How Guard Training Can Reduce Workplace Violence in Healthcare

Doctor consults with patient

In early June, a man walked into the Encino (Calif.) Hospital Medical Center, went to the emergency room, and stabbed a doctor and two nurses. The man had remained inside a room in the hospital for about four hours as SWAT team members tried to negotiate with him before he was finally arrested.  

The attack came only two days after a gunman killed four people and then himself at a hospital in Tulsa, Oklahoma. The assailant got inside a building on the Saint Francis Hospital campus with little trouble, just hours after buying an AR-style rifle. The two events are an example of the types of workplace violent incidents that occur in hospitals and healthcare facilities each year.

Workplace Violence Prevalence

While the threat of workplace violence is not specific to any one industry, healthcare facilities seem to be affected the most, due to their environments that are largely open to the public 24/7. 

OSHA defines workplace violence “any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site. It can affect and involve workers, clients, customers, and visitors. Workplace violence ranges from threats and verbal abuse to physical assaults and even homicide.” 

Many hospitals are filled with individuals who are under stress, and who also may have money challenges due to healthcare costs. Even more, hospitals are filled with large amounts of expensive goods that can add to the risk of theft and violence.  

For example, in the United States, there are roughly 2 million victims of workplace violence each year, and the healthcare and social assistance industries have an 8.2-percent workplace violence incident rate.  

Workplace violence affects doctors and nurses at an alarming rate. According to the American College of Emergency Physicians (ACEP) and the Emergency Nurses Association (ENA), 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. And 80 percent of emergency physicians say violence in the emergency department harms patient care. 

Legislation to Help Reduce Healthcare Violence

Recent legislation may help in reducing healthcare violence: the U.S. House of Representatives passed H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, on April 16, 2021.  

The legislation, if passed by the U.S. Senate and signed by President Biden, would mandate healthcare employers to implement a plan that protects their workers from workplace violence in accordance with the national standard provided by OSHA.  

Workplaces that have a healthcare professional would have to follow H.R. 1195 and implement a plan for worker safety such as workplace violence prevention training to staff, investigate violent occurrences, and implement risk assessment and a workplace violence prevention plan. Workplaces would have to maintain a record of five years.

The Role of Security in Preventing Workplace Violence

Security guards and officers play an important and strategic role in mitigating workplace violence in the healthcare setting.  

What specific actions can they take to prevent workplace violence and ensure the safety of healthcare workers, patients, and visitors?

Establishing a sense of professionalism goes a long way in shaping a team’s image. Something as simple as using branded uniforms, cross-training to provide services at more than one location, and helping to ensure that excellent customer service is provided every day, at every location, makes a difference.  

However, security companies can take the lead in helping to mitigate the threats of workplace violence. This includes de-escalation training as well as healthcare security training such as situational awareness and workplace violence training for healthcare workers.

Situational Awareness Training

Situational awareness training includes knowing the warning signs of a potential violent situation. Such indicators of potential workplace violence can include an individual: 

  • Boasting of prior violence 
  • Slurred speech 
  • Inappropriate (nervous) laughter 
  • Personal space violation 
  • Standing toe to toe 
  • Finger pointing 
  • Making fists 
  • Face flushing 
  • Heavy breathing 


De-escalation is an essential skill for any security officer, to protect himself and others. It can reduce an individual’s anxiety, agitation, and possible aggression.  

“The use of communication or other techniques during an encounter to stabilize, slow, or reduce the intensity of a potentially violent situation without using physical force, or with a reduction in force.” – Department of Homeland Security Policy Statement 044-05 

As soon as physical violence or force occurs, the safety of staff and patients will be compromised. De-escalation can be used to defuse potentially violent situations. It can mean the difference between a situation becoming violent or an individual who will have his/her concerns addressed and leave a facility without incident.  

Security teams can use some of the following de-escalation tools such as: 

  • Speaking slowly 
  • Using the person’s name  
  • Asking to take notes 
  • Paraphrasing
  • Allowing time for reflection before responding 
  • Giving options, an idea, or a solution  
  • Maintaining eye contact  
  • Showing the individual that they are being heard 

Reducing Violence in Healthcare Starts with Proper Guard Training 

For decades, workplace violence has been a recognized hazard in the healthcare industry. The issue is difficult to mitigate, given the volatility and openness of the environment. However, by training security guards in situational awareness and de-escalation, security guards can offer better protection to healthcare workers.