New laws and a workplace violence prevention toolkit aim to address violence against healthcare workers in Texas


Maddie McCarthy


In December, the Texas Hospital Association (THA) and Texas Nurses Association (TNA) released a Workplace Violence Prevention Toolkit, which is meant to help healthcare facilities protect their workers.

The toolkit outlines four different types of violence in the healthcare setting: patient-on-worker violence, worker-on-worker violence, personal relationship violence (where the perpetrator has a relationship with their target, but not to the facility), and criminal intent violence (where the perpetrator has no relationship with the victim or the hospital).

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Healthcare workers are five times more likely to suffer a workplace violence related injury than workers in other industries, according to the US Bureau of Labor Statistics. Senate Bill 240, SB 840, (both of which passed the legislature in 2023 and spurred the creation of the toolkit), and the toolkit itself aim to address this.

Sen. Donna Campbell, MD, (R-New Braunfels) sponsored SB 240. It was the first bill passed during the 88th Texas legislative session. 

“This bipartisan legislation puts Texas at the nation’s forefront of protecting healthcare workers from violence and helps prioritize what’s best for Texas healthcare workers: their safety,” Campbell said in a statement sent to State of Reform. 

The bill, Campbell said, requires healthcare facilities to establish a workplace violence prevention committee that creates prevention plans and policies, which are subject to annual review. The bill also requires annual violence prevention training, availability of immediate post-incident services, and a reporting system so incidences of violence can be investigated. 

“The passage of this bill was extremely crucial because healthcare workers are the frontline and backbone of our healthcare system and deserve to work in facilities that prioritize their wellbeing. 

This is especially important when considering that 83 percent of Texas nurses reported to have experienced some type of workplace violence during their careers, yet 60 percent of these nurses did not report their most recent violent event through their facility’s incident reporting system for fear of losing their jobs or for other reasons. SB 240 is an example of the immense good that can come from our legislature when we work together for all Texans.”

— Campbell

Jack Frazee, JD, director of government affairs and general counsel at TNA, spoke with State of Reform and said the bill also prevents workers from facing retaliation when they report an incident.

“If they report any incident of violence either up the chain, so to management or out to law enforcement, those are protected activities,” Frazee said. “The idea behind that is that we want hospitals and other healthcare facilities to work with their local law enforcement agencies to actually intervene when violence occurs and prosecute them.”

This will allow communities to use their local resources, rather than waiting for a centralized response, Frazee said. 

SB 840, sponsored by Sen. Royce West (D-Dallas), makes the penalty for assaulting a healthcare worker on hospital property a third degree felony. The toolkit includes signage detailing the law for facilities to post so hospital workers, patients, and visitors are aware of the penalty.

In a statement sent to State of Reform, Heather De La Garza, associate general counsel for THA, discussed how the toolkit is meant to help hospitals follow both of these new laws. All facilities must have their committee established by Sept. 1st, 2024.

“The purpose of our toolkit is to give hospitals guidance and materials to help them achieve compliance with SB 240 as soon as possible,” De La Garza said. “We felt that it was important because hospital staff are day-to-day heroes in our Texas communities, and they should be protected.”

Creating the toolkit required collaboration between THA, TNA, legislators, and healthcare workers. Frazee noted that THA did much of the initial legwork in developing the toolkit.

“There are years of work that our associations have done, gathering feedback from frontline nurses and hospital administrators,” he said. “There is a ton of data that we have been gathering together and you can see some of the stats in the report. [The collaboration] really spans from the front lines of our membership all the way up to the policy teams of our associations.”

Frazee emphasized the connection between staffing shortages and workplace violence. 

“There is an interesting relationship in the data where, if you don’t have sufficient staff, you see an increase in workplace violence,” he said “… If we can reduce workplace violence, that helps us retain professionals at the bedside, so that alleviates some of our staffing issues and some of the burnout issues.”

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