that nurses are at a greater risk for violence than police officers (personal communication, March
25, 2015). "Police officers are always on alert for their safety. It is on the top of their mind.
Nurses on the other hand, are thinking about how they can help their patients feel better and
improve their overall well being. Because of this, they are not prepared to act when the patient
lashes out verbally or physically" (L. Reetz, personal communication, March 25, 2015).
Implications and Consequences of Legislation
With any change in policy comes change within the community it affects. Legislation
such as Senate Bills 0250 and 0360, have implications for nursing and the public and could help
them gain increased protection against the negative effects of WPV. However, convicting

WORKPLACE VIOLENCE

perpetrators might increase imprisonment and law enforcement costs, as well as, potentially
decrease efforts towards preventative measures.
Emergency nurses do not feel safe in their work environment and hospital administrators
have failed to change that (Gacki-Smith et al., 2009; Wolf et al., 2014). Lack of incident
reporting and post-violence care suggests that ED leaders have not made WPV a priority
(Gillespie et al., 2014). Government agencies have not mandated healthcare organizations to
adopt WPV prevention programs (Gacki-Smith et al., 2009). Nurses feel vulnerable as a result
(Wolf et al., 2014). The nature of WPV is multifaceted. Many healthcare organizations have
used one-dimensional approaches to mitigate the problem such as education or increased security
measures (Doby, 2015). This approach has proven to be ineffective and does not compensate for
the nature of this violence (Doby, 2015). Legislation that increases workplace safety for nurses
could decrease feelings of vulnerability and perceived lack of safety.
Societal complacency towards this type of violence exists (Wolf et al., 2014). Nursing
has tolerated a culture in which WPV is considered "part of the job" (Wolf et al., 2014). It has
led to underreporting, penalization of victims, minimal consequences for perpetrators, and the
attrition of highly skilled nurses (Wolf et. al, 2014). As a result, nurses report feeling as if
"nothing changes and nobody cares" (Wolf et al., 2014). Without appropriate legislation,
prosecuting offenders is very difficult (Wolf et al., 2014). Receiving a felony for assaulting or
battering a nurse, sends a strong message to the public, healthcare organizations, and nursing as
whole, that this type of violence is not acceptable and carries serious consequences.
What would the passing of these bills mean for the public? Approximately one-third of
emergency nurses have considered leaving their job due to WPV (Gacki-Smith et al., 2009).
Maintaining the integrity of the healthcare team and its ability to deliver safe and effective care is
one of the most pressing issues facing healthcare today (Mason, Leavitt, & Chaffee, 2014).
Consumers want and expect high-quality care. Workplace violence leads to serious

WORKPLACE VIOLENCE

consequences for nursing, healthcare organizations, and the patients they serve. Unsafe work
environments, staff turnover, and nurse burnout compromise care (Mason et al., 2014). Creating
an environment that supports excellent care is critical to optimal patient outcomes.
Legal consequences to WPV can be difficult to achieve and enforce (Wolf et al., 2014).
Typically, less than half of all incidents are reported to law enforcement (USDJ, n.d.). Some
employers prefer to handle matters internally, decreasing law enforcement's ability to address
concerns (USDJ, n.d.). Local law enforcement agencies are overburdened by high workloads
and may be reluctant to take on increased security measures and respond to calls (USDJ, n.d.).
According to FBI Special Agent Melissa Bayan, "in most medium and large cities, law
enforcement is unable to respond to violations that are not immediately life-threatening. Having
private security personnel available to assist nurses with problems would be a better solution"
(personal communication, March 23, 2015).
Convicting perpetrators of WPV with mental illness and substance abuse disorders adds
another challenge to the situation. "The fact that an individual must be medically cleared prior to
their release to law enforcement adds another hurdle to enforcing this type of legislation. The
practicality of enforcing and prosecuting WPV offenses for someone with mental illness would
probably not be reasonable, and at best, not meet the expectations of the individuals fighting for
the legislation. Most individuals with mental illness are not deterred by legislation" (M. Bayan,
personal communication, March 23, 2015).
Not only will obtaining law enforcement's support and prosecuting offenders be
challenging, but enforcing this type of legislation can be costly. The Michigan Department of
Correction's (MDOC) annual budget is 1.9 billion dollars (American Legislative Exchange
Council [ALEC], n.d.). Michigan's prisons house 42,904 inmates costing Michigan taxpayers
34,183 dollars per inmate each year (ALEC, n.d.). Increased felony convictions could lead to
increased law enforcement, incarceration, and judicial system costs.

WORKPLACE VIOLENCE

Stakeholders on the Issue of Workplace Violence

Nursing organizations, hospital administrators, collective bargaining, law enforcement,
and government agencies are key stakeholders on the issue of WPV. Although not all of them
have made a stance on legislation that protects nurses, they have provided input on the issue and
what it means to the constituents they represent and protect.
In their position statement, Violence in the Emergency Setting, ENA (2010) states that
WPV is an occupational hazard for emergency nurses. They have championed legislation that
protects nurses against WPV. A professional nursing organization with over 40,000 members, it
actively addresses issues of concern to emergency nurses (ENA, 2010). The ENA believes
felony legislation that protects nurses who are victims of WPV should become law in every state.
To help make this goal a reality, the national ENA chapter helps state ENA chapters advocate on
behalf of their members (ENA, 2010). They also generate research on WPV against emergency
nurses to gain greater understanding of the problem as well as solutions (ENA, 2010).
According to ENA, legislation mandating safety standards for WPV prevention and protecting
victims of WPV should be strengthened and supported in every state (ENA, 2010).
A strong commitment from hospital administrators is imperative to reducing WPV
(Gacki-Smith et al., 2009; Wolf et al., 2014). The American Association of Nurse Executives
(AONE) supports efforts to mitigate WPV against nurses. With 8,500 members nationwide, they
are a subsidiary of the American Hospital Association (AHA) and the predominant voice for
nursing leadership within the United States (American Association of Nurse Executives [AONE],
2015). They believe all aspects of WPV should be addressed including: zero-tolerance policies,
immediate reporting of WPV incidents to persons of authority, universal standards of behavior
for all members of the healthcare organization, as well as, equal accountability for all persons
either employed or visiting the organization (AONE, 2015). Speaking from a nurse executive's
viewpoint, L. Reetz believes legislation is a necessary component to mitigating WPV in

WORKPLACE VIOLENCE

10

healthcare (personal communication, March 25, 2015). "Legislation protecting nurses against
violence would afford me the benefit of a zero tolerance approach to this type of violence in the
workplace. Nurses would be more apt to report incidents and law enforcement would be more
supportive. Legislation would allow for a more streamlined and consistent process for dealing
with the problem" (L. Reetz, personal communication, March 25, 2015).
The MNA is the largest union representing registered nurses in the State of Michigan
(MNA, n.d.). They lobby for pro-nursing legislation such as WPV prevention measures and
played a vital role in the passage of Senate Bills 0250 and 0360 (MNA, 2014). In 2009, MNA
joined forces with National Nurses United (NNU) bringing their combined membership to
155,000 nurses nationwide (MNA, n.d.). Key components of collective bargaining contracts
include language to address WPV against nurses (Mason, et al., 2014; MNA, n.d.). The recent
past president of MNA, Jeff Breslin, states, "having the threat of violence present, distracts
nurses' ability to provide quality care that Michigan patients deserve. Legislation protecting
nurses against that violence is an excellent way to allow nurses to better care for their patients in
a safer environment. MNA will continue to testify, advocate, and promote this legislation until
nurses get the protection they deserve" (personal communication, March 20, 2015).
Law enforcement considers WPV a growing threat to public safety and is recognized by
the United States Department of Justice (USDJ) as a violent crime (USDJ, n.d.). While some
nurses feel that legislation could deter WPV, law enforcement does not necessarily agree. "Most
individuals that act violently are either criminals or have a mental illness. Both of these groups
are not aware of legislation and the consequences of their actions. In addition, it has been proven
that harsher penalties do not deter these types of individuals from committing an offense" (M.
Bayan, personal communication, March 23, 2015). Law enforcement agencies play a pivotal
role in WPV prevention and prefer to participate in preventative measures rather than managing

WORKPLACE VIOLENCE

11

or arresting perpetrators (USDJ, n.d.). Since prevention is their highest priority, they have
acquired specialized training in providing background checks, workplace site reviews, and
assisting employers with WPV prevention and evacuation plans (USDJ, n.d.). Involving local
police departments in interdisciplinary task forces to address WPV is critical to eliminating it
(Gacki-Smith et al., 2009).
Workplace violence in healthcare is recognized as a serious problem by government
regulatory agencies (Gillespie et al., 2014). Advisory guidelines for preventing WPV during
patient encounters have been established (The Joint Commission on Accreditation of Healthcare
[JCAHO], 2010). Healthcare employers have incurred fines from OSHA when little was done to
stop WPV incidents from reoccurring (Gillespie et al., 2014). Improving the health of the public,
by providing safe and effective care through the accreditation of healthcare organizations, is a
premier goal of the Joint Commission on Accreditation of Healthcare (JCAHO). The JCAHO
requires healthcare facilities to develop a written plan for maintaining the safety of patients, staff,
and visitors (JCAHO, 2010). Conducting WPV risk assessments and developing strategies to
address and mitigate it are also required (JCAHO, 2010). Establishing extra security measures in
EDs, training staff to manage patients and visitors who become violent, and consistently
reporting all violent crimes to appropriate law enforcement officers are requirements set forth by
JCAHO (JCAHO, 2010).
Strategies for Promoting Legislation
Nurses are the largest group of healthcare professionals in the United States and regularly
interact with patients, families, and other members of the healthcare team (Mason et al., 2014).
They also understand the healthcare system which puts them in a perfect position to advocate for
legislation that benefits patients, healthcare, and society as a whole. Effectively delivering a
message to the appropriate audience requires careful planning and consideration. Many ways to

WORKPLACE VIOLENCE

12

promote WPV legislation exist. Some options include: email, personal testimony, meeting with
elected officials, social media, and aligning with professional organizations (Mason et al., 2014).
Both ENA and MNA use personal testimony as a strategy to promote felony legislation
(ENA, 2015; MNA, 2014). Personal testimony is a very powerful form of advocacy. One's
personal story brings the emotional and moral pieces of the issue to the forefront and allows for
real-world experiences to be shared with lawmakers. Recent past president of MNA, Jeff
Breslin, states, "I had the opportunity to testify in House Committee on Senate Bills 0250 and
0360 during the last couple congressional sessions. This strategy makes a difference. Getting
people to understand the necessity for this type of legislation by using personal stories is
paramount" (personal communication, March 20, 2015). With ENA's support, several nurses in
Texas testified in favor of similar felony legislation. Their testimonies played a major role in the
passage of Texas House Bill 705 (ENA, 2015).
Aligning with professional organizations is another viable political strategy. When
supporters demonstrate a united front, it is typically more effective than individual efforts
(Mason et al., 2014). Both ENA and MNA take advantage of this opportunity to promote WPV
legislation at the state and federal level. In 2015, ENA joined forces with AONE creating a joint
position statement for addressing WPV (AONE, 2015). In order to make WPV a felony in all 50
states, ENA teams up with state ENA chapters and state emergency physician associations to
help promote legislation. The NNU supports MNA's efforts to secure felony legislation in the
State of Michigan. They work together for WPV reform at the federal level (MNA, n.d.)
Although meeting directly with elected officials is considered a very powerful and
successful form of political advocacy, it can be time consuming and difficult to achieve
geographically (Mason et al., 2014). Located in Lansing, Michigan, MNA has a geographical
advantage. "We have used the strategy of talking directly to senators and representatives, their

WORKPLACE VIOLENCE

13

aids, the public, and our members. This strategy will help us prevail and create a safer place for
our nurses to practice in Michigan" (J. Breslin, personal communication, March 20, 2015).
Social media sites such as Facebook and Twitter can help an issue reach a large audience
relatively quickly, but brings the challenge of reaching a specific target audience (Mason et al.,
2014). Nursing organizations and collective bargaining may find great success with these sites
as they already have like-minded constituents. A pre-written letter can be personalized and sent
by email to various elected officials and political leaders. This method can be less timeconsuming (as a majority of the letter is already written) and very achievable by members of the
nursing profession, as well as the public, as it does not require the sender to have education or
training in political advocacy (Mason et al., 2014). Pre-written letters keep the message clear
and consistent and could be a successful form of advocacy for this type of legislation.
Conclusion
Despite the efforts of hospital administrators, nursing organizations, government
agencies, and collective bargaining, WPV in healthcare continues to escalate. As a result, serious
consequences to nurses, healthcare organizations, healthcare consumers, and the general public
have occurred. Legislation similar to Senate Bills 0250 and 0360, would bring a needed solution
to this ever growing problem. Without appropriate legislation in place at the state and federal
level, there is no real hope of significantly reducing WPV in healthcare (Gacki-Smith et al.,
2009). Successful outcomes will require the full participation and support of all stakeholders.
Since the public has already made a stance on behalf of police officers, it is time they do the
same for healthcare workers, including nurses, in the State of Michigan. Nurses play a vital role
in advocating and promoting WPV reform, and must align with all stakeholders in order to
eliminate the negative effects of WPV in todays healthcare environment.

WORKPLACE VIOLENCE

14

References
American Legislative Exchange Council [ALEC]. (n.d.). Prison Overcrowding: Michigan.
Retrieved from http://www.alec.org/initiatives/prison-overcrowding/prisonovercrowding-michigan/
American Association of Nurse Executives [AONE]. (2015). AONE guiding principles:
Mitigating violence in the workplace. Retrieved from http://www.aone.org/resources/
guiding-principles-violence-in-the-workplace.shtml
Doby, V. (2015). Leadership's role in eliminating workplace violence and changing perceptions
in the emergency department. Journal of Emergency Nursing 41(1), 7. doi: http://
dx.doi.org/10.1016/j.jen.2014.08.013
Emergency Nurses Association [ENA]. (2010). Violence in the emergency care setting.
Retrieved from http://www.ena.org/government/State/Documents/ENAWorkplace
ViolencePS.pdf
Emergency Nurses Association [ENA]. (2013). Workplace violence penalties and terminology
database. Retrieved from http://www.ena.org/government/State/ Documents/WPV
Penalties.pdf
Emergency Nurses Association [ENA]. (2015). Emergency Nurses Association applauds Texas
legislation that raises assaults against emergency department personnel to third degree
felony. Retrieved from http://www.ena.org/about/media/PressReleases/Pages/TexasLegislation.aspx
Gacki-Smith, J., Juarez, A. M., Boyett, L., Homeyer, C., Robinson, L., & MacLean, S. L. (2009).
Violence against nurses working in US emergency departments. Journal of Nursing
Administration 39(7-8), 340-349.
Gillespie, G. L., Gates, D. M., Kowalenko, T., Bresler, S., & Succop, P. (2014). Implementation
of a comprehensive intervention to reduce physical assaults and threats in the emergency
department. Journal of Emergency Nursing 40(6), 586-591. doi: http://dx.doi.org/
10.1016/jen.2014.01.003

WORKPLACE VIOLENCE

15

The Joint Commission on Accreditation of Healthcare [JCAHO]. (2010). Preventing violence in

the healthcare setting. Retrieved from http://www.jointcommission.org/assets/1/18/
sea_45.pdf
Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2014). Policy & politics in nursing and health
care (6th ed.). St. Louis, MO: Elsevier.
Michigan Legislature. (2013a). Senate Bill 0250. Retrieved from http://www.legislature.mi.gov /
28S%28d03vrznuqy3nmrnq5be2srfk%29%29/mileg.aspx?
page=getobject&objectname=2013-SB-0250&query=on
Michigan Legislature. (2013b). Senate Bill 0360. Retrieved from http://www.legislature.mi.gov/
%28S%28d03vrznuqy3nmrnq5be2srfk%29%29/mileg.aspx?page=getobject&
objectname=2013-SB-0360&query=on
Michigan Nurses Association [MNA]. (n.d.). About MNA. Retrieved from http://www.minurses.
org/about
Michigan Nurses Association [MNA]. (2013). Workplace violence legislation passes senate.
Retrieved from http://minurses.org/news-and-events/p/openItem/5431
Michigan Nurses Association [MNA]. (2014). SB 250 & SB 360: Protecting nurses from
violence in the workplace. Retrieved from http://www.minurses.org/files/files/
Legislation/ Fact%20Sheets/FactSheetWorkplaceViolence.pdf
Nolan, J. M., Fee, C., Cooper, B. A., Rankin, S. H., & Blegen, M. A. (2015). Psychiatric
boarding incidence, duration, and associated factors in United States emergency
departments. Journal of Emergency Nursing 41(1), 57-64. doi: http://dx.doi.org/
10.1016/j.jen.2014.05.004
Trotto, S. (2014). Workplace violence in health care. Safety and Health Magazine. Retrieved
from http://www.safetyandhealthmagazine.com/articles/11172-workplace-violence-inhealth-care-nurses
United States Department of Justice [USDJ], Federal Bureau of Investigation. (n.d.). Workplace
violence: Issues in response. Retrieved from http://www.fbi.gov/stats-services
publications/workplace-violence

WORKPLACE VIOLENCE

16

United States Department of Labor [USDL], Office of Occupational Safety & Health
Administration. (2014). Safety and health topics: Workplace violence. Retrieved from
www.osha.gov/ SLTC/healthcarefacilities/violence.html
Wolf, L. A., Delao, A. M., & Perhats, C. (2014). Nothing changes, nobody cares: Understanding
the experience of emergency nurses physically or verbally assaulted while providing care.
Journal of Emergency Nursing 40(4), 305-310. doi: http//dx.doi.org/10.1016/ j.jen.
013.11.006