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The Hidden Layers of Violence in Healthcare: Why Some Workers Bear the Brunt

A System That Doesn’t Protect Everyone Equally

Violence in healthcare isn’t just a case of bad behavior between individuals—it’s a layered issue that disproportionately affects certain groups. Nurses and nursing assistants, particularly women and people of color, face alarming rates of verbal threats, shouting, and even physical assaults. Yet many studies overlook the deeper forces at play: gender, race, and systemic power imbalances shape who is targeted—and who gets away with targeting them.

Power Imbalances in Healthcare: Who Holds the Risk?

Healthcare is far from an equal playing field. Women dominate nursing staff, often occupying lower-paying assistant roles, while patients and families sometimes redirect their frustration—not at the system, but at those who look or sound different from them. When identities collide—a Black woman in a leadership position, a Latino man in an aide role—the risks compound exponentially.

Enter intersectionality, the concept that explains why a single solution, like de-escalation training, rarely works for everyone. Such policies often fail to address deep-rooted biases and hierarchical structures that perpetuate hostility. A review of past studies reveals a glaring gap: most research focuses on incidents after they occur, not on why certain workers face hostility shift after shift.

The Overlooked Threat: Colleagues, Not Just Patients

Here’s the unsettling truth: patients and families aren’t the only ones lashing out. Coworkers can be just as harmful. Racist jokes, sexist remarks, and exclusionary behavior often go unchallenged, slipping through cracks in workplace culture. When research ignores these layers, it misses half the problem—and half the solutions.

Why This Matters

Healthcare violence isn’t just a workplace safety issue—it’s a systemic failure. Without acknowledging the intersection of race, gender, and power, no policy or training will fully protect those on the front lines.