This story is part of our latest Super Issue, which examines how money, burnout and policy are changing the way NKY gets — and gives— medical care. Click here to learn more.
Emily Kraft remembers the incident well.
She was working at a hospital when one of her patients, an older teenager with autism, began to experience what she described as a severe mental health crisis.
As her nursing unit tried to de-escalate the situation, the patient’s mother became increasingly agitated, Kraft said. She began insulting the nursing staff, even calling them racial slurs. Eventually, Kraft said, the patient’s mother physically pushed Kraft onto the ground and attempted to strike her.
As shocking as this may seem for someone who doesn’t work in the medical field, Kraft said it’s not rare. Not even close.
“The thing I want to emphasize is this is not a unique or isolated experience,” said Kraft, who is a flight nurse and union member with the Registered Nurses Association of Ohio. “Every single day, there are attacks on healthcare workers.”
In the aftermath of the incident, Kraft said what shocked her the most was the hospital’s response. Instead of inquiring about her safety or the patient’s safety, she said management asked whether she had physically retaliated.
The experience, Kraft said, exemplifies part of a broader hospital culture more concerned with liability and public image than with safeguarding nurses.
Kylee Ham, a registered nurse in the emergency department at the University of Cincinnati Medical Center and president of the Registered Nurses Association, corroborated Kraft’s accounts of nursing violence, telling LINK nky that the phenomenon is common yet underreported.
“It’s extremely common,” Ham said. “It’s underreported, unfortunately, because I think there are a lot of nurses that just feel like it’s part of the job, or they don’t always report the incidents because it’s an extra step of charting and filling out paperwork.”
The Ohio Nurses Association 2026 Workplace Safety Report found that 68.72% of direct care nurses experienced workplace violence — including verbal abuse, threats or physical assault — in the past 12 months, while 63.62% of direct care staff consider workplace violence an ongoing and serious concern.
Kraft said she chose nursing driven by her passion to care for others. Over her years in the field, she’s seen verbal abuse and physical conflicts lead to burnout among nurses and questions about the future of one of the United States’ essential healthcare careers.
Prior to her current role, Kraft accrued years of experience in emergency departments, where she recalled staff regularly working in unpredictable and volatile environments, encountering patients in severe distress, including those experiencing trauma, mental illness, intoxication, dementia, or psychotic episodes.
“All those things weigh on you, not being able to provide proper care because you’re scared, causes you moral injury,” Kraft said. “We’re in this job to do everything we can for people, no matter what their problems are, and the weighing moral injury, as I put it, because it wasn’t safe for me is really heavy.”
Another factor that comes into play for nurses, Ham said, is the 12-hour shifts. Having to deal with a constant barrage of verbal abuse, racial slurs, sexual harassment and threats wears down nurses more quickly because of the long shifts often required in the profession. Over time, it begins to take a toll on nurses’ mental and emotional health.
Since the waning of the COVID-19 pandemic, violence against nurses has steadily increased, according to multiple academic studies. A 2023 Press Ganey report found that 16,975 physical assaults against nurses occurred nationally, a 5% increase from the previous year.
Ham said she believes workplace violence has worsened significantly in recent years, particularly after the COVID-19 pandemic, as the healthcare system became more strained.
Oftentimes, the very nature of a healthcare setting in the post-pandemic world can create conditions that could lead to violence against nurses. Statistically, up to 82% of emergency department nurses experience physical assaults on the job, according to the American Association of Critical-Care Nurses.
“The ER is not set up for somebody to be admitted to,” Ham said. “A lot of times, it’s loud — the lights, there’s always activity. That can be a lot of times where you end up getting that agitation building and building. I think people are also just maxed out. Everything’s so stressful right now. Going into a hospital is extremely stressful. You’re gonna have, most likely, depending on your situation, some type of insane bill from that, denials from insurance and dealing with that. It’s just compounding that stress, plus you’re sick.”
Laurie Conkright, senior vice president of nursing at St. Elizabeth Healthcare, the largest healthcare provider in Northern Kentucky, told LINK nky that their internal assessments revealed that nurses in emergency departments and intensive care units are most likely to face situations that could lead to violence.
“I think a lot of times you’ll see EDs, ICUs. Those are definitely areas where you typically have scenarios that are critical or emergent,” she said. Anxiety is high, patients are fearful. Those can be the scenarios that lead to that type of behavior.”
Gene Barber, St. Elizabeth’s senior vice president of facilities, added that patients with dementia can lash out because of confusion about what is happening around them.
In addition, Kraft said another contributing factor to the high anxiety levels some patients experience while being admitted to the ER is an eroding lack of faith and trust in the U.S. healthcare system in general. An investigation published in the JAMA Network, a collection of peer-reviewed medical and scientific journals, found that trust in physicians and hospitals decreased substantially over the course of the pandemic, from 71.5% in April 2020 to 40.1% in January 2024.
“Post-COVID, because of everything in the news, in the government, in the communities — there was a massive uptick in a lack of trust in the healthcare system,” she said. “Our patients lost trust in the hospitals, and therefore lost trust in their nurses.”
One of the primary issues highlighted by Kraft and Ham is internal reporting systems, which they both deemed inadequate for effectively reducing violence against nurses. Ham said that at her hospital, nurses are encouraged to document incidents through surveys and forms, such as “Assignments Despite Objection” reports, which are formal documents nurses use to protest an unsafe or unmanageable workload.
However, Ham said many nurses stop filing reports because they feel as though they don’t see meaningful changes result from them. Others become overwhelmed by the sheer volume of incidents and begin selectively reporting only the most severe cases, fearing that documenting every occurrence could be dismissed as excessive or frivolous.
Kraft said she feels personally apathetic toward the incident-reporting system, noting that she doesn’t believe it has the capacity to change future outcomes.
“It’s repeatedly seeing nothing coming of that which makes me apathetic to filling those out and reporting,” she said. “It’s apathy. Nothing’s ever happened before, nothing’s gonna happen now.”
Eventually, some nurses hit a breaking point, choosing to leave bedside care entirely and switch to outpatient clinics or office settings to escape hospital stress, or they leave the profession altogether.
The U.S. is currently in the midst of a nationwide nursing shortage, with a 2022 Health Workforce Analysis by the Health Resources and Services Administration estimating a shortage of 63,720 professionals by 2030, citing pandemic-related burnout and many nurses approaching retirement age. Digging deeper, Nightingale College found that shortages varied by position and geographic location, with the largest deficits among Registered Nurses and Licensed Practical Nurses.
However, bedside care nurses are the most statistically likely to alter their course.
“They will work remotely or take a non-one-on-one caregiving job,” Kraft said. “No more touching the patient. 50% of new nurses will leave bedside within 18 months.”
Ham said that many younger nurses enter the profession with idealistic expectations, only to quickly discover they lack the time and support needed to properly care for patients. Ham cited unsafe patient loads, skipped meal and bathroom breaks, and chronic stress as reasons many nurses leave bedside care early in their careers.
In February, Lisa Cooper, a senior analyst at Cincinnati Children’s, mentioned during the Northern Kentucky Chamber of Commerce Eggs ‘N Issues breakfast panel that a major obstacle to restoring the nursing talent pipeline is the negative public perception of the profession since the COVID-19 pandemic, along with its inherent difficulty as a job.
Cooper said that nurses were once widely touted as frontline heroes, but now often face increased skepticism, hostility and scrutiny. In turn, this perception, she believes, is discouraging prospective workers from entering the profession. Moreover, the rise in reports of violence against nurses does not improve that perception.
Kraft and Ham believe there was a direct correlation between understaffing and violence. 68.74% of respondents in the Ohio Nurses Association 2026 Workplace Safety Report said they felt staffing levels were determined by budgetary goals or limits rather than patient care needs.
Ham argued that hospitals lack sufficient nurses, support staff and security resources to create a safe treatment environment for both patients and staff. Essentially, when workers are spread too thin, they cannot spend enough time with patients to build trust or de-escalate tense situations before they become dangerous.
“We need more staff, and we also need more ancillary staff,” she said. “We need more staff to support us.”
Furthermore, Ham argues that there isn’t a shortage of nurses, but rather a shortage of nurses willing to remain at the bedside under current conditions.
“There’s not a shortage of nurses, there’s a shortage of nurses that are willing to stay at the bedside and just put up with this,” she said.
In the face of these issues, Greater Cincinnati healthcare systems have started implementing preventative measures. However, determining their long-term effectiveness will take time.
In addition to making incident reporting forms more accessible and less time-consuming to complete, both UC Health and St. Elizabeth Healthcare have posted signs throughout their facilities warning that violence against staff will not be tolerated. Ham noted that while this is a small step in the right direction, the process to get the signs approved required difficult negotiations between her union and UC Health management.
Conkright and Barber said St. Elizabeth has begun investing more heavily in its security staff, de-escalation protocols and other preventive measures. St. Elizabeth Public Relations Manager Sally Thelen said the healthcare company currently has 88 security personnel on staff, an increase from previous years.
“You have a patient that could be experiencing a loss of independence, so what we’ve tried to focus on is trying to de-escalate that behavior in the patient or the visitor,” Conkright said. “Being in the hospital is a critical situation for a lot of folks, and you feel like that, loss of independence, stress/anxiety levels are high. We try and work on de-escalation for the patients and for the family members, if needed.”
Internally, St. Elizabeth uses Behavioral Assistance Response Teams, composed of employees with specialized crisis training who can respond rapidly to escalating patient situations. Security officers are also trained in “safe wrap” techniques to physically restrain individuals without injuring patients, staff members or officers.
Other measures include deploying more armed security personnel, upgrading camera systems, limiting after-hours access to high-risk zones and conducting mobile security patrols across hospital campuses.
According to Barber, the measures have helped reduce rates of physical violence against nurses.
“Our verbals are staying about the same, but we’re really seeing the physical go down with our de-escalation and response teams and training,” he said.
Hospitals and nurses face a complex situation. Hospitals are now expected not just to treat illnesses but also to handle the emotional, economic and social pressures that impact emergency rooms and patient floors. The solutions vary depending on who you ask. For hospital executives, it’s an investment in training, technology and security.
For nurses, it’s hiring more staff, increasing responsiveness to incident reports, but more than anything, greater support from their employers.
Regarding nursing as a profession, Ham remains optimistic, describing nurses as deeply compassionate, caring and highly skilled professionals who provide an essential service under increasingly difficult circumstances. Despite this, she worries that without meaningful reforms, nursing will continue to lose experienced nurses and institutional knowledge, making it more fragile over time.
“I’m optimistic for nursing,” she said. “We have amazing nurses. I say it all the time, but they’re phenomenal. They care so much. They just want to do their job, and they’re so good at it. It is hard to be optimistic about the fixes. That’s what is really hard and really difficult is seeing this career and the way they’re treated burn out these nurses that are great. They’re excellent — and educating the next generation nurses, you start losing your longevity and that experience.”
