The Staffing Crisis Security Teams Aren’t Talking About: When Safety Concerns Drive Healthcare Worker Exodus

Many healthcare administrators know the numbers by heart: recruiting a single registered nurse costs around $60,000 and up to $71,000 or more, according to the 2025 NSI National Health Care Retention & RN Staffing Report, when accounting for agency fees, training, and productivity losses during onboarding. Replacing an experienced emergency department physician can exceed two to three times their average salary. Yet when evaluating security investments, those decisions are rarely connected to the staffing crisis eroding their workforce from within.

Hospitals invest millions in clinical recruitment while watching experienced staff leave due to workplace violence concerns. But security budgets are typically justified through incident prevention metrics and liability reduction, not workforce retention. What many organizations haven’t yet connected is how security decisions ripple through their entire financial picture, from recruitment to retention to operational efficiency.

The real cost of unsafe environments

Workplace violence affects healthcare workers at five times the rate of other industries. In 2024, 91% of emergency physicians reported that they or a colleague had been threatened or attacked in the past year. Over 80% of nurses experienced workplace violence within twelve months. 

The 2025 Survey of Registered Nurses found that only 39% of nurses plan to continue working in their current roles and organizations, with 58% reporting burnout. While burnout has multiple causes, the constant stress of working in environments where violence feels inevitable ranks high among them. Emergency department nurses, behavioral health workers, and overnight staff cite safety concerns as primary reasons for leaving their positions.

When a seasoned ED nurse with eight years of experience resigns after a violent patient encounter, the hospital doesn’t just lose clinical expertise. It loses institutional knowledge, team cohesion, and the investment made in that individual’s development. The replacement nurse will need months to reach comparable efficiency. During that transition, remaining staff shoulder additional burden, accelerating their own burnout trajectories.

Security ROI we’re not calculating

Healthcare facilities typically evaluate security investments against theoretical incident prevention: “If this system prevents one lawsuit, it pays for itself.” This is one consideration in a larger financial impact picture.

Consider a 400-bed hospital losing ten experienced nurses annually due to safety concerns. At a conservative $50,000 replacement cost per nurse, this equates to $500,000 in direct turnover expenses. But the indirect costs multiply: temporary staffing premiums, overtime for remaining staff, reduced patient satisfaction scores affecting reimbursement, and the compounding effect as departures trigger additional departures.

In competitive healthcare markets, facilities known for workplace violence problems struggle to attract top talent. Nursing candidates research hospitals before applying. They talk to current staff and they check social media. A facility’s reputation for staff safety (or lack thereof) directly impacts its ability to recruit and the premium it must pay to do so.

The security investment that prevents staff departures preserves recruiting competitiveness, maintains team stability, and protects the institution’s reputation as an employer of choice. These benefits dwarf traditional security ROI calculations but rarely appear in the spreadsheets justifying security budgets.

The hidden operational drain

Beyond recruitment and retention costs lies another budget leakage point that many healthcare systems haven’t fully quantified: the operational drain of managing security incidents themselves. 

A chief security officer at a major university healthcare system recently shared revealing data from his organization. In just the first half of January, he had already spent five full days in court related to security incidents. 

If that CSO earns $250,000 annually, and two or three staff members earning $150,000 each assist with incident investigation and court appearances, and each incident requires roughly 50 hours of combined time for investigation, management, and legal proceedings, that’s a minimum of $13,750 per incident in leadership time alone. Five court appearances in half a month suggests budget leakage exceeding $68,000 monthly, just in senior staff time diverted from strategic work.

Hospitals struggling with workplace violence often aren’t capturing this “leakage” in their budgets and efficiency metrics. The costs hide across departments: security leadership time, HR investigation hours, legal counsel, staff interviews, documentation review, and testimony preparation. Each incident creates a ripple of diverted attention and resources that rarely shows up in security ROI calculations.

The organizations quantifying these hidden costs are discovering that the price of inadequate security far exceeds the investment in effective solutions. Yet budget conversations often focus narrowly on equipment costs rather than the total financial impact of the security environment they’re creating.  

Reframing the investment

Hospital CFOs wouldn’t evaluate MRI machines solely on their ability to prevent malpractice suits. They’d measure diagnostic capability, patient throughput, and competitive positioning. Security deserves the same multidimensional analysis.

Environments where staff feel protected demonstrate measurable differences in workforce stability. When clinical teams trust that their safety is prioritized, they stay longer, perform better, and refer colleagues to open positions. This creates a reinforcing cycle: better retention leads to more experienced teams, which improves patient outcomes, which strengthens the institution’s reputation, which makes recruitment easier.

The challenge is that workforce retention benefits from security investments appear gradually, while costs are immediate. A new security system might cost $500,000 upfront. The avoided turnover savings of $500,000 annually only become visible when comparing actual turnover to projected rates. CFOs need frameworks that make these connections explicit.

What actually works

Effective workplace violence prevention requires layered approaches combining policy, culture, environment, and technology. But the most sophisticated security infrastructure fails if staff don’t trust leadership’s commitment to their safety.

Successful programs start with transparent acknowledgment of the problem’s scope. Underreporting remains endemic in healthcare because workers fear retaliation or have normalized violence as “part of the job.” Organizations making progress are creating reporting systems where staff feel empowered to document incidents without professional consequences. And they’re seeing more accurate data as a result.  

Environmental modifications matter. Secure entrances, controlled access to high-risk areas, and improved sightlines all contribute to safer spaces. But these physical changes must connect to response protocols. Staff need to know that when they signal distress, help arrives quickly and reliably. Trust in response capability affects whether workers feel safe enough to stay.

Technology plays a role when it empowers rather than surveils. Real-time communication tools that enable immediate calls for assistance can de-escalate situations before they become dangerous. Data from these systems should inform continuous improvement, identifying patterns that allow proactive intervention rather than reactive response.

Right now, a new graduate nurse choosing between two job offers weighs compensation, location, and culture. Increasingly, they’re also asking: “Will I be safe?” The facilities that can answer yes (credibly, with systems and track records to back it up) will capture the best talent. The ones still treating security as an afterthought will compete for whoever’s left.

Patients deserve care from professionals who aren’t operating in fear. Clinical staff deserve environments that protect their wellbeing. And hospitals that recognize the connection between these truths and workforce economics will define the next generation of healthcare employment.

Photo: sturti, Getty Images

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