“How do we honor the role of the nurse by building systems that reflect the same level of commitment they bring to patient care?”

Workplace violence (WPV) remains a persistent and serious challenge in health care. Nurses, bound by the American Nurses Association (ANA) Code of Ethics to provide compassionate care and prevent harm, experience assaults at significantly higher rates than other health care professionals—a trend that intensified during the COVID-19 pandemic. These experiences are not only harmful; they create a profound ethical conflict by directly undermining professional role obligations and disrupting the alignment between ethical expectations and workplace realities. This misalignment diminishes professional role clarity, fosters cognitive dissonance in nurses’ professional role identity, and ultimately strains their commitment to the nursing profession.

Nurses’ ability to uphold compassion and provide nursing care is compromised when their safety is not protected. The 2025 revision of the Code of Ethics, particularly Provision 5, directly addresses this concern. It affirms what we’ve long known to be true:

“The nurse has moral duties to self as a person of inherent dignity and worth including an expectation of a safe place to work that fosters flourishing, authenticity of self at work, and self-respect through integrity and professional competence.”

This guidance reframes workplace safety—not as a matter of personal resilience or policy—but as an ethical obligation rooted in nursing values and woven into the nursing professional role. It highlights the responsibility of organizations, leaders, and the profession to ensure nurses can practice without compromising their own safety in the name of care.

Targeting Workplace Violence: Translating Ethics into Practice

To meet the expectations of Provision 5, ethically grounded strategies must address the systems shaping the nurse’s environment.

Nurse Scientists

WPV is complex. Evidence-based solutions must account for both environmental and behavioral contributors. Teams must distinguish between behaviors linked to illness and deliberate acts of aggression. Recognizing these distinctions allows for protocols and support systems that are both ethically appropriate and clinically sound. Nurse scientists contribute by conducting research that deepens understanding of the local prevalence and impact of WPV, developing and testing interventions to prevent and respond to violence, and advancing theoretical frameworks that explain how WPV affects nurses’ moral agency, professional identity, and commitment. Their work informs the creation of policies and educational strategies that are grounded in both ethics and evidence.

Leadership

Nurse leaders are critical to creating environments where safety and ethics are prioritized. A culture that turns a blind eye to WPV erodes the foundation of the nursing professional role. WPV and employee injury data should be regularly monitored for patterns and trends, helping leaders identify risk areas, track the effectiveness of interventions, and drive continuous improvement in workplace safety. Leaders must ensure that WPV incidents are acknowledged, addressed, and followed by consistent action to foster psychological safety and trust.

This begins with organizational values that affirm nurses’ ethical obligations and the organization’s duty to support them. The guiding question becomes: How do we honor the role of the nurse by building systems that reflect the same level of commitment they bring to patient care? Ethical leadership includes engaging interdisciplinary partners (security, behavioral health experts, chaplains, social workers, risk management) to prevent violence and to support a coordinated response.

Education and Professional Development

Nursing education must prepare clinicians to navigate WPV with both ethical clarity and practical skills. This includes de-escalation techniques, risk recognition, and institutional response protocols. Just as important is reinforcing that enduring harm is not an expected part of the nurse’s professional role. Ethical education affirms that retreating for self-protection is not abandonment—it is part of a coordinated response to uphold the professional role of the nurse.

Policy

Nurse safety must be protected by clear, enforceable policies at every level. Locally, organizations should clearly communicate structures and processes for WPV mitigation, response, and support. Provisions for accessing information about high-risk patients must balance the safety of health care staff with the dignity and rights of patients. Incident reporting should be confidential, accessible, and followed by consistent action. Regulatory frameworks, such as those provided by OSHA, provide voluntary WPV prevention guidelines but lack enforcement mechanisms. Health care organizations should proactively adopt and routinely update these practices.

State legislation varies. Some states mandate WPV prevention programs or impose legal penalties for assaults on health care workers. Advocacy is essential to expand and strengthen these protections across all settings. Finally, national organizations and accrediting bodies must continue leading efforts to establish and uphold workplace safety standards. Their influence is critical in promoting ethical practice and preventing avoidable harm.

Takeaway

Workplace violence undermines the very core of ethical nursing practice. Protecting nurses requires more than individual resilience; it demands systemic, ethically grounded action across leadership, education, policy, and research. Nurses cannot uphold their professional role if their own safety is compromised. Ensuring safe practice environments is a moral imperative.

Leah Korkis, MSN, RN, AGCNS, NPD-BC, has a master of Science in Nursing as an adult-geriatric clinical nurse specialist and a certification in nursing professional development. Leah serves as the director of Clinical Education and Nursing Excellence within Keck Medicine of the University of Southern California and is an adjunct faculty member at Mount Saint Mary’s University for the master of science in nursing program.