Special Report: Nurses Are More Likely to Get Punched in an ER Than in a Jail
When people think of correctional healthcare, the assumption is that jails are dangerous places to work. However, real-world data tells a very different, much safer, story. According to a landmark article published in the New England Journal of Medicine, workplace violence in healthcare is alarmingly common:
61% of home health workers experience violence annually.
82% of emergency department nurses report physical assault.
70% of staff in forensic psychiatric hospitals experience annual physical violence.
Nursing aides in dementia care units report daily abuse at rates as high as 16%.
The most common perpetrators in these cases are individuals experiencing dementia, delirium, substance intoxication, or acute mental illness. However, while jails house individuals with similar diagnoses, correctional facility results are markedly better.
From 2020 to the present, internal data from Advanced Correctional Healthcare (ACH) found only 3 total assault incidents across over 500 facilities. This equates to an annual incidence of just 0.0528%. This is not only far below national average of 81% for other healthcare settings, but it confirms what the profession’s culture has long emphasized: correctional healthcare is among the safest environments for medical professionals. Correctional facilities are built for vigilance. Unlike traditional healthcare settings, jails operate within an environment of structure, heightened security, and situational awareness. Since 2018, over 96% of ACH associates have consistently reported feeling safe at work in workplace surveys, with 100% of associates reporting they feel safe in 2024. This environment, combined with strong partnerships between healthcare and security staff, creates a framework where risk can be proactively managed.
A 2024 workforce study by University of North Carolina researches on violence trends further reinforces these differences. The study revealed a 30% increase in workplace violence across healthcare settings over the past decade, regardless of role or department. Psychiatric hospitals, nursing homes, and residential mental health units accounted for the vast majority of assaults. The study's authors recommend targeting prevention efforts based on environment type and structural risk, highlighting how structured settings like jails are uniquely positioned to outperform traditional healthcare environments in safety. In a healthcare landscape where workplace violence is often accepted as a given, jails are not only necessary community institutions, but also some of the safest workplaces for clinicians.
References
National Nurses United. (2024). High and rising rates of workplace violence and employer failure to implement effective prevention strategies is contributing to the staffing crisis. https://www.nationalnursesunited.org/sites/default/files/nnu/documents/0224_Workplace_Violence_Report.pdf
Phillips J. P. (2016). Workplace violence against health care workers in the united states. The New England Journal of Medicine, 374(17), 1661–1669. https://doi.org/10.1056/NEJMra1501998
Lombardi, B., Jensen, T., Galloway, E., & Fraher, E. (2024). Trends in workplace violence for health care occupations and facilities over the last 10 years. Health Affairs Scholar, 2(12), qxae134. https://doi.org/10.1093/haschl/qxae134
