Operationalizing Staff Safety: Unexpected Obstacles

It’s never been riskier to be a nurse.

Nearly 81% of nurses report experiencing some form of workplace violence in the past year, and almost half (45.5%) say conditions have worsened compared to the year before. Emergency department nurses face the sharpest end of that trend, with seven in ten reporting physical assaults. These figures reflect a clinical workforce that is not only overstretched but increasingly unsafe, and they’ve prompted hospitals across the country to invest in wearable duress technology as a frontline response.

Yet surveys of wearable device usage across clinical staff consistently reveal the same uncomfortable truth: the tools meant to protect nurses often go unworn, unclipped, or abandoned at the nurses’ station by the middle of a shift. Clearly, it’s not enough to simply purchase a duress solution; the real challenge lies in encouraging staff (across every shift and unit) to use it consistently.

Beyond Device Deployment: Key Concerns

In order to design a duress program that works, the first step is to understand why usage is so low. When nurses, safety professionals, and leaders discuss duress badges in forums and peer conversations, the frustrations that surface tend to fall into several categories.

• Design and user experience. Devices are too bulky, or buttons are awkwardly positioned, creating excessive false alarms or making them too difficult to access in threatening situations.
• Insufficient battery life. Batteries die mid-shift, leaving clinicians with unusable devices.
• Logistical concerns. How nurses wear duress buttons can also create issues. Some clip badges to lanyards that swing and snag on equipment; others tuck them under scrubs where any attempt at a discreet button press becomes impractical.

Devices should also provide haptic feedback to confirm that buttons were pressed and alerts sent, giving immediate confirmation to nurses in rapidly escalating situations.

Lastly, devices need to have sufficient battery life, because nurses already have enough to worry about without having to think about charging. Ideally, devices would have years-long battery lives, so that they can be replaced all at once in a unit or facility, without forcing users to charge at the end of each shift or day.

These requirements are the baseline threshold for a solution that earns consistent adoption; without it, even a well-funded program will see low utilization rates that undermine its very purpose in the first place.

The Privacy Problem

Beyond hardware, there is another key concern that vendors may be unaware of: many staff members are genuinely uncomfortable with the idea of being tracked in real time.

Yet real-time location is what makes modern duress technology so powerful. When a nurse activates an alert, responders need to know not only the wing or the floor, but also the specific room, and ideally whether the staff member is moving. That level of precision is the difference between help arriving in under three minutes, or help arriving too late.

But many nurses have worked in environments where technology has been used not to support them, but instead to evaluate, discipline, or monitor them; this history creates understandable resistance. The concerns will generally be:

• Will this data be used to measure my productivity?
• Who has access to this data?
• What happens if I step away for a few minutes?

The most successful duress deployments address these questions directly and early, pairing the technology rollout with transparent communication about data governance. Location data exists to protect staff, not to surveil them, and the practical case for that position is straightforward: more precise tracking means faster backup, and faster backup means that when alerts go out, security officers won’t spend critical seconds searching the floor.

The policies around who can access location data, for what purpose, and under what circumstances matter as much as the platform itself, and hospitals that neglect that conversation will find correspondingly low adoption rates.

Operationalizing Duress Badges

For CNOs, CIOs, and security directors, the challenge isn’t simply deploying a badge; it’s building a duress program. That means change management, staff education, clearly defined escalation protocols, and sustained measurement of whether the solution is functioning as intended over time. One frequently overlooked metric is whether staff are actually activating the device when they feel threatened; underreporting safety incidents can be commonplace, so a low alert volume does not necessarily mean a safe environment.

From Theory to Practice

Hospitals that treat staff safety as a genuine operational investment, rather than a compliance checkbox, tend to get meaningfully better outcomes: higher nurse retention, faster incident response, and a workforce that feels confident enough to press a button because they trust it will work.

Rather than having a duress program for the sake of having one, the real goal is to provide a practical, usable, and effective device: one that fits existing workflows and preferences, works exactly as needed, and addresses key privacy concerns.

With the right combination of hardware, policy, and organizational commitment, the barriers to duress badge adoption (and protecting staff) are entirely solvable.