Ivette Palomeque, RN, recalls the incident as though it happened yesterday—even though it occurred many years ago while working for a different health system. As a new nurse with less than a year of bedside experience at the time, she was already no stranger to managing irate patients and their frustrated family members and visitors. But that day was different. Palomeque was in a crowded room with clinicians performing CPR on a patient who had just coded. “All of a sudden, the patient’s spouse ran into the room and started frantically kicking and punching the people who were trying to save their spouse’s life,” said Palomeque, now a nurse in the Intensive Care Unit at Memorial Hermann-Texas Medical Center (TMC)

in Houston. The individual was removed from the room but quickly returned. The kicking and punching intensified to the point where the medical team had to stop CPR. Tragically, the patient didn’t survive. “The next thing I knew, a huge group of family members came in screaming at us, threatening extreme violence,” Palomeque shared. “Nurses were hiding. It was a truly terrifying experience that I’ll never forget.”

Violence is Not “Part of the Job”

Palomeque’s experience is not an isolated story. Palomeque can recall many examples of workplace violence before coming to Memorial Hermann, including seeing a pregnant colleague getting kicked in the abdomen and watching as fellow nurses had to run for cover when situations became violent. Thankfully, Palomeque is quick to say she feels safer coming to work after joining Memorial Hermann.

Unfortunately, that is not the case in all hospitals. Findings from a 2021 Texas Nurses Association report stated that nearly 40% of nurses reported experiencing physical violence at work, while over 70% said they had faced verbal abuse. Even these figures might understate the problem as, historically, many hospital employees say they don’t always report incidents, fearing retaliation or believing that dealing with abuse is “just part of the job.”

But violence is not—and should never be—a part of a nurse’s job. Nurses are real people who feel a calling to help others. They should feel safe when caring for their patients. Memorial Hermann is focused on fostering a culture where every staff member understands that abuse is unacceptable, and this effort has become a personal passion of mine. At Memorial Hermann, we are not just talking about prioritizing workplace safety—we’re taking action. We are committed because we believe no nurses or health care providers should have to choose between their own safety and caring for a patient.

The Reality of Workplace Violence

Every day, hospitals face situations that have the potential to turn violent. The lingering effects of the COVID-19 pandemic—distrust, fear, and anger—combined with patients’ pain and frustration create a volatile environment. People seem to have less patience, are quicker to anger, and often believe lashing out at healthcare workers is acceptable.

According to OSHA, 73% of all reported workplace violence incidents occur in a healthcare setting, and Press Ganey & Agency for Healthcare Research and Quality (AHRQ) data shows that reported assaults against nursing personnel jumped 5% year over year—ranging from shouting and cursing to physical attacks such as hitting and throwing objects.

At Memorial Hermann, initiatives from our Workplace Violence Prevention Task Force have led to year-over-year improvements in the safety of our employees at work. Despite our best efforts, we know we might never reach zero incidents, but we are committed to keeping that number as low as possible. We want to continue providing transparency to our frontline staff about our ongoing efforts to keep them safe.

A Two-Pronged Approach

Memorial Hermann’s strategy to combat workplace violence focuses on clinical caregiver communication and enhanced security measures. De-escalation training is mandatory for clinical staff and available to all employees. This training helps employees identify potential threats, remain vigilant, and develop exit strategies when dealing with difficult individuals.

At Memorial Hermann-TMC, the Behavioral Emergency Response Team (BERT) consistently addresses workplace violence through a structured, multi-tiered response system. Behavioral incidents are meticulously tracked, allowing staff to anticipate and prepare for potentially volatile situations with patients or family members. If a patient exhibits escalating aggression—ranging from cursing to physical outbursts—this information is documented in the patient’s chart and flagged in their electronic health record. In addition, predictive scoring is done every shift to develop individualized care plans proactively focused on safety.

The three levels of behavioral response include the Early Intervention Huddle, where a BERT clinician responds to emerging concerns; Code BERT, which involves both a BERT clinician and security officer for more serious incidents; and Code Green, activated when a patient becomes verbally or physically threatening, prompting security to secure the area before the BERT team intervenes.

Facility security has been upgraded with weapons detection technology, and security officers now wear body cameras to document behavioral incidents. We have also increased the number of security personnel and improved their visibility throughout the hospital. High-risk areas such as the Emergency Center, intensive Care, Labor and delivery, and Pediatrics units receive increased attention, with security officers conducting regular rounds, both independently and with clinical staff.

Looking ahead, Memorial Hermann is exploring advanced technologies, such as facial recognition and license plate readers, to identify individuals with a history of violent behavior before they enter our facilities.

Building a Culture of Kindness

One of Memorial Hermann’s most impactful initiatives is our Kindness Campaign. In partnership with our Legal and Marketing teams, we revised our Code of Conduct and created internal signage reminding everyone entering our facilities that our employees are also human beings. Each one is someone’s mother, father, sibling, or child. At its core, the message is simple: kindness matters. Healthcare workers are doing their best to provide care in challenging circumstances. A little empathy can go a long way in fostering a safer, more supportive environment for everyone.

Advocacy for Safety

While we tirelessly work within our own walls to ensure our nurses feel heard and protected, our voice does not stop there. We extend our advocacy beyond our facilities to address broader industry challenges. Workplace violence in hospitals is costly on multiple levels. It is a factor in the ongoing nursing staffing crisis as more nurses leave the profession. Hospitals must prioritize workplace safety to retain and protect their workforce.

Texas made strides in addressing workplace violence during the 2023 state legislative session, during which lawmakers passed three critical laws with significant input from healthcare advocates. I had the opportunity to testify on behalf of Memorial Hermann and am thrilled that the following bills were enacted into law:

SB 240: Requires healthcare facilities to prioritize employee safety through initiatives like Workplace Violence Protection Task Forces.
SB 840: Elevates the penalty for assaulting health care workers from a misdemeanor to a felony in Texas.
SB 1004: Makes tampering with or removing an ankle monitor a felony offense. This bill was prompted in part by the tragic shooting at Methodist Hospital in Dallas, where the suspect had removed his ankle monitor and could not be tracked. While not solely focused on workplace violence, it addresses a significant public safety gap.

I will continue to advocate during the current legislative session so I and other nursing leaders can speak on behalf of nurses and, hopefully, make a real difference.

We are committed to keeping our nurses safe and ensuring they feel supported daily. By advocating for stronger protections and continuously improving our security measures, Memorial Hermann strives to create a workplace where violence is rare, and kindness is the norm. We hope our efforts today are shaping a safer tomorrow for all who work in the healthcare industry.

The post Protecting Our Nurses: How Memorial Hermann Health System is Tackling Workplace Violence and Building a Culture of Kindness first appeared on Daily Nurse.