Objectives Hospital sitters provide continuous observation of patients at risk of harming themselves or others. This study examined violence perpetrated by patients/visitors (type II) against hospital sitters in two US healthcare systems.

Method Anonymous, cross-sectional survey data were collected from staff, including 41 sitters, across six hospitals to characterise the magnitude of and circumstances surrounding type II violence. Focus groups and interviews (n = 17) provided contextual details.

Results Unit/float pool aides, patient care attendants, unit secretaries, and contract employees served as sitters. Compared to other staff, sitters had higher 12-month prevalences of physical assault (61%;11%), physical threat (63%;18%), and verbal abuse (73%;37%). Sitters were more likely to experience a patient (rather than visitor) perpetrator (94%;76%), have a weapon (s) used against them (72%;31%), be alone with the perpetrator (65%;40%), perceive intent to harm (33%;17%), and feel frightened about their personal safety (61%;38%). Sitters often reported events verbally to unit staff and rarely through official channels (e.g., first report of injury). In focus groups and interviews, sitters and staff indicated their need for clarification of sitters’ roles regarding patient care and sitter well-being (e.g., calling for assistance, taking lunch/restroom breaks), training of sitters in personal safety and patient/visitor de-escalation, and methods to inform sitters and other staff of patient/visitor conditions and behaviours.

Conclusions The burden of type II violence among hospital sitters is high. Policies surrounding sitters’ roles and violence prevention training – supported by hospital and unit management – are needed. Continued efforts to describe the safety and health of this workgroup are warranted.