In Their Own Words

ER Violence Rises – Nurses and Doctors Say These Changes Could Prevent Assaults

LDI Fellows Call for Real-Time De-Escalation Teams and Safer Staffing Ratios to Prevent Chaos Before it Erupts

October 22, 2025

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A team of clinicians in the ER standing shoulder-to-shoulder with their backs facing the camera.

This op-ed originally appeared in the Philadelphia Inquirer on October 21, 2025.

In winning a new contract on Oct. 12, Temple University nurses and technicians didn’t just get pay raises. They won more protections from violence.

It’s an extraordinary moment when basic safety becomes a bargaining issue. But that’s the reality for emergency room workers who continue to face rising levels of physical, verbal, and sexual assault. Touted as heroes during the pandemic, these workers now show up in risky environments that are wired to create more violence.

One simple yet little-used strategy is to ask frontline nurses and doctors what works, and what doesn’t, to prevent assaults. We did that, and the answers cited below may surprise you.

Tougher laws by themselves haven’t worked. The airline industry has laws that protect staff from assaults in the workplace: If a passenger attacks an airline crew member, they are removed from the airline and could face a fine or criminal charge.

It is not so straightforward in health care. Safety protections vary state by state for workers who face a stigma for reporting an event, and no guarantee their concerns will reach employers or authorities. Most crucially, a violent patient differs from an unruly airplane passenger. Most patients need care and support when they become violent.

As emergency room clinicians, we know patients come to us during their most vulnerable moments. Their medical challenges, coupled with worry, compounded by prolonged waiting room times and care delays, create the perfect recipe for rising ER violence. The larger frustrations patients experience get offloaded onto the clinician before them.

Read the full op-ed here.