Health Care Workplace Violence Prevention Act


Any state should adequately address violence of any kind directed toward innocent people. It has fundamental importance for the United States because its democratic values are based on the protection of the safety and dignity of American citizens. One of the most acute problems is the existing violence in the workplace, especially in the hospitals, which are the main object of consideration in bill HR 5223. This paper will justify the bill’s relevance through the multi-side analysis of the act’s main arguments, stakeholders, and theoretical foundations.

Risks for Violence in the Workplace

Many American citizens know nothing about the escalating problem of violence in the workplace. The healthcare staff experiences a high level of violence compared to other spheres (Kumari et al., 2020). The main groups of people in danger are “primary healthcare providers,” that are doctors and nurses (Kumari et al., 2020, p. 150). The data about the incidents of workplace violence in hospitals is also instructive – according to the American Journal of Managed Care, 75% of all workplace assaults occur in healthcare (Stephens, 2019). What is more, healthcare workers stay silent about the enduring problem, with approximately 28% of healthcare workers reporting the violence they experienced (Stephens, 2019). The data says a lot about the catastrophic state of affairs in this sphere.

The bill HR 5223, which is called the Health Care Workplace Violence Prevention Act, will contribute by fixing the internal problem of the healthcare system. It will mandate the federal Occupational Safety and Health Administration (OSHA) to create a national standard of rules and policies that will protect healthcare workers. The main emphasis of the bill lies in the training, accountability of employers, and worker participation, so it will significantly help a large proportion of American citizens to become more protected.

Support from Professional Nursing Organizations

The relevance and importance of the law for the community are justified by the support and call for a change of several important professional nursing organizations. Firstly, National Nurses United, the largest union of registered nurses, showed full support for the bill under discussion. Bonnie Castillo, the executive director of the union, said that “violent attacks can be drastically reduced through workplace violence prevention plans that are specific to the needs of each facility and unit” (National Nurses United, 2018). Secondly, the Emergency Nurses Association (2018) also endorsed the creation of an act that will require the creation of policy at the workplace. Their demands fully satisfy the needs of the current act: “in particular, ENA urges Congress to pass legislation that would require health care employers to develop comprehensive workplace violence prevention plans” (Emergency Nurses Association, 2018). Thus, the endorsement of big unions and professional organizations says a lot about the relevance of the bill HR 5223.

Theoretical or Regulatory Model

Another explanation that is needed to understand the rationale under the implementation of some particular law is a theoretical and regulatory model from the academic literature. In other words, there is a need to create a theory that will explain the main drivers that should change the situation in the right direction. First of all, the creation of a theory should address the current state of affairs in health care, so it should be evidence-based (Baldwin-Edwards et al., 2019). The model for this paper is called the “Conceptual model of organizational determinants of workplace violence” (Arnetz et al., 2018, p. 694). It states that there are three key factors: work stress, lack of staff interaction, and unsafety climate that cause workplace violence (Arnetz et al., 2018). This model also emphasizes that violence may be both verbal and physical (Arnetz et al., 2018). The relevance of the model for understanding the bill’s nature is evident because it focuses on the critical sides of reasons for violence. The HR 5223 will ensure that all three described aspects will be addressed by healthcare managers. Thus, the model guides the implementation of violence prevention plans.

Another problem that creates the foundation of the theoretical model is the lack of reporting of violence because of the lack of accountability from healthcare facility management. It is evident that employers have an obligation to protect their staff from any kind of abuse (Morphet et al., 2019). Morphet et al. (2019) indicate that there is a “need for managers to prioritize resources such as reliable rapid response systems to prevent and manage violence, particularly against staff working alone or home visiting.” The bill HR 5223, in particular, will force all the healthcare organizations accountable to OSHA to create plans and policies that will find the actor responsible for the violent abuse. It will be managers who will not have opportunities to ignore the incidents of violence.

Stakeholders Who Benefit from HR 5223

Particularly any bill that goes through Congress impacts two interest groups in a different fashion. One side will benefit from the implementation of the law, while the other side will oppose the adoption of the law because it conflicts with their interests. In the case of bill HR 5223, the main interest groups are nurses and physicians. These groups of healthcare workers interact with patients and colleagues for the majority of the time. Hence, it is the interest of physicians and nurses to be protected from the violence that they can face. Besides, scholars identify the tendency that male nurses prefer not to report cases of violence against them because of social biases and prejudices (Li et al. 2020). The proper plans and policies will also be in the interest of this group of stakeholders.

Barriers to Passage of HR 5223

The barriers to the adoption of the law legislators can find in healthcare managers and the executives of medical facilities. The reason is that the law will make them responsible for the unsatisfactory statistics of violence in the workplace. The text of the bill clearly states that employers cannot just formally create plans and policies without actual implementation. It states that “health care employer shall establish methods to coordinate the implementation of the Workplace Violence Prevention Plan” (Health Care Workplace Violence Prevention Act, 2018). Their commitment to the bill can be achieved by the elaboration of clear steps on how the plans should be written.

Another crucial impediment that exists is the polarization of parties in the U.S. Congress. Some legislators can vote against the bill just for the reason that it was proposed by someone from another party. The formal arguments against the bill can be of every style: economic irrelevance, the absence of urgency, and unclear requirements for healthcare managers. This barrier can be overcome by the increase of public attention to the bill. It is especially important to achieve close connections with healthcare workers’ unions in order to make public demand more decisive.


To sum up, the issue of violence in the workplace in healthcare is highly relevant, which is evident from statistics and reports. The bill received tremendous support from the nurse unions “National Nurses United” and “Emergency Nurses Association”. The major drawback of the system that the bill should fix is the lack of accountability from healthcare managers and the lack of incentives to speak out about cases of violence. The primary stakeholders of the act are the large proportion of the population, in particular, the nurses, physicians, and other medical staff. Singling out the main adoption barriers, the policy analyst should elaborate clear steps of creating violence prevention acts that will eliminate opposition from healthcare managers.


Arnetz, J., Hamblin, L. E., Sudan, S., & Arnetz, B. (2018). Organizational determinants of workplace violence against hospital workers. Journal of Occupational and Environmental Medicine, 60(8), 1-21. Web.

Baldwin-Edwards, M., Blitz, B. K., & Crawley, H. (2019). The politics of evidence-based policy in Europe’s ‘migration crisis’. Journal of Ethnic and Migration Studies, 45(12), 2139-2155. Web.

Emergency Nurses Association. (2018). Emergency nurses association members assemble at Capitol Hill to advocate for better emergency care. P.R. Newswire. Web.

Health Care Workplace Violence Prevention Act, H.R. 5223, 115th Cong. (2018). Web.

Kumari, A., Kaur, T., Ranjan, P., Chopra, S., Sarkar, S., & Baitha, U. (2020). Workplace violence against doctors: Characteristics, risk factors, and mitigation strategies. Journal of Postgraduate Medicine, 66(3), 149-154. Web.

Li, M., Liu, J., Zheng, J., Liu, K., Wang, J., Miner Ross, A.,… & You, L. (2020). The relationship of workplace violence and nurse outcomes: Gender difference study on a propensity score matched sample. Journal of Advanced Nursing, 76(2), 600-610. Web.

Morphet, J., Griffiths, D., Beattie, J., & Innes, K. (2019). Managers’ experiences of prevention and management of workplace violence against health care staff: A descriptive exploratory study. Journal of Nursing Management, 27(4), 781-791. Web.

National Nurses United. (2018). Nurses applaud introduction of H.R. 5223 – Federal legislation to prevent workplace violence in health care facilities. Web.

Stephens, W. (2019). Violence against healthcare workers: A rising epidemic. AJMC. Web.

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