By Sheral C. Kellar, President
National Association of Workers’ Compensation Judiciary
Louisiana Workers’ Compensation Judge – Chief
Louisiana Workforce Commission


In February 2024, a former patient attacked Louisiana dentist Katie Tran and two of her colleagues with a three-inch blade.   The patient stabbed Tran on the right side of her neck and in her left eye, which she is likely to lose because of the attack.[1] The arrest of the patient is a stark and chilling reminder that healthcare professionals are suffering more workplace violence than those in any other industry, including law enforcement.  “Healthcare professionals endured 73% of all non-fatal workplace injuries in 2018, the most recent year for which figures were available.”[2]

A 2021 Press Ganey Survey Report suggests that assaults against nurses occur every two (2) hours in an acute care setting because of their close proximity to patients.[3] Approximately one of four nurses is assaulted on the job according to The American Nurses Association.  Forty (40%) percent or more of these assaults go unreported. Michelle Mahon, a registered nurse and representative for the labor group National Nurses United opines that many nurses do not report violence because they have the perception that nothing will change. In Milwaukee, a nurse waited over a month to report that an irate patient who did not want to leave the emergency room had attacked her.  Joni says she was grabbed from behind as she walked down the hallway past the patient’s room.  It all happened in a matter of 45 seconds, she said. “The patient ended up grabbing me from behind by my hair.  I was punched in the back of the head several times, my fingers broken.”[4] It all ended when the patient kicked Joni in the jaw.  Now, Joni says, “… I have chronic pain in my left ear every time I chew something that’s crunchy.”  She also had quarter and nickel-sized chucks of hair missing after the attack.

Thirteen percent (13%) of workdays are missed because of violence against nurses.  Sonia, a registered nurse at Kauai Veterans Memorial Hospital was medicating a patient in the emergency room when she felt excruciating pain.  She looked down to see the patient’s mouth on her forearm.  While she screamed for help, his teeth kept going deeper into her tissue.  Sonia suffered extensive injuries and will be out of work for at least 10 weeks.[5]

According to the Bureau of Labor Statistics (BLS) workplace violence in health care settings was already on the rise across the country before the pandemic began.  After the arrival of COVID-19, the prevalence remained high.  During COVID hospitals began experiencing longer wait times in the emergency rooms, were short staffed, and rationed care, factors that only escalated frustration. In another National Nurses United survey in 2022, 40% of hospital nurses report an increase in violent incidents.  The violence is usually kicking, punching, biting, or bodily fluids. But, not always.  In October 2022, a gunman opened fire at Dallas Methodist Medical Center, killing two nurses.  In October of the preceding year, a certified nursing assistant was murdered at Jefferson Hospital in Philadelphia, PA.  An unknown man just walked, unfettered, off the street and onto the CNA’s unit. No one stopped him.

The death of a Louisiana nurse, Lynne Truxillo, prompted a clarion call from medical workers nationwide demanding workplace safety.  Members of the nursing community expressed outrage over Truxillo’s story and called for better hospital safety practices to minimize the dangers of their profession.  Advocates said the nurse’s death in 2019 marks a line of tragedies from a persistent threat of workplace violence that healthcare workers face in hospitals across the country.  In this case, a behavioral health patient at Baton Rouge General Regional Medical Center had initially grabbed another nurse when Truxillo stepped in to stop the attack. The patient then turned on Truxillo, grabbing her neck and striking her head on a desk. She injured her leg trying to escape. Truxillo finished her shift before undergoing a medical exam, which revealed she would need surgery to repair a torn ACL.  She died five days later after a blood clot traveled to her lungs – a death the East Baton Rouge Parish coroner ruled a homicide because her injuries caused the blood clot.[6]

In August 2022, Louisiana created a number of new requirements for healthcare facilities directed towards addressing, mitigating, and preventing workplace violence.[7] “Workplace violence,” as defined in the legislation, means violent acts, including battery or the intentional placing of another person in reasonable apprehension of sustaining battery, directed toward persons at work or on duty with their employment.  In honor of the deceased nurse, the legislation was named the “Lynne Truxillo Act.”   It covers a wide-range of “regulated entities” including, but not limited to, adult day health care facilities, behavioral health services providers, ambulatory surgery centers, case management providers, urine drug screening providers, home health agencies, hospices, hospitals, nursing homes, rural health clinics, intermediate care facilities for people with developmental disabilities (ICF/DD), end stage renal disease facilities, outpatient abortion facilities, psychiatric residential treatment facilities, children’s respite care centers, pediatric day health care facilities, community-based care facilities, and free-standing birth centers.

The new Louisiana legislation requires facilities to post signage, like that below, which states that abuse or assault of healthcare staff and others will not be tolerated and could result in a felony conviction.[8]  Anyone in Louisiana, who has been to a health care facility, a doctor’s office or a pharmacy lately, has seen this signage:


A workplace violence prevention plan is required by Louisiana’s legislation. The plan must address and encompass ongoing education and policies requiring health care workers to be trained, at least annually.  It also must include such topics as resources for ongoing education on the issue of workplace violence, preventing violence, responding to incidents of violence and debriefing about such incidents and responses.  Education and training is required to cover topics like how to recognize the potential for violence, when and how to seek assistance to prevent or respond to violence and how to report violent incidents to law enforcement.  Staffing, sufficiency of security systems, security risk associated with particular units of the workplace, areas of the facility with uncontrolled access, late night or early morning shifts, and areas surrounding the facility such as employee parking areas must be addressed.  Finally, the legislation requires healthcare facilities to report all instances of workplace violence and prohibits any adverse employment action being taken against an employee who reports an instance of workplace violence.

Again, in February 2024, JAMA, the Journal of the American Medical Association reported that, at least, 29 states have passed or are looking to enact legislation that allows health care facilities to establish independent police forces to address a rising tide of violence against health care workers.[9]  Like Louisiana, many other states are approaching the issue by increasing the punishment for perpetrators or by mandating that health care facilities implement prevention measures designed to improve workplace safety.  JAMA suggests that states are stepping in since Congress has yet to take any action on the issue.

While there are currently no national standards in place, the Workplace Violence Prevention for Health Care and Social Service Workers Act of 2021[10] was recently reintroduced in the U.S. House of Representatives.  This legislation would require health care and social service employers to put in place comprehensive workplace violence prevention plans, including procedures to identify risks.  It also would require all instances of violence to be reported to the Occupational Safety and Health Administration.  Meanwhile, groups like the Silent No More Foundation, Inc.[11] continues to work on legislation on a state-by-state basis to obtain basic legal protections for those in the healthcare professions.  While violence against healthcare workers will always be an issue, especially in emergency rooms, there are steps that can be taken to help keep the environment as safe as possible.

Otherwise, experienced nurses like Rebecca from the Duke Raleigh Hospital are considering leaving the profession.  Right now, Rebecca is off work recovering from a brutal attack by a patient that left her with a concussion, broken nose, a fracture at the floor of her left eye socket, which resulted in her eyeball sagging, and a need for reconstructive surgery.  Rebecca said ER is her passion but she is considering not returning.  “… It has me questioning, is it even worth it?”[12]

There is already a shortage of healthcare professionals in the U.S.  Mercer, a consulting firm, forecasts that by 2025 there will be “a shortage of more than 400,000 home health aides and 29,400 nurse practitioners.”[13] A shortage leads to burnout for everyone.  It also increases wait times for care.  When seeing more patients, health care professionals are often rushed and stressed.  That can lower patient satisfaction and negatively affect patient outcomes.  Errors in medication and other care delivery are more likely when facilities are understaffed.  These errors can have serious consequences.  The shortage of health care professionals also fuel even more frustration amongst patients and therefore, more violence in the work place.  Until the needs and safety of healthcare professionals can be addressed this is a vicious cycle that will continue.

Recently, I was in the hospital.  It was an unscheduled visit.  I had just returned from a trip abroad and caught a bug that caused my doctor to send me to the hospital.  I was frightened, worried, and alone. The only people there to comfort and care for me, at the time, were nurses.  They were compassionate, patient, tender, and loving.  I cannot imagine any one of the few nurses who cared for me being violated by another patient, let alone being killed by one.  These selfless healers deserve our help.  We need them.  Nurses are there to save patients, not each other. They are our caretakers, our caregivers.  They not only take care of us they take care of our loved ones.  They shoulder a burden that we cannot carry and many do not want to.

As judges, we cannot openly support political candidates. However, we can, support causes that improve the law, the legal system or the administration of justice.  That’s why I applaud groups like the Silent No More Foundation, Inc.[14] It protects healthcare workers before, during, and after workplace violence through education, advocacy, awareness, and legislation.  Until Congress acts to address the crisis facing healthcare professionals, groups like #SilentNoMore are essential to bringing to the public’s attention heightened and continuing awareness about this national problem.  Mahatma Gandhi said, “The best way to find yourself is to lose yourself in the service of others.”  That is what healthcare professionals do every day.  Do not allow the death of Lynne Truxillo and the injuries to Dr. Tran and Nurse Rebecca to be in vain.   If you love a healthcare professional or appreciate a healthcare professional, share this article.

[1]              “US dentist may lose eye after allegedly getting stabbed in face by ex-patient.” The 09 [New Orleans, LA],

[2]              U.S. Bureau of Labor Statistics (USBLS) 2018.  Workplace Violence in Healthcare. [Google Scholar][Ref. list]

[3]              Press Ganey, hour-new press-ganey-analysis-finds/Chicago 08 September 2022

[4]              Felio, Julia, “Nurse attacked by patient in Milwaukee hospital:  ‘A street brawl that you would see in a movie’” 2022 December 15, -street-brawl-that-you-would-se-in-a-movie. Accessed 1 March 2024

[5]              Tamashiro, Kristy, “Kauai nurse attacked in emergency room recovering from extensive injuries” 23 December, 14. www/  Accessed 1March 2024

[6]              Skene, Lea, “Baton Rouge nurse’s death prompt medical workers nationwide to demand workplace safety”,, 26 April 2019

[7]              L.S.A.-R.S. 40:1299, et seq.

[8]              L.S.A.-R.S. 14:38.5

[9]              Campisi, Jon, “States addressing more violence against health care workers”,  Business Insurance, 27 February 2024,  Accessed 27 February 2024.

[10]             H.R. 1195 – 117th Congress (2021-2022)

[11]    Staff, “Nurses Say violent Assaults By Patients Are a Silent Epidemic”, 10 September 2023,  Accessed 1 March 2024.

[12]             Kummerer, Samantha, “‘I don’t remember what happened after that.’  Nurse demands change after being attacked by patient”, 15 December 2022,  Accessed 1 March 2024

[13]             “The Shortage of Healthcare Workers in the U.S.”,  Accessed 12 March 2024