Violence in the workplace


Steps to take

Nursing staff encounter a range of potential hazards, often on a daily basis, but few are as distressing and difficult to manage as violence.

You have a right to be safe at work irrespective of whether you are based in hospitals, in the community or other healthcare premises. Employers are required by law to identify hazards to which staff are exposed and take all reasonably practicable steps to eradicate or minimise them.

If you have been physically assaulted at work:

  • Contact the police immediately to report the assault. This is important, even if you have been assaulted by a confused patient. If you do not, then any later criminal injuries compensation claim (see below) will be refused. Your employer’s policy may offer guidance.
  • Check your employer's sickness policy and see our sickness advice if you've been injured.
  • If you are asked for a statement, read our guidance here.
  • Read your employer’s policies on violence in the workplace and check for any specific processes in place that you should follow.
  • Always report your concerns to your manager as soon as possible and document the assault on an incident form.
  • Read our advice on personal injury and accident at work. While violence in the workplace is not an ‘accident’, similar principles apply in relation to reporting incidents and what action to take if you have suffered an injury. In some circumstances, you may be entitled to compensation from the Criminal Injuries Compensation Authority (CICA) if you were injured in England, Scotland or Wales.  For injuries sustained in Northern Ireland contact Northern Ireland Criminal Injuries Compensation SchemeContact us if you would like to discuss making a claim
  • Access emotional support. Being assaulted at work can be very traumatic and in addition to any physical injuries, you may be traumatised, stressed and anxious.  

Once you have reported an assault, violence or the threat of violence to your employer, your employer should:

  • Carry out an assessment of the risks to health and safety through a risk assessment (or review current risk assessments).
  • Decide on the arrangements which must be implemented to prevent an assault occurring again and put in place protective measures.
  • Provide information and training to employees e.g what measures need to be taken if caring for a patient with a history of violence towards staff.

Verbal abuse from patients and the public can be equally as distressing, particularly where it relates to a protected characteristic e.g. homophobic or racists abuse.  We encourage members to report incidents of verbal abuse using their organisation’s incident form.  Where the verbal abuse contains a threat to harm this should be taken seriously and reported to the police.

Employers should also review cases of verbal abuse and take measures to address the issue.  Such measures may include behavioural agreements, formal warnings on behaviour and medication reviews

Check your employer’s sickness absence policy for any exceptions to normal rules for absence management and/or the payment of occupational sick pay following injury at work. You may be entitled to certain NHS injury benefits or allowances if you work in the NHS.

You may refuse to treat a patient if there is a serious threat of violence but this needs careful consideration. It may be possible for care to be given whilst the patient’s violence is managed.

Each situation needs assessment and you should discuss this with your manager and the rest of the care team. Read your employer's policies on managing violent patients. Remember that your employer has a responsibility to ensure the safety of both you and the patient.

Your employer cannot dismiss or discipline you for leaving your workplace because of danger which you believe to be "serious and imminent" and which you could not be reasonably expected to prevent. This includes taking any appropriate steps to protect you or others from danger.

Read our advice on refusal to treat.

Under health and safety legislation, employers have an obligation to protect the health, safety and well being of their employees. The legislation also requires employers to assess the risk of violence towards their employees and put in place measures to reduce that risk. An effective system of risk assessment is therefore crucial. Some examples of measure that could be taken include:

  • improvements to the physical environment
  • alarms systems
  • signage
  • safe staffing levels
  • training for staff. 

The importance of your safety is equal to that of your patients. You need support to identify and avoid working in unsafe conditions, and you need to know how to manage situations that become unsafe.

As a lone worker, your organisation must assess the risks from lone working activities and take measures to reduce the risk of injury and harm including violence and abuse.  In turn, you have a responsibility to follow safe working practices. Please see our guide on prioritising personal safety for more information. 

If you often work alone and there is the threat of violence, or you are aware that more violent incidents are taking place, read the guidance in Personal safety when working alone: guidance for members working in health and social care

The NHS Staff Council provides a range of guidance for lone workers including a guide for lone workers.

Always remain watchful for your own safety and that of your colleagues. If you feel that your employer is not dealing with the issue sufficiently, please contact us.

Although some types of violence may be related to the patient's clinical condition, anger or fear are just as likely to lead to violence in mental health settings. Training should be provided to help you to deal with physical violence and verbal abuse. It should also help you to prevent verbal abuse developing into physical violence (de-escalation). 

Do not accept verbal and physical violence as an inevitable part of your job. 

Always report incidents and discuss them with your manager, the wider care team and your RCN Safety Representative. If you feel that your employer is not dealing with the issue sufficiently, please contact us

The Health and Safety Executive provides guidance to employers on how to manage the threat of violence in the workplace.

Statements, investigations and discipline

Establish next steps and how we can help.

Sick leave and sick pay

Read about your sick leave and sick pay entitlements, including absence management processes.

Confidential help and support line

If you have been affected by any of the issues relating to the recent reports of sexual harassment, please call our confidential help and support line on 0800 783 1157 (open every day of the week, 24 hours a day). Further information can be found here.

Page last updated - 13/09/2021