Violence Is Part of the Job. But Nurses Say Supports Aren’t There

Last March, an emergency department nurse was violently attacked by a patient at Langley Memorial Hospital during an otherwise routine shift.

Just a few feet away, her colleague watched in shock. “There was no alarm, no rapid response system, no immediate backup,” Emily, who asked that her real name not be used, says. “I had no way to call for help.” (Some names have been changed over concerns of employer retribution or on the advice of their union.)

What happened next reflects an ongoing crisis in B.C.’s health-care system. Nurses reporting workplace violence say they face long waits, complex rules and rigid treatment paths from WorkSafeBC, the provincial agency responsible for support for workers injured on the job.

While WorkSafeBC says its timelines for care are improving, nurses and researchers say the system remains deeply out of step with nurses’ realities.

After witnessing the assault on her co-worker, Emily says she was left with a “serious psychological injury.” Her case was reported to WorkSafeBC for wage-loss coverage and treatment support.

Rather than receiving compensation and therapy, Emily says she spent eight weeks off the job without income or treatment. By May, she could no longer wait for her claim to be assessed. “I returned to work earlier than I was medically ready simply because I needed income as a single mother. The lack of access to appropriate therapy added months to my recovery.”

Her story is far from the exception.

WorkSafeBC data shows that psychological injury claims from social services and health-care workers have surged 92 per cent since 2020.

In a letter sent to B.C.’s labour minister in January 2025, BC Nurses’ Union president Adriane Gear said nurses often wait up to three months just to have their claims reviewed.

Unlike physical injuries, which can be certified by a family doctor, psychological claims require a DSM diagnosis from a psychologist or psychiatrist. Gear says this is a bottleneck given “a lack of adequate access to psychologists and psychiatrists.”

Emily felt that delay firsthand. “By the time anything was approved, I’d already gone back to work out of financial stress,” she says.

In an emailed statement, WorkSafeBC says psychological assessment wait times across all workers and industries dropped from an average of 14 weeks in 2024 down to 6.5 weeks in 2025.

Nurses, however, say those averages don’t reflect their experience, with many taking far longer to have their case reviewed.

Time to treatment matters. A 2025 report from Sedgwick Insurance found that workers who received mental health treatment within 90 days had half as many disability days as those who started later. Long waits don’t just slow recovery — they can deepen the psychological injury.

Even if an assessment eventually leads to an approved claim, nurses say the delays continue since they then have to wait to be connected with a WorkSafeBC-approved counsellor.

Erin, not her real name, is a psychiatric nurse who was diagnosed with workplace-induced PTSD. She waited six months after her claim’s approval before meeting with a therapist. “I was crying daily, barely sleeping. I could hardly get out of bed,” she says.

Once therapy finally began, she said it was generic talk therapy rather than the trauma-focused support she had asked for. “It made everything worse.”

After months of struggling, she was moved into an intensive program for frontline workers, but it didn’t help either. An in-house WorkSafeBC doctor, who she says she’d never met, then cleared her to return to work. She says she was far from ready to go back.

The backlog is one part of the story. The other is how often claims are disallowed.

A “disallowed” WorkSafeBC claim means it hasn’t met the required criteria for processing. This could be for a wide range of reasons, including insufficient documentation, no DSM-5 diagnosis, inadequate evidence, late reporting or no clear connection between the incident and work.

WorkSafeBC approved 54 per cent of psychological injury claims from health-care and social services workers in 2024, disallowing a total of 1,066 claims — 38 per cent more than in 2023.

Farinaz Havaei, an associate professor at the University of British Columbia School of Nursing, says there is a “prevalent misperception that violence is part of the job,” adding that there is “certainly an underestimate” of the rate of violence that’s actually occurring.

The gap between psychological violence on the job and claims that get accepted is exemplified by stories on the front line.

Mark — not his real name — was accosted and groped by a patient experiencing delirium while working a shift at a Vancouver hospital. Startled and shaken up by the incident, he took the following day off, then filed a WorkSafeBC claim for back pay — as per his employer’s protocol.

After he described the incident in a phone call with WorkSafeBC, he was told several days later his claim was disallowed as he did not have a documented diagnosis. He says the agency never offered to help him obtain one.

“Worse than the experience at work was the implication that I was faking the whole thing for a sick day,” Mark says. “It caused me to give up on advocating for myself because of how poorly I felt I was treated.”

He abandoned the claim and says he was lucky to afford the day without pay.

His experience reflects a broader pattern. While Mark’s case occurred in 2022, WorkSafeBC’s acceptance rate for health care and social services psychological injury claims has been steadily declining from 65 per cent in 2020 to 54 per cent in 2024.

Havaei’s research suggests nurses are now avoiding reporting violent incidents altogether. As colleagues’ claims are disallowed or dragged on for months, many conclude the effort — and risk of going without pay or benefits — is not worthwhile.

The BCNU has pushed for reforms. In her letter to the labour minister, Gear urged WorkSafeBC to allow primary care providers to diagnose psychological injuries, arguing it would get nurses into treatment sooner.

When asked in November about the BCNU’s proposed reforms, WorkSafeBC said that “while speeding up the process by reducing forms might seem appealing, doing so would compromise critical information needed for case management and recovery planning.” The agency emphasized its timelines for assessments and treatment are improving.

Nurses, researchers and union leaders say the system meant to protect them doesn’t account for the realities of workplace trauma.

In reflecting on her recovery, Emily said, “WorkSafeBC made it harder to heal. If this is how we treat injured nurses, we won’t just lose experienced staff, we’ll see that harm ripple down to patients who need us most.”