In January 2019, a nurse was killed in the garage of a suburban Milwaukee hospital shortly after leaving her 3 a.m. shift. In June 2022, a gunman killed a surgeon and three other people in a Tulsa, Oklahoma, medical campus building, blaming the doctor for his pain after surgery.

These are not isolated stories. Over the past decade, the U.S. healthcare industry has faced an epidemic of violence in the workplace according to the U.S. Bureau of Labor Statistics, with multiple factors as to what causes it. 

The questions below follow that evidence in order, from how big the problem is to what actually protects staff.

In short Violence against healthcare workers is high, it drives people out of the profession, and hospitals are now expected to run formal prevention programs. A wireless staff duress system gives those programs a way to protect staff in the moment, indoors and out.

How common is workplace violence in healthcare?

Far more common than in other industries. OSHA data cited by the Joint Commission shows healthcare workers are four to five times more likely to suffer workplace violence injuries than private-sector workers overall.

Emergency departments feel it most. A January 2024 ACEP poll found that 91% of emergency physicians said they or a colleague had been a victim of violence in the past year.

A look at the statistics is eye-opening:

• Healthcare and social service workers are five times as likely to suffer workplace violence as any other worker (U.S. Bureau of Labor Statistics).
• 85% of emergency physicians said in a 2022 ACEP survey that they believe violence in emergency departments has increased.
• Healthcare workers suffer more nonfatal injuries from workplace violence than law enforcement (Associated Press).

Numbers like these raise the next question: why is it happening?

What causes workplace violence in healthcare?

Several overlapping factors. There are numerous reasons, and the list goes on. No single cause explains it, which is why no single fix does either.

• Too many patients per caregiver and long wait times.
• Little or no consequence for people who commit violence.
• Not enough screening for weapons.
• Untreated mental health and substance use issues.

Whatever the cause, the effect lands on the people providing care.

How does workplace violence affect staffing and costs?

It pushes staff out and adds cost for the hospital. In a National Nurses United survey, 25.5% of nurses considered leaving the profession because of workplace violence, and 18.6% took time off after an incident.

Each departure is expensive. The 2026 NSI retention report puts hospital RN turnover at 17.6% for 2025, with each bedside RN departure costing about $60,090. For the average hospital, RN turnover costs about $5.19 million a year.

The Joint Commission has also estimated that non-fatal workplace violence costs range from $109,000 per year in treatment and indemnity for injured nurses to over $330,000 per year in a single hospital system.

Safer staff are easier to keep. A workplace duress RTLS system can help attract and retain staff because it gives them peace of mind and makes their jobs far safer. For many hospitals, costs like those above can outweigh the cost of installing a staff duress system like Help Alert. But where does the risk actually sit?

Does the danger stop at the hospital door?

No. The Milwaukee and Tulsa incidents above happened in a parking garage after a late shift and inside a campus building. Serious crimes and even death are happening to healthcare workers across the country:

• October 2022, Dallas, Texas: a man on parole, on leave to be at the birth of his child, killed two hospital workers.
• May 2023, Atlanta, Georgia: a U.S. Coast Guard veteran shot and killed one person and wounded four in a medical waiting room.
• July 2023, Oregon: a man nurses had warned might try to abduct his partner’s newborn later shot and killed a hospital security guard inside the hospital.

Staff are exposed wherever they work, including parking structures, lots, and walkways between buildings.

A safety plan that ends at the exterior wall leaves those gaps open. So what are hospitals now expected to do about it?

What are hospitals now expected to do?

Make protecting staff a top priority and run a formal prevention program. Expectations come from three directions.

Accreditation. The Joint Commission’s National Performance Goals, effective January 1, 2026, make workplace violence prevention a formal goal for hospitals. Hospitals need a program led by a designated individual, an incident reporting and follow-up process, ongoing training, an annual worksite analysis, and support for victims and witnesses. RFT’s 2026 guide explains it in plain language.

OSHA. OSHA guidelines for healthcare settings call for assessing risk factors, building prevention programs, training staff, and enforcing policies.

Legislation. At least 20 states require healthcare employers to adopt workplace violence prevention plans, according to Health Law Advisor. At the federal level, the Save Healthcare Workers Act (H.R. 3178), introduced in May 2025, would make knowingly assaulting hospital personnel a federal crime.

Is a prevention program enough on its own?

Not in the moment of a crisis. Policies, training, and de-escalation reduce risk, but when a situation turns violent, staff still need a fast way to call for help and responders need to know where to go.

A staff duress system fills that gap, and it maps to the same program elements regulators look for:

What is a staff duress system, and how does it work?

A wearable panic button that sends an alert to security with the wearer’s location. A workplace duress RTLS system works by letting staff press the button on a badge, pendant, or fob, and security is notified immediately. The better systems confirm to the wearer that the alert was received.

Not every system performs the same, so what separates a strong one from a weak one?

What should you look for in a staff duress system?

Match it to the gaps the evidence points to:

• Indoor and outdoor coverage. Protection should not end at the exterior wall.
• Discreet activation. A single press that does not escalate the situation.
• Confirmation feedback. Staff should know the alert was sent and acknowledged.
• Accurate location. Security needs to know where to go.
• Independence from the hospital network. A system that does not rely on Wi-Fi is less exposed to outages and cyber risk.
• Fast deployment. Wireless devices without wire pulls install faster and more economically.
• 911 and system integration. Alerts should reach the right responders and work with existing technology.

How does RFT’s Help Alert® address these needs?

Help Alert® is a wireless BLE/LoRa, 24/7 mobile staff duress solution that integrates with existing technology systems and pinpoints staff inside and outside a hospital or healthcare building.

It solves problems other wireless RTLS systems struggle with:

• Coverage outside buildings, such as parking lots, using a blend of BLE/LoRa hubs and gateways.
• No wire pulls.
• Both low and high-priority buttons.
• True 911 integration.

Staff can wear the Help Alert Badge or the newer staff duress pendant. Both give LED and vibration feedback that confirms the alert was sent and acknowledged. The system operates independently of hospital Wi-Fi, and lone-worker coverage extends protection to home health staff off campus. Learn more about RFT staff protection.

What is the bottom line?

Hospitals and healthcare facilities need prevention programs, education, training, enforcement, and a workplace duress RTLS system in place for crisis situations when time is of the essence. Policies, procedures, and technology are helping staff feel safe and valued, saving costs, and most importantly, saving lives.