Homicides of Nurses in the United States, 2003-2022: An Exploratory Study

ABSTRACT Background: The causes and contexts of homicide of U.S. nurses have not been well studied, although recorded numbers have risen rapidly in recent years, drawing greater attention. Purpose: This exploratory study aimed to describe nurse homicide trends and identify potentially remediable factors. Methods: Using data in the National Violent Death Reporting System (NVDRS) database, an analysis of records of reported homicides of all nurses and nursing assistants from 2003 through 2022 was conducted. Data analyses included descriptive statistics and examinations of paired characteristic variables. Results: Between 2003 and 2022, 1,577 nurses and nursing assistants were identified in the NVDRS as homicide decedents. Of these, 88% were female; the median age was 42 years; and 51% were identified as White, 43% as Black. Fifty-three percent resided in urban areas, while 28% resided in rural areas. At the time of death, 94% were in a relationship. An argument led to the homicide in 29% of cases, and in 81% of those, death occurred during the argument. While intimate partner violence was the leading attributed cause (44%), only 10% had documented prior abuse by the suspect. Among the suspects, 93% were male, and 52% were partners or ex-partners of the decedent. Twelve percent had had prior contact with law enforcement within the last year. Of the homicides, 75% occurred in private residences, and 8% took place in streets, sidewalks, or alleys. Co-occurring variables that suggested important associations in over half the cases were female decedents with incidents that took place in houses or apartments (65% of cases) and male suspects with female decedents (64% of cases). Conclusions: While assaults on nurses are serious regardless of where they occur, this analysis revealed patterns indicating that nurses most often die by homicide within private residences, often after or during arguments with partners or ex-partners, and rarely from random acts of violence. Nurse homicides in the workplace are relatively rare. Intra- and interpersonal strategies are indicated for those at risk for committing acts of violence or homicide. In keeping with the National Institute for Occupational Safety and Health's Total Worker Health program, preventive, evidence-based workplace strategies should be evaluated for their applicability in keeping nurses safe everywhere.