Hospital workers are injured on the job by violent acts at seven times the rate of the general working population, according to Bureau of Labor Statistics injury data cited in reporting from NPR and KFF Health News, and the gap has become a bargaining issue on picket lines in at least five states.
The collaboration between the two newsrooms, published this week, centers on a Michigan strike approaching its first anniversary, with patient violence among the stated grievances.
For patients, this is not a labor story happening somewhere else. It describes the conditions inside the emergency departments where they will eventually sit.
Inside the Number and What It Actually Counts
The seven-times figure measures a specific thing: injuries recorded on the job as a result of violent acts, compared across industries. It is not a survey of how many workers have been threatened, grabbed or spat at.
That distinction matters because it makes the number a floor rather than a ceiling. MedicalDaily reported in July on an industry survey of nurses and technicians in which 52% of 2,240 respondents described experiencing some form of workplace violence in the previous year, and in which 70% said they did not report every incident and 39% reported none at all.
An injury statistic drawn from recorded events, sitting atop a workforce that documents only a minority of what happens to it, understates the problem by an amount no one has measured.
Federal figures cited in earlier years put the comparison differently, with health care workers roughly five times more likely to experience workplace violence and accounting for a large majority of nonfatal workplace injuries from violence. The measures are not interchangeable, and readers encountering both should not treat one as a replacement for the other.
What counts as workplace violence in a hospital is broader than an assault charge. It includes physical contact from patients who are confused, intoxicated, in withdrawal, or experiencing a psychiatric crisis, alongside deliberate aggression from visitors. Cognitive impairment and patients demanding to leave are among the most consistently identified triggers in incident-report research.
A Michigan Picket Line Approaching Its Twelfth Month
Crystal Dhooghe is an emergency room nurse at Henry Ford Genesys Hospital in Grand Blanc, Michigan, and one of hundreds of unionized employees who walked out on September 1, 2025. It is now among the longest-running hospital strikes in the country.
"I've seen nurses get shoved, pushed, scratched. The biggest one is bitten," Dhooghe told NPR. She said she gets by on strike benefits and extra shifts at another hospital, and described being asked why she keeps working in a place where staff are treated that way.
The pattern is not confined to Michigan. Workplace violence has featured in disputes in Louisiana, New York, Pennsylvania, and Rhode Island. At Butler Hospital, a private psychiatric facility in Providence, mental health worker Andrew Kimball-Mirzaie said he was punched in the face in February 2024 by a patient he had been sent to monitor while the man waited for an inpatient bed. He had been on the job for about six weeks.
Kimball-Mirzaie later joined roughly 700 other unionized Butler workers in a months-long strike in 2025 that forced the hospital to close nearly half its beds. The union representing them, which covers more than 800 frontline staff, reported a 41% increase in patient assaults on staff between 2022 and 2024 and cited chronic short staffing and low wages as drivers.
Criminal Penalties Exist in Forty-Five States Already
The main policy response so far has been to make assaulting a health care worker a more serious crime. The American Hospital Association has argued that punishment is central to prevention and has lobbied Congress to create a federal offense carrying up to 10 years in prison.
At least 45 states, including Michigan and Rhode Island, have already enacted laws along those lines. That is the fact worth sitting with. Enhanced criminal penalties are nearly universal at the state level, yet the injury gap persists.
That does not establish that such laws fail. It does suggest that penalties alone have not changed the underlying rate, and it points attention toward the conditions that generate incidents: staffing levels that leave workers alone with agitated patients, emergency departments holding psychiatric patients for days without appropriate placement, and long waits that escalate frustration.
Federal workplace safety guidance reflects that framing. OSHA's healthcare workplace violence resources center on employer risk assessment and prevention programs rather than on prosecution, and there is no federal standard requiring hospitals to have a workplace violence prevention program, though CMS has told facilities it expects an environment that prioritizes staff and patient safety.
Patients and Families Sit Inside This Too
Most people reading this will never assault anyone in a hospital. The relevance runs a different direction.
Security measures change the experience of seeking care. Metal detectors at emergency entrances, bag checks, and security officers are increasingly common, and families arriving in a crisis encounter them at the worst possible moment. That trade-off is real and is being made largely without public discussion.
Understaffing and violence also feed each other. Workers who are assaulted leave, and departures worsen the staffing conditions that make assaults more likely. MedicalDaily has reported that workplace violence protections now appear alongside staffing ratios in nurse contract negotiations.
There are also things a visitor can do, and they are ordinary. Confusion and agitation in an ill relative are medical symptoms, not misbehavior, and telling staff early that a family member is disoriented, in withdrawal or frightened helps them plan. Bringing a familiar person to sit with a confused patient reduces incidents. Escalating anger at a nurse over a wait almost never shortens it.
Anyone who witnesses violence in a hospital should move away and alert staff rather than intervene.
Key Questions Answered
What does the seven-times figure measure? Injuries recorded on the job resulting from violent acts, comparing hospital workers with the general working population, using Bureau of Labor Statistics injury data.
Is that the same as how often workers are attacked? No. It counts recorded injuries. Survey data indicate most incidents are never formally reported, so the injury rate understates total exposure by an unmeasured amount.
Why are hospital workers at higher risk? They work directly with people who are confused, intoxicated, in withdrawal, or in psychiatric crisis, and with families under extreme stress. Emergency departments and psychiatric units carry the highest exposure.
What is happening in Michigan? Hundreds of unionized employees at Henry Ford Genesys Hospital in Grand Blanc have been on strike since September 1, 2025, with patient violence among the stated issues.
Are there laws against assaulting health care workers? Yes. At least 45 states have enacted enhanced penalties, and the American Hospital Association is lobbying for a federal offense carrying a penalty of up to 10 years.
Do those laws work? The injury gap has persisted despite near-universal state penalties. That does not prove the laws fail, but it suggests penalties alone have not changed the rate.
What can a visitor do? Tell staff early if a relative is confused, frightened or in withdrawal. Sit with a disoriented patient if allowed. If violence occurs, move away and alert staff rather than intervening.
