18 Billion and Counting

They say hospitals spent $18.27 billion on violence last year.
That figure didn’t come from a nursing association or an advocacy group — it came from the American Hospital Association, the very organization representing the institutions that carry this weight every day.

Their own report breaks it down:
$3.6 billion to prevent violence.
$14.6 billion to recover from it.

The largest expense? Treating the injuries of people hurt doing their jobs.

The math speaks for itself: it costs far less to keep staff safe than to respond after harm has occurred.
And prevention doesn’t just save money — it protects teams, morale, and patient care.

If hospitals invested in staffing, training, and safer design with the same urgency they bring to crisis response, fewer of us would end up as part of the “post-event” budget.
Prevention isn’t an expense; it’s protection.
Every dollar spent before an incident is an investment in keeping the lights on, the units stable, and the caregivers intact.

Because when nurses don’t feel safe, they leave — and they take years of skill and mentorship with them. That’s the kind of loss no staffing plan can replace.

Still, there are losses that don’t show up on a balance sheet.
The nurse who finally resigns because she can’t face another threat.
The one who stays but stops speaking up.
The one who jokes his way through the shift because humor’s the only coping mechanism left.

Budgets can capture repairs and overtime, but they can’t quantify trust once it’s gone.
They can’t measure the moment someone says “It’s part of the job,” and the room falls quiet — the kind of silence that stings, when you’re too tired to argue and too offended to stay.

We don’t need another spreadsheet to tell us what this costs.
We live it.

Written by Cassandra Esposito, MSN, APRN, FNP-C — founder of Code Violet and practicing nurse practitioner.