Violence Against Emergency Department Health Care Workers and the Effect of Wisconsin Act 209

Lauren Nickel, PhD; Corey Sell, MD; Meredith Hiller, BA; Arthur Derse, MD, JD; Nancy Jacobson, MD; Christopher Torkilsen, DO; Jamie Aranda, MD; Bradley Burmeister, MD, MBA; Matthew Chinn, MD

WMJ. 2025;124(5):438-444.

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ABSTRACT

Background: Health care settings are not immune to workplace violence, and emergency department workers are especially susceptible. In 2021, Wisconsin Act 209 made it a felony to “intentionally cause bodily harm or threaten to cause bodily harm to a person who works in a health care facility.” We conducted a study of emergency department workers to assess their experiences with violence and the perceived effects of Act 209.

Methods: We developed a survey for health care workers (nurses, physicians, and advanced practice providers) who were currently practicing in a Wisconsin emergency department. The reporting timeframe was March 23, 2022, through June 30, 2023.

Results: A total of 194 Wisconsin emergency department workers responded; 70.6% reported experiencing bodily harm, threats of bodily harm, or both. The median number of bodily harm incidents was 2, and 51.4% did not report these incidents. The median number of threats reported was 4, and 66.7% did not report them. Nurses experienced more threats of bodily harm than physicians. Overall, 40.2% of respondents were unaware of Act 209, and 67.6% indicated that abuse toward health care workers occurred at the same rate after its enactment as before. The most frequent barrier to reporting was “Person has a medical condition that might complicate application of the law.”

Discussion: Most workers reported experiencing bodily harm or threats, and most did not report these incidents. Beyond clinical factors and time constraints, limited law enforcement bandwidth and perceptions of law enforcement as obstructive were the next most cited barriers. Only 1.2% of respondents reported feeling “definitely safer” after Act 209.

Conclusions: Violence against health care workers has become an expected consequence of working in the field. Legislative action is one tool to attempt to curb this trend. Further efforts to identify strategies that ensure the safety and wellness of health care workers should be a priority.

Author affiliations: Medical College of Wisconsin, Milwaukee, Wisconsin (Nickel, Sell, Hiller, Derse, Jacobson, Torkilsen, Aranda, Burmeister, Chinn); Northeast Emergency Medicine Specialists, Willimantic, Connecticut (Sell); Green Bay Emergency Medicine Services SC, Green Bay, Wisconsin (Burmeister).
Corresponding author: Matthew Chinn, MD; Medical College of Wisconsin; 8701 W Watertown Plank Rd, HUB A3123, Milwaukee, WI 53226; email mchinn@mcw.edu; ORCID ID 0000-0002-2127-3505
Financial disclosures: None declared.
Funding/support: None declared.
Acknowledgements: The authors would like to acknowledge the Wisconsin Emergency Nurses Association, the Wisconsin Chapter of the American College of Emergency Physicians, the Wisconsin Academy of Physician Assistants, and the countless other colleagues and friends who helped with survey distribution. They also would like to acknowledge the emergency medicine physicians, advanced practice providers, and nurses who completed the survey. And to those working in emergency departments and health care settings everywhere, thank you for showing up to work every day and providing the best care to your patients.

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