Nurse Crystal Dhooghe has spent years treating fractures and lacerations in the emergency department at Henry Ford Genesys Hospital in Grand Blanc, Michigan. Yet the aggression directed at her colleagues—shoves, scratches, bites—has grown more unignorable than the physical injuries she patches up.
“I’ve seen nurses get shoved, pushed, scratched. The biggest one is bitten,” said Dhooghe.
Her frustration has led to collective action. Since last Labor Day, Dhooghe and hundreds of coworkers have participated in strikes alongside protests in Louisiana, New York, Pennsylvania, Rhode Island, and Michigan. The walkouts address more than compensation—they demand basic safety.
“People will question me and be like, ‘Why are you still working in a place if you’re treated like this?’” said Dhooghe, who gets by on strike benefits and working extra shifts at another hospital. The reality is stark: other hospitals present no better alternatives. “It’s the same everywhere I go.”
Strike benefits and temporary shifts at alternative facilities keep her employed, for the moment.
Hospitals admit violence is a national crisis
Henry Ford Health acknowledges the issue in an official statement, labeling workplace violence a “national epidemic.” The system has installed metal detectors, deployed armed security officers trained to make “misdemeanor arrests,” and expanded de-escalation training. “We have zero tolerance for violence of any kind,” said Dana Jay, a spokesperson for Henry Ford Health, asserting the strike is not about safety but is instead “simply an economic strike.”
However, statistics contradict this framing. Nationwide, hospital workers face seven times higher injury rates from violent acts compared to other professions, per the Bureau of Labor Statistics. The outcry has exposed an uncomfortable truth: understaffing and inadequate preparation directly increase violence risks.
Emergency departments operate like “a powder keg,” according to Rachel Odes, an assistant professor at the University of Wisconsin-Madison School of Nursing. In hospitals, a combative or violent patient is known as a “code gray.” Outbursts can be spontaneous and unpredictable, making some almost impossible to prevent. But research shows the risk of violence increases when hospitals are understaffed or employees are insufficiently trained or experienced.
Andrew Kimball-Mirzaie, a mental health worker at Butler Hospital in Providence, Rhode Island, experienced this firsthand. In February 2024, he was assigned to monitor a patient awaiting inpatient placement. The man, in his 20s, was alone in a back room watching a basketball game when he suddenly lunged, punching Kimball-Mirzaie in the face.
The attack resulted in a concussion and broken nose, documented in the hospital’s incident report. “I understand that there is an inherent danger with the job,” Kimball-Mirzaie said. He doesn’t blame the patient, who was very ill at the time. “We should have had at least another staff member with us,” he said, “and I should have been adequately trained on the unit.”
The assault spurred his participation in a three-month strike in spring and summer 2025, during which nearly 700 unionized Butler employees walked out. The strike forced the hospital to close nearly half its beds. Service Employees International Union 1199 New England declared the strike a win. Employees received wage increases that union leaders said would enable the hospital to attract and retain more staff. The hospital also agreed to provide financial support for workers violently injured on the job. And the hospital and union agreed to jointly fund a “time bank” to supplement workers’ compensation for injured workers who need more time to recover.
Patients turn deadly when staffing fails
Five months later, a nurse supervisor at Butler had to call 911 because an unarmed patient in the hospital’s ER was assaulting staff. According to the police report, by the time police arrived, the patient had already injured two nurses, a security guard, and a police officer. He was later charged with four counts of felony assault, including against the two nurses.
Mary Marran, Butler’s president and chief operating officer, stated the hospital remains “proactive” about safety measures, holding regular staff meetings to review protections and “identify opportunities to strengthen protection for everyone.”
The American Hospital Association has said punishment is key to preventing violence. It has been lobbying Congress to make assaulting healthcare workers a federal crime that would carry up to 10 years in prison.
Striking healthcare workers around the country often have demanded “safe staffing” instead of stronger punishments for patients who cause injuries. The rise in violence against healthcare workers has caught the attention of the Joint Commission, the accreditation organization for more than 80% of U.S. hospitals and health systems. The commission released national performance goals that took effect in January and require hospitals to be properly staffed and that staff be trained “to provide safe, quality care.”
States and Congress push new safety laws
In Michigan, the state legislature approved a bill in April 2025 requiring hospitals to implement workplace violence prevention plans. The measure, signed into law, mandates annual training and incident reporting. Violations could result in fines up to $10,000 per occurrence, with repeat offenses doubling the penalty.
The law applies to all acute-care facilities, long-term care centers, and psychiatric hospitals. Advocates hope it will pressure hospitals to address staffing shortages and improve response protocols. “This is the strongest state-level protection yet,” said one union representative. “But enforcement will be critical.”
Meanwhile, a federal bill introduced in March 2025 would create a national workplace violence database, track assaults, and fund state-level prevention programs. The Healthcare Workplace Violence Prevention Act has drawn bipartisan support but remains stalled in committee.
At Butler Hospital, the three-month strike concluded with a tentative agreement in August 2025. Workers gained a 12% wage increase over three years, along with hazard pay for those injured in violent incidents. The hospital also agreed to hire 50 additional security personnel and expand mental health training for frontline staff.
Dhooghe’s strike at Henry Ford Genesys Hospital entered its seventh week in October 2025. The union has proposed a 15% pay raise and mandatory staffing ratios tied to patient acuity. Hospital administrators have not yet responded to the latest offer.
The Michigan law takes effect January 1, 2026. Until then, nurses like Dhooghe continue to treat injuries while demanding protection from the same dangers they face daily.
