The Investigation Gap

What New Survey Data Tells Us About Workplace Violence Prevention

National Nurses United released new survey data this spring. The findings are yet another testament to the scope and scale of workplace violence in healthcare. The data and conclusions, while clear, are hard-hitting. They are also exactly why OPTICS exists.

The union surveyed 1,267 registered nurses across 28 states and D.C. between July 2025 and May 2026. The results confirm what frontline caregivers have been saying for years. Workplace violence is rising. Prevention is not keeping pace. Almost 85 percent of nurses report experiencing at least one form of workplace violence in the past year. Seven in ten report being verbally threatened. About 37 percent report being pinched or scratched, and 33 percent report being slapped, punched, or kicked. These are not isolated incidents. They are the working conditions of American nursing.

The most important number in the report is not about violence itself. It is about response. Nearly half of nurses, 42.5 percent, say their employer does not change practices after an incident. Over one in five say their employer ignores the report entirely. Seventeen percent say they were reprimanded or blamed for coming forward. Read that again. Reporting a violent incident carries real risk of professional punishment. That statistic is not a training failure. Training is already common. Nearly three-quarters of employers provide it. This is a trust failure, and trust failures do not respond to more training.

This is the gap OPTICS was built to close.

Most healthcare organizations already know violence is a problem. Leadership teams do not need convincing. What they lack is a structured way to move from awareness to sustained action, and a way to prove that movement to a board, a regulator, or a jury. OPTICS organizes that work around four stages: Assessment, Analysis, Action, and Assurance. The framework matters because the NNU data shows exactly where organizations stall. They assess informally, through incident reports and hallway conversations. They rarely analyze systematically. They act inconsistently. And they almost never build the kind of documented assurance that would hold up under scrutiny, whether that scrutiny comes from Cal/OSHA, from a plaintiff's attorney, or from their own staff.

Consider the prevention measures nurses were asked about directly. A charting or room flagging system to identify high risk patients is in place at 40 percent of facilities. A clear, known pathway to report incidents exists at just 38 percent. Staff availability to respond to a violent incident in real time, such as a security presence or a behavioral emergency response team, is reported at 35 percent. Every one of these is a scoreable item in the OPTICS Current State Assessment. An organization using OPTICS does not have to guess where it stands relative to these benchmarks. It gets a number, a gap, and a prioritized path to close it.

One statistic deserves particular attention. Only 18.2 percent of nurses report that their employer includes nurses and other frontline staff in violence risk assessments. The research is clear that staff inclusion is one of the strongest predictors of an effective prevention plan. Yet it is among the least implemented measures in the entire survey, just above metal detectors and behind nearly everything else employers try. 

Prevention plans fail not because organizations lack policies, but because frontline staff do not always trust the reporting process enough to engage with it honestly. Interestingly, this is one of the points sociologist Charles Levy raised in his white paper, “The Storm Is Already Here.”

One reason healthcare workers become cynical about this issue is that everyone seems to know it exists, yet the same situations keep happening,” Levy wrote. “People get trained. Committees are formed. Emails go out. Posters appear. And still, the pattern remains. The reason is simple: the conditions producing the pattern usually stay in place.

The NNU data gives that hypothesis a number. Nine percent of nurses say their employer actively discourages reporting. Nearly a quarter say reports are simply ignored. An Anonymous Climate Pulse and a Reporter Protection and Retaliation Detection component could address this directly, by giving organizations a way to hear from staff without the fear of professional consequence that the survey shows is already suppressing disclosure.

There is also a financial case buried in this data. A quarter of nurses, 25.5 percent, say they have considered leaving the profession because of workplace violence. Nearly one in five took time off work after an incident. Almost 12 percent say the psychological impact of an incident has prevented them from working at all. Every one of these numbers is a staffing cost, a recruiting cost, and an overtime cost, on top of the human cost. A workplace violence prevention plan is not only a compliance investment. It is a retention strategy in a labor market that healthcare cannot afford to keep losing.

A note on where this data comes from. National Nurses United is a labor union, and some healthcare leaders may feel that fact before they feel anything else. That reaction is fair. Hospital leadership and organized labor do not always sit on the same side of a negotiating table, and healthcare executives have earned the right to read union-sourced data with a careful eye. But careful is not the same as dismissive. These numbers were not built to make hospitals look bad. They were reported by nurses describing their own shifts, and they line up closely with what independent researchers and industry groups have found using entirely different methods. The source does not make the pattern less real.

Nothing here suggests a system-wide reluctance to act. Most healthcare leaders did not create the conditions this survey describes, and most are already stretched thin trying to manage them within budgets and staffing markets they do not fully control. Culture change is slow, strategic, and rarely rewarded on a quarterly timeline, even when every leader in the room agrees it matters.

The work ahead is therefore practical as much as moral,” Levy wrote. “It asks whether institutions are willing to reduce preventable strain, whether leaders are willing to count harms before they become catastrophic, and whether the culture of care will finally stop defining professionalism as the ability to endure what should never have been normalized in the first place.

That is a call to action, not an accusation. OPTICS was built on the same premise. Leaders already carrying enormous weight deserve a clear, practical path forward, not a verdict.

The gap described in the NNU Survey will not close on its own. OPTICS gives healthcare organizations a way to close it, and a way to prove they did.

About David Kendric Brake

David Kendric Brake is CEO of OPTICS for Healthcare, an AI-native workplace violence prevention platform serving hospitals, physician practice groups, assisted living facilities, and skilled nursing organizations across the United States.

After 16 years in the book publishing industry, David became an entrepreneur with a consistent focus: building technology that helps organizations engage their target audiences, gather meaningful insights, and convert that information into actionable intelligence. That through-line runs directly into OPTICS — a platform designed not simply to produce compliance documents, but to assess organizational risk, surface gaps, generate facility-specific action plans, and give healthcare leaders and frontline staff the intelligence they need to prevent violence before it happens.

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