What To Do If There's an Active Shooter in The Hospital

The news lately has been filled with multiple shooting incidents involving elementary school children, pregnant women, and young families. The most recent ones have occurred in one of the least expected places - hospitals. 

In Dayton, Ohio, an inmate who was receiving treatment shot a personal security guard. He also pointed a gun at others before killing himself in the parking lot. The guard he shot sustained multiple skull fractures and lacerations.

On the same day, another shooting incident happened in a medical center in Tulsa, Oklahoma. Four people died, including two physicians and the gunman. 

Incidents like this raise multiple concerns, including, 

• Gun access and ownership
• Safety of healthcare workers
• Security in hospitals

^{This content used under license from "Ask Nurse Alice."}

Hospital Responses to Shootings

In response to these deadly shootings, healthcare facilities are reviewing their security systems and policies. Others are increasing security and holding refresher active shooting drills. These drills may seem trivial at the time; however, in light of recent events they are more important than ever. Nurses are urged to remain vigilant and up to date on their hospitals policies regarding active shooters. 

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Duke University Hospital in North Carolina is one of them. The hospital already does frequent active shooting training; however, with the recent shootings, they are offering refresher training for those who need them. According to a hospital press release, the last drill was in December and plans for another this summer given the increase in violence within hospitals. 

"Duke University Health System has written policies and procedures to assist staff with the management of multiple types of security-related events, including workplace violence, isolated security events, active shooter and other potential scenarios. All staff members are required to take regular education and trainings, and key staff also participate in drills,” said Jason Zivica, assistant vice president of emergency services.

Active shooter drills in hospitals are usually incorporated into emergency response training. Training is designed to prepare you for situations that involve safety and security. This also includes domestic abuse and workplace violence. 

CHRISTUS Health System, a non-profit healthcare system comprised of more than 600 centers, including hospitals, clinics, and urgent care in Texas, Louisiana, and surrounding states,  is also taking a similar approach. 

The recent incidents in Dayton and Tulsa force management to reassess security policies. Reassessing policies allows management and staff to see if there’s something else they can be done to improve training and if there’s a need for more equipment to ensure the facilities’ security.

Healthcare facilities recognize that these shootings can breed feelings of sadness, anxiety, and helplessness amongst staff, patients, and community members. On top of reviewing safety and emergency plans, UNC Health is offering emotional and psychological support. 

UNC Health offers free telephone hotlines staffed by team members specifically trained for providing support in these situations. Virtual support group meetings are also available. 

What Healthcare Staff Should Do in Case of an Active Shooter

Part of safety drills in healthcare facilities is learning to identify and communicate the threat immediately. 

When you sense a threat, these drills will teach you who to notify (usually security but sometimes 911) and how to do it. It is important to understand the verbiage to use when notifying the proper authorities. This will ensure the proper steps are taken when responding to the scene. It can be scary and nerve-wracking but keeping calm is paramount. Notification can be done through auditory systems, visual cues, or text messaging. 

Some hospitals recommend the “Run, Hide, Fight” strategy if the staff are near the threat. This is also recommended by the Department of Homeland Security, here's the full PDF to review. 

1. Run

• Avoid the assailant – if safe to do so, evacuate the immediate areas where the shooter(s) are located,and lock down other units; leave personal belongings behind. 
• Avoid escalators, and elevators and encourage others to come with you. Call 911 when safe to do so.
• Secure patients and lockdown critical areas, such as operating rooms, treatment and intensive care units; move mobile and immobile patients to a secure area if possible; run to a designated safe location in the unit if escape from the building is not immediately possible.

2. Hide

• If running is not an option, preserve the safety of patients and visitors. Seek to hide in a room with thick walls and limited windows. This will likely be the primary responsibility of immobile patients and their caregivers.
•  Silence electronics.
• Secure entryways or rooms by locking door(s) and securing them with available furniture/equipment.

3. Fight 

• Defend yourself and your patients – as a last resort, attempt to disrupt or subdue the attacker, using available items, such as a fire extinguisher.

How Nurses Can Stay Safe

Active shootings can happen with little to no warning at all. And active shooters can be anyone - patients, colleagues, or random individuals. It’s important to be alert when you notice someone who is acting suspiciously. 

This includes behaviors showing aggression, depression, or withdrawal. It should also alert you when a colleague suddenly shows an antagonistic behavior, a significant change in performance, and visitors who refuse to show proper identification. 

Here are some key things to remember,

Alert someone when you notice a threat

Whenever you feel there is a threat, never hesitate to reach out to your manager. If a patient is showing aggressive behavior, never hesitate to ask for security presence. Also, make sure to document all interactions. 

Participate in training exercises

Although nothing can really prepare you a hundred percent, participating in training can help. Safety drills usually teach you how to recognize gunshots, how to respond to them, and how to have a survival mindset. Training involves active shooter drills and exercises with law enforcement personnel.

It’s also important to know your facility’s emergency plan. It will tell you your areas of responsibility, emergency phone numbers, and response plans. If yours doesn’t have one, volunteer to help come up with one. 

Final Thoughts

In general, hospitals are non-permissive environments. The topic of carrying concealed weapons places many healthcare organizations in a dilemma. This is especially important for individuals who hold carry permits or in states that have relaxed gun laws.

When it comes to carrying a stun gun, you have to check with your state’s laws and hospital’s policy.

Nurses may never be a hundred percent prepared for active shooters, but you can train to be ready.

*This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease.