A Blueprint to End Violence

Nurses have come together to create ten demands to end violence in health care. Now it’s up to decision-makers to do their part.

For the nurses holding up British Columbia’s health-care system, violence is not an abstract policy issue – it is something they brace for ahead of every shift. Nurses are hit, threatened, harassed and intimidated in hospitals, long-term care homes and community settings across the province. For too long, these incidents have been dismissed as “part of the job.”

For years, nurses have been pushing back – together – against the idea that workplace violence is something they should just accept. Now, they are putting forward a clear plan for change.

Nurses have been speaking out publicly about what they face while caring for others through the union’s Violence. Still Not Part of the Job campaign – and, critically, what could be done to prevent violence in the first place. The campaign, along with years of research, advocacy and consultation with BCNU members, has culminated in ten concrete measures they are asking employers and government to follow – a blueprint to prevent violence in health care.

These measures did not come from a boardroom. They were built from the ground up by nurses dealing with violence in real time – on night shifts, in understaffed units and in long-term care homes without security. They were refined by joint occupational health and safety (JOHS) committee representatives and union staff whose job is to analyze incident data, push to enforce health and safety standards and support members. Now, BCNU elected leaders are presenting the measures and demanding action when they meet with politicians and health employers. The recommendations represent what happens when union members, experts, and leaders work together to define what a safe workplace looks like.

For Brigette Henning, a BCNU occupational health and safety representative and emergency department nurse at Arrow Lakes Hospital in Nakusp, that refusal is deeply personal. In a small rural site without dedicated security, she says nurses often feel exposed.

You never know who’s coming through the door. You don’t know whether they have been violent before.

Brigette Henning

“We rely on the police as our security because we don’t have any other options,” she explains. “We don’t have anything else.”

On night shifts, she says staffing levels are hard to maintain, and nurses are often unsure if they’ll have enough coverage to provide care, which can leave them feeling pressured to take on unsafe assignments.

“We’re one sick call away from having our patients diverted to another hospital,” she says. “You never know who’s coming through the door. Until you start triaging the patient, you don’t know whether they have been violent with health-care workers before.”

After dealing with the problem for years, Henning and nurses like her have had it with the status quo.

In Nakusp, Henning says the lack of dedicated, trained security has led nurses to adopt their own informal safety measures. “We have some really violent people in our community. One guy is 6’6” and close to 400 pounds, and he comes in frequently,” she says. “We always carry our personal cell phones with us on shift and about a year ago, nurses on night shifts were bringing their dogs.”

These aren’t solutions – they’re workarounds.

In worksites across BC, nurses are seeing the same pattern and calling it what it is: a systemic failure.

From nurses’ voices to a plan of action

The process to create the t violence-prevention measures began with listening.

BCNU surveyed members and held health and safety check-ins across the province to listen and gather their observations. Members shared what they have observed: similar patterns of chronic understaffing, insufficient security, escalating patient acuity, poorly designed workspaces and reporting systems that fail to capture what’s really happening.

Those similarities extended beyond the broader patterns and into specific examples ranging from broken panic buttons, inconsistent risk flagging, delays in implementing corrective measures after serious incidents and absent relational security officers.

When comparing members’ stories with employer incident reports and WorkSafeBC data, the mismatch was striking. Incidents of violence were both widespread and underreported.

“Nurses know what the problems are, and they have solutions. It’s time to listen,” says BCNU President Adriane Gear. “Violence leaves lasting scars – physically, emotionally and professionally,” says Gear. “Every act of violence pushes another nurse out of the profession. We cannot continue to accept this as the cost of care.”

BCNU leaders gathered the survey data and members’ accounts of violence and brought nurses’ voices directly to elected officials at the Victoria legislature in October 2025. The union met with MLAs from all parties to present ten specific measures to prevent violence before it escalates – and directed five measures each to government and health authorities.

The five recommendations to government:

The first five measures call on the provincial government to set clear expectations, provide funding and enforce standards across the health system:

Implement minimum nurse-to-patient ratios
Enhance the role of relational security officers across the province
Adopt an effective safety alert system and technology to aid prevention
Improve data collection and monitoring to mitigate risks
Fulfill the government’s 2016 promise to deliver a violence-prevention framework

The five recommendations to health authorities:

The remaining measures focus on actions health employers can and must implement at the operational level:

Standardize violence risk assessments, so patients are placed appropriately
Provide mandatory, role-specific violence-prevention training
Establish effective incident reporting, debriefing and support systems
Improve facility design to support safety for health-care workers and patients
Leadership accountability and safety culture

Together, these ten measures form a blueprint for change – one rooted in evidence and frontline expertise.

Union strength in action

One of the most powerful aspects of this campaign has been the breadth of leadership behind it.

Grassroots activists have shared their stories publicly in a series of campaign videos launched on BCNU’s social media, including Henning and BCNU OHS rep and long-term care nurse, Tash Minwalla, who both spoke about the urgent need for relational security officers in their respective sectors.

JOHS committee reps are pushing for hazard assessments and corrective measures at the worksite level. OHS staff are backing up what members have been saying with data, investigations and enforcement. The bargaining team are raising violence-prevention at the negotiating table, and BCNU’s regional executive and lobby coordinators are meeting with politicians of all stripes and every level of government to demand action.

This is what bench strength looks like: members, activists, leadership and staff aligned around a clear set of demands.

The campaign has also evolved beyond internal advocacy to engage the public through a province-wide letter-writing initiative inviting patients, families and community members to contact their MLAs and demand implementation of the five measures directed at government. The message is clear – violence in health care is not only a workplace issue; it affects everyone who relies on the system.

By opening the campaign to the public, nurses are making it clear that safety in health care is a shared responsibility – and that elected officials will be held accountable for their response.

The tone to government and health authorities is no longer patient.

For years, nurses have been told to raise concerns through internal channels. Many filed incident reports, joined employer-led committees and trusted that promises would translate into action. Too often, their earnest efforts have met delays, deflections or partial changes. Publicly, BCNU has been advocating for years, first launching its groundbreaking Violence. Not Part of the Job campaign in 2015, which is credited with shining a light on the issue and forcing conversations about violence in health care.

After years of advocacy and empty promises, patience is running out for nurses like Minwalla,

“Some days are really bad for staff,” she says of her work in long-term care – a sector where nurses often experience high levels of violence. “There was a time I was told by a doctor that this is just part of the job – and I reminded her that no, this is not part of my job.”

I was told by a doctor that this is just part of the job – and I reminded her that no, this is not part of my job.

Tash Minwalla

Unlike acute-care sites, long-term care homes often have no dedicated security presence. “We don’t have security officers in long-term care. We rely on the staff that is available to us at that time,” Minwalla explains. She believes the presence of trained relational security officers would make an immediate difference. “Unfortunately, sometimes people take advantage of the fact that there’s only staff here,” she adds. “When a trained security officer shows up, things change.”

“Violence is driving experienced nurses out of the profession,” says Gear. “It is undermining recruitment at a time when the province is trying to bring more nurses on to implement minimum nurse-to-patient ratios. It costs the system millions in injury claims, sick leave and private agency staffing. Most importantly, it is traumatizing the very professionals British Columbians depend on for care.”

Nurses are not prepared to accept a future where assault is normalized.

Unsafe working conditions and systemic violence are central issues at the bargaining table as negotiations continue between the Nurses’ Bargaining Association and health employers for a new collective agreement. Through legislation, advocacy, enforcement and operational change, nurses are raising their voices to ensure meaningful progress is made at the worksite level, and employers and government use every tool available to them to secure safe workplaces.

The path forward

BCNU’s ten violence-prevention measures are practical, evidence-based and achievable. Many have already been piloted with positive results. What is missing is consistent, province-wide implementation and accountability.

“The province cannot hope to retain or recruit the nurses needed to stabilize emergency departments if those workplaces remain unsafe, unpredictable and unsupported,” says Gear. “Our violence-prevention campaign makes it clear: protecting nurses is inseparable from protecting patient care, and the status quo is no longer tenable.”

Gear says members have done the work: identifying the problems, building solutions, and standing together against violence, and she is grateful they have brought forward their expertise in good faith. “Nurses have invited everyone to come to the table and assess the current working conditions – now, we are looking to decision makers for results.”

British Columbians deserve a health-care system where safety is foundational – for patients and the nurses who care for them. The ten recommendations are a roadmap. What remains is the political will to act. Violence is still not part of the job – and the status quo is no longer acceptable.