Workplace violence in health care has become one of the most urgent occupational safety crises in the United States. Anesthesiologists, as well as other physicians, nurses, emergency personnel, therapists, technicians, and support staff, routinely face verbal threats, intimidation, physical assault, and psychological trauma while performing their duties.
The National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as acts or threats of violence, harassment, intimidation, or disruptive behavior occurring at the workplace. Violence may range from verbal abuse and threats to physical assault and homicide.
Scope and contributing factors
Health care workers experience workplace violence at rates significantly higher than most other professions. According to the Occupational Safety and Health Administration (OSHA), serious workplace violence incidents occur in health care settings nearly four times more often than in private industry overall.
Moreover, the American Society of Anesthesiologists (ASA) “Statement on Harassment, Incivility, and Disrespect (HID)” suggests that the experience of HID is pervasive in anesthesiology, with data and surveys revealing rates that are at least equal to, if not higher, than average for anesthesiology compared to other specialties. Several interconnected factors contribute to the rise in workplace violence in health care, including overcrowding, long wait times, mental health crises, staffing shortages, burnout, societal polarization, and increasing aggression toward health care workers.
Impact on health care
The effects of workplace violence are both immediate and long-lasting. Victims commonly report anxiety, depression, insomnia, post-traumatic stress disorder (PTSD), emotional exhaustion, and fear of returning to work.
When these behaviors are demonstrated in the operating room and hospitals, they negatively affect personal and team performance, adversely impacting patient safety, quality of care, and outcomes. Furthermore, these behaviors strongly affect the growing imbalance in the supply of anesthesiologists and anesthesia care professionals we are seeing. The work environment and culture of a health care facility have a direct correlation to its ability to recruit and retain staff. The economic burden of workplace violence is substantial and includes workers’ compensation claims, staff turnover, recruitment and retraining costs, security enhancements, lost productivity, legal liability, and increased insurance expenses.
Prevention strategies
Health care organizations should establish zero-tolerance policies, improve security infrastructure, provide de-escalation training, encourage transparent reporting systems, and offer post-incident counseling and support services. The “ASA Statement on HID” provides critical recommendations that prioritize commitments and actions at both the organizational and individual levels to foster better work environments and help eradicate these behaviors in the operating room and hospitals. Health care executives and physician leaders must recognize that violence prevention is not solely a security issue; it is also a workforce retention, patient safety, and ethical responsibility issue.
Workplace violence and HID of any kind in health care represent a growing national crisis that threatens both caregivers and patients. Violence should never be accepted as an inevitable part of health care delivery. Every health care worker deserves a safe environment in which to provide compassionate, high-quality care.
John Scott, DO, MHA, is a member of the American Society of Anesthesiologists Committee on Communications.
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research, and scientific society with more than 60,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during, and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.
For more information on the field of anesthesiology, visit ASA online at asahq.org. To learn more about how anesthesiologists help ensure patient safety, visit asahq.org/madeforthismoment. ASA publishes Anesthesiology, Anesthesiology Open, and ASA Monitor, and stays connected with members and the public on Facebook, X, Instagram, Bluesky, and LinkedIn.
