In 2013, the Federal Bureau of Investigation (FBI) reported that 160 active shooter incidences occurred in the United States between 2000 and 2013. This averaged to about 6.4 annual incidences between 2000 and 2007 and 16.4 annual incidences between 2008 and 2013. An active shooter engages actively in killing or attempted killing of people in a populated or confined area. An example of such a place is a hospital and statistics show that 154 active shootings took place in hospital settings in the United States between 2000 and 2011. In the 154 incidences, there were 204 victims some of which lost their lives (Martaindale, 2013). An active shooting in a hospital setting can take place either within the hospital itself, in the emergency department, in the parking lot or in the patient’s rooms. The purpose of this paper is to discuss four different articles and establish their views on active shooter incidences in hospital settings.
A Review of the Articles
While active shooters cannot be profiled, some commonalities have been established based on the previous active shooter incidences. For instance, most incidence have been recorded to take place during the daylight hours, where the shooter targets a highly-populated place and shoots randomly to kill as many people as possible. The fact that the shooter always has a specific target, makes prevention of hospitals shootings a difficult task. Moreover, the unpredictability of active shooters further complicates measures to prevent the situation. In other incidence, more males have been known to engage in active shooting situation, and the shooter normally takes their own life afterwards. A major theme emerging from the four articles under review is the rising wave of active shootings in hospital settings over the last few years. The Security InfoWatch (2013) article, describes how hospitals can manage active shooter situations. A surprising scenario that is described in this article is an alleged shooting that took place at Connecticut hospital, which involved shooting of two hospital supervisors by a co-worker. It is explained that the shooting was due to the co-worker being disciplined by one of the supervisors. Another shooting scenario described by Balingit (2012) explains a shooting occurrence in Oakland at Psychiatric Institute and Clinic of UPMC, which resulted in death of one employee, and injury to scores of others including policemen. It is surprising that despite the high level of security in this facility, the gunman was able to perpetrate such an action. In this case however, the gunman did not kill himself, but a gun battle with the police resulted to his death. The increasing rate of active shooting in hospitals means that hospitals need to focus on practices and procedures that can best manage an active shooter situation.
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Similar to the previously mentioned incidence, the Hospital Employee Health (2013) article discuses a shooting that took place at St. Vincent's Hospital in Birmingham, AL. The shooting resulted in injury of three people but contrary to the other articles, this articles accounts hospital shootings as irrelevant citing that only 3% on the national hospitals experience this unfortunate incident. This is according to the earlier mentioned study and the statistics translate only to about 2% annual cases. The study also mentioned the shooting of a surgeon which occurred at the Baltimore, MD, hospital, which led to a research by Johns Hopkins University researchers on strategies that can be put in place for the management of active shooter incidences in hospital settings. Surprisingly, the Baltimore gunman ended up shooting himself and his mother, with the surgeon surviving. A surprising finding that is mentioned in the Hospital Employee Health (2013) is that although approximately one-third of hospital shootings can be prevented by gun detection technology or a magnetometer, there are some instances where the gunman uses a gun that is taken from the security personnel. The findings from the study state that such cases were established in one out of every four emergency department shooting incidences.
Active shooting incidences have evolved to become three times as many as cases of assault, rape, homicide and suicide. The joint commission, reported that between 2010 and 2014 it received a total of 16 cases of shooting in healthcare facilities, which resulted in loss of 27 lives. Nine of these were suicide or murder cases involving the patient and the significant other, while the remaining cases were active shooting incidences (The Joint Commission, 2014). Though prevention of active shooting situations has been considered a difficult task, the Joint Commission has established some safety actions, that healthcare organizations can consider utilizing to prevent active shooter incidences.
Involvement of law enforcement agencies in the prevention plans can ensure that individuals from the agency have access to various areas of the healthcare facility. For instance, provision of a Go Kit to the law enforcement people can ensure that evacuation of individuals in case of an emergency is carried out smoothly. In addition to this, an effective communication plan can be developed, which will ensure that law enforcement arrives in time in case of an emergency. Creation of an emergency hotline and provision of employees with contact address for the law enforcement agency is also essential. An effective prevention strategy that is used by most healthcare settings is assessment and preparation of the building such that there is prohibition of walk-in traffic in case of an active shooting incidence. This In-case of the occurrence of an incident, the healthcare facility should have, measures in place to ensure safety of employees as well as that of patients. Moreover, employees should be trained and prepared on how to respond to active shooter situations by conducting periodic drills. It is important for healthcare facilities to have plans in place which will facilitate management of post-event anxiety and fear among the different people involved in the incident (The Joint Commission, 2014).
When the shooting at Western Psychiatric Institute and Clinic occurred, nearly all of the above mentioned actions took place, and which is an indication that the healthcare facility was prepared for such incidences. I would say that my current place is well prepared for an active shooting because various protocols have been met by the hospital. The hospital has formal engagements with the local law enforcement agency, where they are allowed to access various hospital rooms in case of an energy. In addition, there are guidelines for the employers on how they can respond to an active shooting situation. A telephone number for the local enforcement agency is also provide to all employees and events post-event activities are also outlined. Finally, every month, we receive a specific training, that focuses on how we as employees should act in case of an active shooting situation. In addition, we are also trained on how we can protect patients and how to act when the law enforcement agency arrives.
The number one priority as a nurse is to ensure patient protection. My responsibilities as a nurse in caring for a patient include; offering psychological and emotional support for the patient, maintaining a patient’s history and monitoring any changes in their health status, ensuring that the rights of the patient are not violated and communication with patients to ensure that they are comfortable in the healthcare facility. As a nurse, I educate patient’s on how they can take care of themselves after discharge, and how the strategies that they can us eto improve their health condition (Cherry & Bledsoe, 2016) .
References
Balingit, M. (2012, March 9). Hospital shootings shock Oakland 2 dead, 7 injured at Western Psych; Police kill gunman in exchange of fire. Pittsburgh Post – Gazette . Retrieved from http://search.proquest.com/docview/926869011?accountid=34574 Click here for article
Cherry, R. A., & Bledsoe, B. R. (2016). Paramedic care: Principles & practice (5th ed.). Retrieved from https://bookshelf.vitalsource.com/#/books/9780134572345/cfi/1!/4/4@0.00:41
Hospital Employee Health. (2013). Most hospital shootings are not preventable . Retrieved from https://search.proquest.com/docview/1282083457/B7656E930CE04F5FPQ/1?accountid=193269 Click here for article
Martaindale, W. (2013). Active Shooter Events in the United States from 2000 to 2010. Active Shooter Events and Response, 49-64. doi:10.1201/b14996-4
Security InfoWatch. (2013). Responding to active shooters in hospitals. SecurityInfoWatch.Com. Retrieved from http://search.proquest.com/docview/1434488744?accountid=34574 . Click Here for Article
The Joint Commission. (2014, July). Preparing for active shooter situations. Quick Safety. Retrieved from https://www.jointcommission.org/issues/article.aspx?Article=h1wY0qOAjXjKMD9Np15aXCoh6JDFt4iaFxb%2f%2fTKfNWE%3d Click here for article
