Introduction
Hospitals are meant to be places of healing and safety. Yet for many security guards working in these institutions, the job is increasingly dangerous — grappling with aggressive patients, mental-health crises, weaponised visitors, and little support. These men and women are the new frontline of occupational risk in healthcare. In Canada, the U.S. and elsewhere, one of the common threads is not just violence but poor training, inconsistent regulation, cost-driven contracting of private security firms, and a failure by governments and health authorities to recognise the scope of the problem.
In British Columbia, for example, the provincial government created a new security guard class — “relational security officers (RSOs)” — in response to nurse assaults, yet the data obtained by CBC News show that the RSOs themselves are injured at a rate of nearly one accepted claim every other day. Similarly, across North America we are witnessing serious assaults, injuries, and even deaths of security staff in hospitals.
This article explores the evidence, exposes the risks, and calls for governments to treat hospital security guards as what they have become — quasi-law-enforcement frontline workers.
The Reality of Violence
In British Columbia, 170 injury claims were accepted for RSOs in a single year, according to CBC News¹. In Long Island, NY, 63-year-old security guard Gardy Coriolan was brutally beaten by a patient and remains unconscious². In Washington State, a security officer, Colleen Hendrickson Bass, was shot and killed in a hospital parking lot³. And in Vancouver, a murder suspect attacked a hospital guard with a Taser⁴.
These are not isolated “nuisance” incidents. They reflect systemic risk for security guards in healthcare environments where they are increasingly called on to manage high-stakes emergencies, often without adequate tools or backup.
Hospitals: A Unique and Hazardous Worksite
Hospitals are a distinct challenge for security personnel. Guards are often the first to confront patients in mental health crisis, dementia, or drug-induced psychosis. These environments are unpredictable. Weaponised visitors, erratic patients, and crowded emergency rooms amplify the danger. The job is made more difficult by chronic understaffing, with guards sometimes working solo night shifts or responding to incidents without support.
Unlike law enforcement officers, hospital security guards often lack the tools or authority to restrain violent individuals. In Fraser Health and Providence Health in BC, RSOs are not allowed to use handcuffs — despite being expected to hold aggressive patients until police arrive¹. In such a vacuum, guards are placed in direct physical risk. Many fear reporting incidents for concern over job security or employer retaliation.
Advance your career with multiple job openings from reputable security companies.
Sign Up TodayTraining and Equipment Deficiencies
Security guards in hospitals are expected to manage psychiatric holds, restrain violent individuals, and respond to threats — without police-level training. In Ontario, for instance, there is no standard training program for hospital security guards. A guard working at a mall one day may be posted to a hospital the next, with no instruction on mental health care or de-escalation techniques.
Equipment is often lacking or restricted. Radios, duress alarms, and body cameras are inconsistent. Handcuffs may be banned. Solo assignments are common. In some hospitals, technology like AI weapon detection is being tested, but basic protective tools remain unavailable to guards in many regions. Oversight and data collection are equally poor — making the true scale of assaults and injuries difficult to track.
A Canadian Snapshot: Ontario and BC
British Columbia’s creation of RSOs was a step forward in name only. Despite being unionized and embedded in hospital teams, RSOs face the same alarming rates of injury. CBC reported the highest rates of accepted injury claims occurred in Fraser and Interior Health regions¹.
In Ontario, security contracts are typically awarded to the lowest bidder. There is no legislative mandate for specialised hospital training. At Southlake Regional Health Centre in Newmarket, a nurse and a guard were severely injured in a 2019 incident. The hospital pleaded guilty to violating the Occupational Health and Safety Act and was fined $100,000 — a figure decried by the Ontario Nurses’ Association as a “drop in the bucket”⁵. Despite improved training efforts on paper, frontline staff report little change in real safety outcomes.
Policy Failures and a Path Forward
What must change? First, there must be a provincially mandated hospital security training program, including modules on mental health first aid, de-escalation, patient rights, and legal authority. Second, guards must be equipped — radios, body cameras, handcuffs where lawful — and never posted alone in high-risk environments. Hospitals must stop treating security as a cost center. Guards are already acting as first responders. They should be compensated, protected, and respected accordingly. Transparency in reporting, proactive audits, and enforcement of safety obligations must follow. The stakes are no longer theoretical. They are visible in the emergency room every day. Guards have died. Others are scarred — physically and emotionally — by the violence. Governments and hospital administrators can no longer look away.
Conclusion
Hospitals must stop treating security as a cost center. Guards are already acting as first responders. They should be compensated, protected, and respected accordingly. Transparency in reporting, proactive audits, and enforcement of safety obligations must follow.
The stakes are no longer theoretical. They are visible in the emergency room every day. Guards have died. Others are scarred — physically and emotionally — by the violence. Governments and hospital administrators can no longer look away.
Conclusion
Hospitals are places of healing, but they are becoming war zones for the underpaid, undertrained, and overexposed men and women who work in hospital security. They are asked to be peacekeepers, caretakers, and enforcers — without any of the protections offered to their counterparts in law enforcement. This is not just about labour rights. It’s about public safety. If hospital guards are to protect us all, they must be protected too.
— Jeff Ketelaars
Footnotes
- CBC News: ‘Relational security officers injured nearly every other day in BC hospitals’
- CBS New York: ‘Long Island hospital security guard on life support after being attacked by patient’
- Campus Safety Magazine: ‘Eastern State Hospital security officer fatally shot in parking lot’
- KATU News: ‘Murder suspect attacks hospital security guard with taser in Vancouver’
- Newmarket Today: ‘Southlake pleads guilty in violent attack on nurse, security guard’
