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Empowerment self-defense training protects emergency department staff, boosts confidence, enhances communication, and fosters a safer work environment.

Violence in hospital emergency departments (EDs) has reached crisis levels. For physicians, nurses, medical assistants, and support staff, workplace violence (WPV) is now a daily hazard, inflicting physical injury, emotional trauma, and eroding the quality of patient care. A 2024 American College of Emergency Physicians (ACEP) poll revealed that 91% of emergency physicians reported that they or a colleague experienced violence in the past year.¹ Similarly, the Emergency Nurses Association (ENA) reports that 70% of emergency nurses have been physically assaulted on the job, often kicked or punched while working.²

EDs operate under intense pressure due to high patient volumes, prolonged wait times, staffing shortages, and patients experiencing pain, intoxication, trauma, or distress. Frustrated visitors compound the strain, creating a constant potential for escalation. The emergency room has become a pressure cooker, and healthcare professionals are paying the price.

The severity of this problem has even made its way into pop culture. The Warner Bros. series The Pitt has drawn praise for its unflinching portrayal of the ED, including a widely discussed episode in which a patient’s family member violently assaults a nurse. Created in consultation with emergency medicine professionals, the show aims to raise awareness and provide validation to frontline healthcare workers everywhere. The series dramatizes what surveys confirm: violence is not an exception in the ED—it is part of the environment.

Current Responses: Necessary but Insufficient

Medical organizations have responded with advocacy efforts and public campaigns. Legislation such as the Workplace Violence Prevention Act for Health Care and Social Service Workers and the Safety from Violence for Healthcare Employees (SAVE) Act aims to enhance legal protections and establish mandatory protocols for preventing violence. Campaigns, including No Silence on ED Violence, spearheaded by ACEP and ENA, have raised public awareness and called attention to the systemic nature of the issue.

Yet these efforts, while essential for long‑term change, offer little immediate protection. Security guards and panic buttons can help, but frontline staff are often left to manage volatile situations with few practical tools

Empowerment Self‑Defense: A Practical Solution

Empowerment Self-Defense (ESD) training offers a timely, evidence-based response. A trauma-informed, evidence-based violence prevention program, ESD equips healthcare workers with skills to prevent, interrupt, and recover from interpersonal violence. Core components include:

• Situational awareness: Recognizing early signs of aggression
• Verbal de‑escalation: Using assertive, clear communication to prevent violence
• Boundary setting: Safely maintaining physical and emotional space
• Physical techniques: Employing simple, effective movements to disengage or escape if needed
• Post‑incident recovery: Encouraging emotional processing, peer support, and formal reporting

Evidence of Effectiveness

A 2021 meta‑analysis in Psychology of Women Quarterly showed that empowerment‑based self‑defense significantly reduces the likelihood of experiencing violence and boosts self‑confidence, and a 2014 study published in Pediatrics reported a more than 50% reduction in assault rates among participants trained in ESD.³,⁴

From Personal Safety to Culture Change

ESD training protects individuals while fostering team confidence, enhancing communication, reducing fear and burnout, and contributing to a safer work environment. As The Pitt illustrates, unchecked violence in the ED leads to moral injury, staff attrition, and compromised patient care. Empowering healthcare workers with practical skills can disrupt that cycle.

Workplace violence in emergency medicine will not disappear overnight, but we can move towards that goal by equipping staff now with the tools to feel safer, act decisively, and recover fully.

Empowered staff are safer staff—and safer staff save lives.

To bring ESD training to your hospital or department, visit PowerUpMoves.com for healthcare-specific programs and workshops, or explore international certification options at ESDGlobalSelfDefense.com.