Emergency Room, Anytown Hospital, USA. Friday night. There is a rush at the door … A gurney is rolled in accompanied by Paramedics and a police officer. The patient is swiftly taken into a Trauma Room. Shortly after, a contingent of what appears to be family and friends flood into the ER. Many are distraught while others are trying to calm the situation down …
This could be any ER, in any hospital, anywhere in the U.S. With the proliferation of violent crime the chances of having to face and deal with some level of threat in an ER of clinical setting is becoming problematic.
While there are a number of reasons why citizens should be armed, it seems that Doctors, PA’s, nurses and other medical professionals should consider doing so while working. Hospitals, clinics and offices are quite frequently ‘gun free zones’ (video) and are therefore ‘soft targets’, lacking adequate security as well. They may also have certain medications that are ’popular’ with certain demographics further increasing the danger. In an emergency room setting, there are a number of potential hazards that should be considered. Individuals arriving with gunshot wounds (GSW) often were shot for a reason (gang related, domestic problems, etc.). If the shooter decides to finish the job, that could put a number of people in danger. Distraught family members and friends might also pose a real concern. In the absence of security personnel, there has to be a plan. Placing security in the ER is an option but has its drawbacks, cost being among the most obvious.
The mind-set of a medical professional is often quite different than the average citizen. Doctors take an oath. One English translation of the original Hippocratic Oath text contains the phrase, “With regard to healing the sick … I will take care that they suffer no hurt or damage.” So, a doctor with a firearm who is ready to use it might, to some, sound counterintuitive to that chosen profession. Most doctors got into the business to help save lives, not destroy them, right? Probably. However, those in the medical profession might feel called to help those in physical need but, standing there, unarmed, with an armed madman in the room, means there is a decent chance everyone inside could end up injured or worse. In fact, a study in the Annals of Emergency Medicine, noted that there were 154 shootings in U.S. hospitals between 2000 and 2011 with 253 dead or injured. How many of these attacks could have been stopped or deterred in the first place if doctors or hospital staff are allowed to carry concealed or just had some level of training?
Doctors are used to helping, not harming. But, in life threatening situations where they, members of their staff or other innocent individuals may be seriously injured or killed, aggressive action must be taken. This action may result in the serious injury or even death of the attacker however, all actions have consequences. This does not mean the armed physician has to be the hospital policeman, but it is their duty to help and protect those around them and under their care from physical harm.
It seems that nearly every day there are reports of deaths by shootings. In the fall of 2016, we were horrified when two off-duty police offers shot the unarmed son of a Texas physician in a hospital behavioral unit. Virtually all emergency physicians and staff have personally experienced or witnessed a violent incident in the ED. Hospital staff and physicians experience double the rate of work injuries when compared to all other occupations with the exception of police forces and the military. Is ED violence getting worse? Research says it is. Here are some possible reasons:
Changing Patient Populations – More psychiatric patients coming through the ED
Understanding the need to report violent incidents
Hospital Security Staff – Training varies for both staff and security personnel
Factors that Affect the Likelihood of Violence in the ED
Violence and Hospital Administration – Administrators need to encourage employees to report incidents Of particular interest should be the staff risk factors of lack of training, inadequate staffing, and working alone. In addition, literature also supports another key reason for the widespread nature of ED violence; it persists, because it’s tolerated. One judge dismissed a complaint with, “Well, isn’t that the nature of the beast, being in the emergency room and all?”
So, for the time being at any rate, health care workers seem to be on their own re: their personal safety. If your employer will does not provide the adequate protection, training or personnel to keep you safe, you need to seek it out on your own. It’s always better to have it and not need it than need it and not have it.