White Paper: Violence Against Nurses in Canada: An Urgent Call to Action
This white paper outlines the dire reality of violence against nurses and health care workers in Canada. The paper details the known data on violence against nurses – from workers’ compensation claims to shocking survey data. The paper highlights the need to enforce existing laws and shares leading practices from across Canada. Recommendations to address violence in health care workplaces include investing in prevention and training, mandating safe staffing practices, upgrading necessary infrastructure to protect workers, and establishing a national standard for violence prevention in health care.
This white paper was presented to federal, provincial and territorial health ministers at a meeting with the CFNU during the Health Ministers’ meetings in October 2025.
Key recommendations
The CFNU calls on federal, provincial and territorial governments to urgently take the following actions to tackle the deepening crisis of violence in our health care systems.
1. Strengthen enforcement of existing laws
- Provide mandatory comprehensive training to police, Crown prosecutors and judges on enforcing the Westray Bill amendments – which should be applied to health care employers – and Bill C-3.
- Establish dedicated Crown prosecutors for workplace violence cases – with heightened attention on the health care sector – and mandate that charges by police should automatically be laid in incidents of violence against a nurse and later removed if deemed necessary by the Crown following further investigation.
- Ensure occupational health and safety legislation and regulations are enforced by enacting penalties on employers who fail to comply with the legislative and regulatory requirements to address violence in the workplace.
2. Invest in prevention and training
- Enforce in all health care settings the use of risk assessment tools and individualized care planning for patients with the potential to become violent.
- Expand access to comprehensive training on de-escalation, crisis intervention, trauma-informed care, cultural safety – particularly in relation to Indigenous workers and patients – and occupational health and safety, addressing the current gap in training in which 37% of nurses report having received no workplace violence training.
3. Mandate safe staffing levels
- Adopt mandatory minimum nurse-patient ratios to reduce risks of violence exacerbated by understaffing and excessive workloads. Inadequate staffing levels in nursing is a structural condition that leads to higher incidents of violence in the workplace.
- British Columbia is the first province to implement nurse-patient ratios, and Nova Scotia is implementing its own safe staffing model. All provinces and territories must follow suit.
4. Establish a national standard for violence prevention in health care, with a particular focus on health care security personnel
- Set minimum thresholds for training of health care security personnel, safe staffing and enforcement penalties, as has been recommended by the Association of Workers’ Compensation Boards of Canada.
- Make adherence to this standard a part of the accreditation process for health care facilities across the country.
5. Ensure infrastructure upgrades are made to protect workers
- Following the lead of Windsor Regional Hospital, Artificial Intelligence (AI) weapons detection systems are being installed in other workplaces and jurisdictions, including in London (Ontario), Winnipeg (Manitoba) and in Nova Scotia. Other provinces are rightfully beginning to explore this technology as one tool among many to help protect health care workers from threats to their safety.
- Security cameras should be widely installed in and around facilities, and various ways of summoning assistance, including personal alarms, should be provided to any health care worker wishing to have access to one.
6. Support workers affected by violence
- Introduce presumptive workers’ compensation coverage for PTSD for nurses, aligning with measures already in place for police, firefighters, paramedics and others. Alberta has recently committed to this, leaving only New Brunswick, Nunavut, Northwest Territories and Yukon to provide this coverage for nurses.
- Ensure violence prevention policies and programs within health care workplaces have thorough debriefing processes in place following violent incidents.
- Provide adequate psychological support and leave options for workers recovering from violent incidents.
7. Adopt recommendations from parliamentary health committee
- The Parliamentary Standing Committee on Health (HESA) report from 2019 on violence facing health care workers provides numerous recommendations that have yet to be taken up by governments. Opportunities exist for federal-provincial-territorial and stakeholder collaboration to implement them.
- Recommendations yet to be implemented include a public awareness campaign across the country to highlight the human cost of violence against health care workers; a pan-Canadian framework to prevent violence in health care; and funding to the Canadian Institute for Health Information (CIHI) to develop standardized definitions around violence in health care and collect national standardized data on it.
