Hospitals are supposed to be the safest places in our communities. They are where vulnerable people go for help, where staff save lives, and where families can exhale. After more than 25 years in uniformed service and security work, I have seen what happens when that safety breaks down. Safety is not a feeling or a slogan. It is a system. And when that system is neglected, people get hurt.
Across the country, health care workers are facing a surge in violence on the job. Federal agencies and workplace safety regulators are sounding the alarm. The Occupational Safety and Health Administration reports that health care and social service workers suffer more serious workplace violence injuries than workers in all other industries combined. These are not isolated events. This is a systemic crisis.
But conversations in hospitals often start with the wrong question. Too often, it becomes a debate between safety and compassion. Security versus healing. Law enforcement versus patient dignity.
That is a dangerous and false choice. Safety is not the opposite of compassion. Safety is what makes compassionate care possible. It is a right that belongs to everyone in the building: patients, staff, and visitors alike.
In San Francisco, we are mourning the loss of behavioral health clinician Alberto Rangel, who was fatally stabbed at Zuckerberg San Francisco General Hospital in December 2025. Reports show that staff had raised concerns about the suspect’s behavior. Metal detectors were not in place. Entry was not controlled. And when the attack happened, the systems that should have prevented it simply were not there.
This tragedy did not come out of nowhere. It followed years of warnings about security gaps and internal debate about reducing the visibility of law enforcement and shifting to a model where response only comes after violence has already begun. But when prevention is removed, it is not violence that is removed. It is the ability to stop it.
This pattern repeats across the country. In Hawaii, nurse Justin Bautista was stabbed to death at a state hospital. In Connecticut, visiting nurse Joyce Grayson was killed during a home visit. In Washington, nurse Doug Brant was shot and killed while doing his job. These were not random accidents. These were foreseeable events in places without the basic protections required to keep people safe.
Hospitals that are serious about safety cannot treat it as a public relations issue. The presence of trained security staff, screening in high-risk areas, clear visitor management, and real behavioral threat assessments are not signs of cruelty. They are signs of care. The absence of those measures, especially in behavioral health clinics, is not compassion. It is abandonment.
There is a better way forward. Hospitals can and must build systems that protect both dignity and life. This means acting on warning signs early. It means controlling access where risk is highest. It means having trauma-informed security staff and the ability to respond quickly. It means treating every violent incident with accountability and urgency, not brushing it off as part of the job.
Because when hospitals fail to protect their staff, they do not just risk lives. They lose the people who do the work. What follows is burnout, resignation, and the collapse of care.
I left the military and law enforcement to work in the private sector, and later dedicated my career to public safety in health care. I have sat with grieving families. I have walked through scenes where tragedy struck. I have listened to nurses and doctors tell me they no longer feel safe at work. Some are afraid to call for help because they think it will reflect poorly on them.
That cannot continue.
San Francisco’s tragedy should not be a passing headline. It should be a turning point. Safety must return to its rightful place as a core part of health care ethics. Because when caregivers are not protected, patients are not either.
Hanley Chan is an Asian American veteran, former law enforcement officer, and licensed private investigator. He serves on the San Francisco Veterans Affairs Commission and is a Selective Service System District Appeal Board member.
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