The Unhealthy State of Violence in the Healthcare Industry

Executive Director, Active Shooter Prevention Project

I saw a photo attached to a post on LinkedIn the other day that struck a chord with me. The photo accompanied an article about nurses demonstrating against the lack of safety and security in their workplaces.

The photo I am speaking of was of a nurse holding up a sign that said, “We NEED metal detectors”. I certainly have a profound recognition of the challenges in healthcare (and in so many other professions) in today’s society regarding safety and security and violence in the workplace.

We are seeing an extraordinary level of violence in society today. Not only that, but it is the immediacy to extreme violence that we are well behind the power curve in adjusting to.

I absolutely sympathize, empathize, and am frustrated by the levels of violence affecting our healthcare workers, but what really struck a chord with me about this image was just how far we need to come to really understand the multifaceted and multidimensional aspects of these issues that we are trying to mitigate. I understand this simple sign was just a representation of the issue.

In discussing this with some of my peers, in just in a short discussion, we were able to come up with roughly eight different scenarios where actually having a metal detector at a facility did not prevent violence, it actually facilitated its use at that particular location.

I will describe one such incident on broad strokes – An individual passed through a metal detector that alerted. The unarmed staff by the metal detectors asked that person if they had a weapon. That individual answered “yes” and then promptly drew a pistol and killed the two people that had confronted them.

The solution goes much farther beyond the implementation of even basic technologies such as metal detectors. It requires policies and training, proper equipping of staff, and goes so much further than metal detectors. We have visual weapons detection, gunshot detection, and we have artificial intelligence which is now pushing the envelope of being able to identify signatures of violence.

Now I will admit that the capabilities of current artificial intelligence technology are nothing less than shocking to those unfamiliar with the technology, and many people are still uncomfortable with – and distrusting of – assessment, evaluation, and presumption by computers versus humans. I don’t intend to delve into that particular discussion, but just want to make it clear that I am aware of it.

In order to solve this problem of seemingly uncontrolled violence in today’s society, it requires holistic and community-based solutions. We need to embrace educating our communities on the indicators of violence and understand concerning behaviors and have immediate access to anonymous, comprehensive, and integrated reporting systems. The horsepower behind these systems are the trained and multi-disciplinary teams evaluate the reporting and taking swift mitigating actions.

We have yet to really scratch the surface of the social and mantal health resources that we need to support the victims of threats and also support what is required to get others off of the pathway to violence.

We have had Run – Hide – Fight as a mantra for over a decade now. We need to start creating specific plans to make run-hide-fight actionable. Each of us needs to have a plan. Where will we run and why? Where would we hide and why? Where and how would we fight? This is admittedly not an easy thing, because it is different in every single place we go and is also different at different times in the same places – so our plans have to be flexible.

There is a direct correlation between how quickly and decisively we can react to a perceived threat, and our likelihood of surviving – and that is a challenge. By and large, we are mentally unprepared to admit that evil can visit us anywhere and at any time, and that is a mistake. This is a large part of why it takes an average of five minutes for law enforcement to be notified of an active shooter incident. We need to force discussions of what we are ready to do when threatened, even if that discussion is just with ourselves.

We need to add actionable substance and mental fortitude to that simple mantra. We need to implement the training, the reporting platforms, and the technology solutions that can provide additional time in response to enable us to put some distance between the threat and the threatened.

This also requires implementation of updated policies, improved staffing, and more training, and, oh by the way, let’s not forget that we need to do some routine and consistent training through exercises and drills to validate these new policies and training received, and determine gaps and places we can still improve. It is absolutely NOT “one and done” – this is something that requires continuous care and feeding.

With the implementation of cutting-edge technologies, we also cannot forget the basic technologies we rely on. I’m thinking specifically of communication technologies out there that virtually everyone takes for granted – does that telephone or VOIP headset in an office, an ER hallway, or an examination room do what it looks like it should? Communicate immediately? In most, if not all, training exercises that I’ve observed there have been levels of communication challenges.

If that phone is your lifeline, imagine picking it up and hearing absolutely nothing. We need to verify – in advance – that it has a dial tone and if ready to work in an emergency. I will equate it at a certain level to that of a patrol officer going on duty who needs to verify that their weapon is loaded and in the proper condition.

We need to do just this in our workplaces, and employers we need to ensure that the resources provided for employees are appropriate, functional, and routinely tested to ensure that they will work in an emergency.

We HAVE to approach this as a community because it affects all of us.