Nurses are facing “abhorrent” levels of violence in A&E departments including being punched, spat at and even having a gun pointed at one of them.
And long waits in A&E are also leading to anger among patients who are not prone to violence, the nursing union said.
The Royal College of Nursing (RCN) said more must be done to protect NHS staff.
Without action to tackle long waits, corridor care and “chronic” staffing problems, then rates of violence will continue to rise, the RCN warned.
It comes after it found rising rates of violence towards staff after sending freedom of information (FOI) requests to NHS hospitals with accident and emergency departments.
Figures from 89 hospital trusts, out of a possible 129, revealed there were 4,054 cases of physical violence against A&E staff recorded in 2024, up from 2,093 in 2019, the RCN said.
One senior A&E nurse based in East London told the RCN she has seen colleagues punched and kicked and described how a colleague had a gun pointed at them.
She herself had been spat at by a patient and threatened with an acid attack.
A senior charge nurse from the East Midlands, Rachelle McCarthy, told the RCN that “even patients you would expect to be placid are becoming irate because of just how long they have to wait”.
“You can only imagine the behaviour of those who are already prone to violence,” she added.
Ms McCarthy also told the union she was punched “square in the face” by a “drunk, six foot two bloke”.
Another nurse said: “It’s not going to help with our retention and recruitment if you think you’re going to be clobbered every shift.”
Sarah Tappy, a senior sister in an A&E in east London, was knocked unconscious after being punched in the head by a patient.
“The violence is awful,” she said. “And it’s just constant. Nurses, doctors, receptionists – none of us feels safe.”
RCN general secretary and chief executive Professor Nicola Ranger said: “Nursing staff not only go to work underpaid and undervalued but now face a rising tide of violence.
“It leads to both physical and mental scarring, lengthy time off and sometimes staff never returning.
“Measures to keep staff safe day-to-day are crucial, but the stark reality is that unless the Government does something about lengthy waits, corridor care and understaffed nursing teams, more nursing staff will become victims of this utterly abhorrent behaviour.
“Left unaddressed, this could see plans to reform the NHS fail completely.”
Health and Social Care Secretary Wes Streeting said: “I am appalled by these findings.
“Nurses dedicate their lives to helping others and deserve to go about their jobs free from violence or intimidation.
“Anyone who violates this core principle will feel the full force of the law.
“I met with the Royal College of Nursing recently to reaffirm our commitment to standing with frontline workers, working together to stop violence against NHS staff and improving their working conditions.
“Just yesterday I announced a new graduate guarantee to get more nurses into our NHS, and I have also committed to shining a light on the extent to which corridor care plagues our NHS, as the first step to eradicating it.
“We are strengthening vital support for victims, including security training and emotional support for staff affected by violence, so no NHS worker has to suffer in silence.”
The Liberal Democrats have called for A&E staff to be given access to a panic button which would give them a “direct line” to the police.
The party’s health spokesperson Helen Morgan said: “Violence against hospital staff is utterly abhorrent and those committing it should feel the full force of the law. Those working in hospitals often do so under incredibly difficult conditions to look after us when we are most in need.
“The Conservatives’ shameful neglect left our hospitals understaffed and patients left at risk. If this Labour Government thinks it can turn that around without addressing this shocking violence, they are badly mistaken.
“The Government must urgently ensure all A&E units have a direct line to their nearest police station through a panic button – to protect patients and staff and ensure these violent criminals are swiftly arrested.”
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