Not Part of the Job: Ending Violence Against Health Care Workers in Canada


Workplace violence is a widespread problem facing health care workers across Canada. It includes physical violence, verbal abuse, sexual and racial harassment and sexual assault. The violence can be perpetrated by patients, family members and other visitors, co-workers or superiors. It is neither normal to experience workplace violence in a health care setting nor “part of the job.”

In a recent national survey conducted by the Canadian Federation of Nurses, 61% of nurses surveyed reported experiencing a violent altercation (e.g., abuse, harassment, assault) over the previous 12 months. Most violent attacks occur in emergency departments, but workers also face a greater risk of violence in psychiatric settings, as well as in long-term care facilities and home care settings. A 2019 survey conducted by the PEI Union of Public Sector Employees on workplace violence of resident care workers, patient care workers and licensed practical nurses revealed that 90% of these front-line workers have experienced violence in the workplace.1

While these numbers are unacceptably high, much of the workplace violence in health care settings goes underreported. This is likely due to fears of reprisal from an employer and a widespread culture of acceptance of a serious health and safety issue.

HESA agreed to study violence faced by workers in a health care setting with the goal of developing recommendations for federal government action to address this serious problem.

At the end of June, the House of Commons Standing Committee on Health (HESA) presented their report Violence Facing Health Care Workers in Canada to the House of Commons. HealthCareCAN has reviewed HESA’s recommendations to address violence faced by health care workers in hospitals, long-term care facilities and in home care settings.


From May to June 2019, the Committee held four meetings and received eight written submissions, hearing from organizations representing the interests of nurses, physicians, paramedics, personal support workers, long-term care facilities, and occupational health and safety experts and researchers.

The Committee’s report is a summary of the oral and written testimony received. It examines the scope of the problem facing health care workers and the factors contributing to it, such as complex patient needs; staffing shortages; aging health care infrastructure; and inadequate security personnel and response systems. The report provides nine recommendations to the Government of Canada on how to move forward in this area. They are summarized as follows:

  1. Work with the provinces and territories to develop a pan-Canadian framework for the prevention of violence in health care settings.
  2. Develop a national public awareness campaign.
  3. Amend the Criminal Code to consider that the victim of assault is a health sector worker in sentencing of offender.
  4. Provide funding to the Canadian Institute for Health Information to develop standard definitions and collect statistics in relation to workplace violence in health care settings.
  5. Provide funding through the Canadian Institutes of Health Research (CIHR) to evaluate the implementation of best practices.
  6. Provide funding through CIHR to support research identifying ways to prevent gender-based violence in health care settings.
  7. Establish the Canadian Centre for Occupational Health and Safety.
  8. Update the Pan-Canadian Health Human Resources Strategy.
  9. Expand Invest in Canada Plan to provide funding to upgrade health care infrastructure.

The recommendations echo what was heard through witness testimony that workplace violence experienced by health care workers must not only be addressed, but prevented.


Research and surveillance account for a significant share of the recommendations – from developing standard definitions and terminology related to workplace violence in health settings, to evaluating best practices in the prevention of workplace violence, and supporting information sharing of best practices across jurisdictions. These recommendations will help to foster the spread and scaling-up of best practices across the country.

The recommendations do not draw upon any particular best practice for the federal government to undertake, but the report does speak to solutions to address violence, including:

  • Education and training in de-escalation of violence
  • Violence risk assessments of institutions, long-term care facilities or individual patients
  • Safety and security protocols to respond to violence

Health organizations would be well advised to consider their current practices and safety response systems that address workplace violence in a health care setting.

For several years, HealthCareCAN has partnered with the Mental Health Commission of Canada in the “By Health, For Health Collaborative” to promote a vision for health institutions to be leaders and role models in providing psychologically healthy and safe work environments for all Canadians.

Central to this work is the development of the Declaration of Commitment to Psychological Health and Safety in Healthcare. This document is a commitment by health institutions to advance the protection and promotion of mental health in the workplace and in alignment with the principles of the National Standard for Psychological Health and Safety in the Workplace.

Ensuring the safety and well-being of health care workers is foundational to delivering first-rate patient care in health settings across Canada. Staffing shortages add to the pressure employees face every day. In fact, workplace violence contributes to the vicious cycle of staffing shortages in health settings. Staffing shortages lead to workplace injuries and workplace injuries lead to staffing shortages. Health facilities and organization have a vital role to play in bringing awareness to this issue and encouraging their staff to report violence in the workplace. It is integral to prevent and mitigate workplace violence facing health care workers and ensure that violence is never accepted as “part of the job.”

HealthCareCAN will continue to champion the issue of enhancing the safety of health care workers with the Government of Canada and keep members informed of progress on the issue.


More information about what steps you and your organization can take to prevent workplace violence against health care workers can be found in the following resources:

  1. International Affairs & Best Practice Guidelines: Preventing violence harassment and bullying against health workers
  2. Government of Ontario: Workplace violence prevention in health care: a guide to the law for hospitals, long-term care home and home care
  3. International Labour Organization: Framework guidelines for addressing workplace violence in the health sector