Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog. Illustration by the author.
We’re on lockdown
Stay home, they announced “active shooter now outside building”
Shocked, barely able to comprehend the message, I texted back:
Are you safe?
She texted back that she and others were in lockdown in the cafeteria. Numbly, I switched on the TV, looking for more information, but found nothing. Not a single report of the event on any station. Turning to the Internet, I found a single tweet referring to an event in progress. Feeling helpless, I texted my husband and daughter and then called my mom, letting them know I was at home, safe, just in case they heard something. Then I waited.
Within an hour, the same coworker texted again:
I stared at my phone, not knowing what to do. I went to work.
The resolution of the shooting situation was heartbreaking. However, no patients or hospital staff were harmed. The outcome could have been much worse.
That evening, local media coverage of the crisis remained scant to the point I nearly felt I’d imagined it. It was as though it never happened.
We were lucky. Our shooting occurred outside, on the hospital grounds—as do 41% of hospital shootings, according to a study in the Annals of Internal Medicine. However, 59% occur inside hospitals, endangering patients and staff. Furthermore, the rate of occurrences, inside or out, is increasing.
Hospital staffs have trained for years to handle fire, child abduction, and disasters, man-made or natural. However, the realization that hospitals are soft targets, similar to schools, shopping malls, and movie theaters, dawns more slowly.
Managing a rapidly evolving and unpredictable crisis can be beyond our control. To stay and protect patients may prove impossible. Some coworkers may or may not choose to stay with their patients; you will have to decide whether or not to abandon them too. Ethical choices may come into play—I for one struggle with the concept of abandoning patients. Teachers live with this fear on a daily basis.
According to the 2015 document, Active Shooter Planning and Response in a Healthcare Setting, from the Healthcare and Public Response Sector Coordinating Council, there are a number of ways to prepare a hospital in practical terms for an active shooter situation, and also to understand the kinds of decisions that may become necessary:
“There is no single method to respond to an incident, but prior planning will allow you and your staff to choose the best option during an active shooter situation, with the goal of maximizing lives saved. The best way to save lives is to remove potential targets from the shooter’s vicinity.”
The report considers warning signs, planning, exercises, plain language communication in a crisis, how to communicate with first responders, a variety of response plans with popular acronyms, and more.
I grew up in a household in which guns were a part of recreation. I was taught to respect firearms, but not fear them. I fear people who choose to harm others. Prevention must come from a respectful, national discussion that preserves constitutional rights, addresses the social complexities surrounding the issue, and acknowledges that public safety is everyone’s responsibility.
In the meantime, what’s your hospital doing to be prepared? Do you know how you’d react?