HMN 2026: How Preventing workplace violence in health care requires paradigm shift

Efforts to address workplace violence against health care professionals need to evolve beyond preventing individual incidents to confronting systemic challenges that impede patient-centered, trauma-informed care, according to an article published in AACN Advanced Critical Care. Titled “Five Topics Overlooked in Workplace Violence Discussions in Health Care Settings,” the study examines five underrecognized yet critical domains of inquiry that form the basis for practice and cultural changes in workplace violence prevention (WVP) on non-psychiatric units.

Co-author Kathleen Delaney, Ph.D., APRN, PMHNP, FAAN, is professor emeritus, Rush University College of Nursing, Chicago. “No one should believe violence or physical assault is part of the job, and we must look beyond preventing individual incidents to addressing the organizational structures, staffing models and cultural expectations that shape systemic issues,” she said.

“We need a paradigm shift beyond current approaches, if we truly want to create safer hospitals, support nurse retention and honor the ethical imperative to provide care in a manner that is safe, compassionate and just.”

WVP efforts often focus on staff skills training to help nurses and other caregivers respond to aggression with de-escalation techniques and response strategies. Such a technique-centric model has proven insufficient to address the complexity of aggression in health care settings, and the authors advocate for using principle-based frameworks, such as patient-centered or trauma-informed care.

Among the factors discussed in the article is how nurses view WVP within the evolving scope of their professional responsibilities, with the recommendation to reframe the issue as integrated into nursing practice, not as an additional responsibility.

The article also examines the ethical tensions that arise when nurses must weigh the duty to provide care with the need to maintain a safe environment when responding to workplace violence. In addition, current approaches to WVP often fail to emphasize patient engagement using relational skills, versus distancing oneself, as a proactive practice to mitigate perceived threats.

The five elements also include organizational constraints, such as lack of teamwork and insufficient staffing, that limit effective WVP, and the unintended consequences of developing a risk-averse environment, such as an overreliance on security and policies that focus on punishing abusive behaviors.

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