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The Federal SAVE Act: a beacon of hope for health care worker safety

It’s a narrative that has become disturbingly familiar: different health care providers, yet the same traumatic story.

Ramon, an idealistic new nurse, was drawn to nursing to make a meaningful impact in the lives of the most vulnerable. But in an instant, his love for nursing changed. After just six months as a nurse, a patient’s son viciously attacked Ramon, enraged over his mother’s COVID-19-related hospitalization. In a blind fury, the son placed Ramon in a chokehold and brandished a fixed-blade knife, threatening deadly consequences unless the hospital immediately released his mother. Fortunately, a police officer who was guarding a nearby prisoner patient happened to witness the incident and intervened, saving Ramon’s life. But the psychological scars of the assault left a deep mark. Haunted by the fear of another attack and unable to reconcile with the trauma, Ramon quit nursing.

This incident is just one example of the dangers health care workers face, highlighting a broader, unspoken fear that pervades the profession. Often, it’s not even the act of physical violence but the ever-present threat of physical violence, like the ICU nurse’s op-ed on how the lack of support and absence of basic safety measures drove her from the field entirely. These professionals are serving people who are vulnerable and in need of health care. But at what cost?

Workplace violence against health care workers is not a new phenomenon, yet it’s an issue that is increasingly worsening. Data from the Bureau of Labor Statistics reveals a striking 63 percent increase in injuries from violent attacks on medical professionals between 2011 and 2018. The COVID-19 pandemic has exacerbated this surge, with hospital safety directors noting a significant increase in aggression towards staff, primarily attributed to factors like overwhelmed health care systems, short staffing, and longer wait times. According to an analysis by Press Ganey, the second quarter of 2022 alone witnessed an average of over two assaults on nursing personnel every hour in the US—this equates to a staggering 57 daily assaults, 1,739 monthly assaults, and 5,217 quarterly assaults.

Under common law, assault constitutes a crime when it involves the intent to threaten, inflict, or attempt to inflict bodily harm on another person. Why wouldn’t the same elements of the law be applied in the health care setting?

While hospitals and health care systems should be responsible for creating a safe space for their employees to perform their calling, there is also a substantive need for state and federal legislation to protect health care workers. Some states like Wisconsin and Florida have enacted laws making assault and battery against health care personnel a felony. Other states, such as Montana, believe violence against health care workers needs to be documented by the health care entity and studied before enacting protective laws criminalizing this activity.

Although forty states have enacted legislation to increase penalties for workplace violence against health care workers, the absence of a federal law underscores a critical gap in providing uniform protection for health care professionals across the nation. A federal law would ensure consistent standards and protections, regardless of state borders, offering a comprehensive framework to address the varying degrees of legal recourse currently available. Particularly for the ten states lacking specific legislation, a federal mandate would provide much-needed legal protection and serve as a powerful deterrent. Furthermore, federal involvement could bring additional resources for safety improvements, enforcement, and support for victims, including legal and financial aid.

Amidst these concerns, the introduction of the bipartisan Safety from Violence for Healthcare Employees (SAVE) Act represents a renewed effort by federal lawmakers to address workplace violence in the health care setting. The SAVE Act would implement more substantial legal penalties for people who knowingly and intentionally assault or intimidate hospital employees. This law is essential to protect our health care workforce, which has been decimated by the extraordinary challenges of the COVID-19 pandemic. There are laws protecting politicians and employees in the postal service and airline industry. It’s time for stronger state and federal laws to be put in place to protect the health care industry’s most precious resource: its people.

Scott Ellner has been a general surgeon for over 20 years, and can be reached at PEAK Health. He has transitioned into health care executive roles due to his passion for patient safety, quality, and value-based care delivery. His authentic leadership style inspires team members to navigate challenging situations, such as resistance to change and innovation, in order to bring about meaningful transformation. Most recently, he served as the CEO of Billings Clinic, the largest health system in Montana. During his tenure, Forbes recognized the clinic as the best place to work in the state. It was also at that time that he formulated a strategic growth plan that included the development of a level 1 trauma network and a rural-based clinically integrated network.


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