TAMPA — Holding signs that read "assaulted" and "physically assaulted," about 90 nurses gathered Tuesday outside the Italian Club in Ybor City to address a quiet epidemic: violence against health care workers.

The violence ranges from verbal confrontations to physical assaults that patients and family members inflict on hospital, clinic and at-home health care workers, said Bonnie Castillo, a director at National Nurses United, the country's largest nursing labor union.

At the head of the crowd, Castillo read off statistics that the Journal of Emergency Nursing published last year, including 76 percent — the number of nurses with at least 10 years of experience who experienced some form of workplace assault in 2013 alone, the year the study was conducted.

"Seventy-six percent!" echoed a union organizer.

Rosel Stuart, a registered nurse from a Pinellas County intensive care unit, said workplace violence is common.

"Just last week I got spit on by a patient," she said at the rally. Stuart said she's been working as a nurse for about 37 years.

"It's very difficult," she said. "It takes a lot of time, patience."

Local union organizers hosted the rally after drafting proposed state legislation intended to standardize workplace-violence prevention, including defining how broad a term it is and training health care staff on recognizing and reporting incidents.

California recently passed similar legislation, Castillo said.

Nurses such as Louise Eastty, who works in a Pasco County emergency room, stood in the sun to support the effort Tuesday. Eastty said she has not experienced an assault by a patient or family member, but has witnessed it many times at her hospital.

"It's unfortunately common everywhere," she said.

Getting sick is stressful, Eastty said. It ups a patient's worry and anxiety, and even those in their right mind can project that worry onto health care workers in harmful ways.

"It's just a public perception that it's okay," Eastty said. "And maybe that's wrong. But that's why we're here, to educate the public. We're here to change the perception."

Eastty said she hopes the union's proposed legislation makes headway.

"Nurses are for healing, not for hurting," Eastty said. "People have to realize the health care worker is not a punching bag."

The proposed legislation currently has no sponsors, but Paula Littles, a legislative representative for the union's Florida affiliate, said she is optimistic. Tuesday's rally kicked off about a week of shopping for sponsors who will support the legislation.

"It's one of those issues that sort of cuts across all lines," Littles said.

Though the Occupational Safety and Health Administration has guidelines for workplace prevention programs, Littles said there are no federal or state statutes that require hospitals to follow them.

She reiterated that the goal is not to persecute patients, but to set a precedent to prevent future incidents.

"One of the things we're hoping is that this can start the dialogue," Littles said. "We didn't necessarily want to criminalize anyone. We wanted to be in a better situation to address the issue."

Contact Rachel Crosby at rcrosby@tampabay.com. Follow @rachelacrosby.