ED Shooting Shows Why Confronting Hospital Violence Must Be A Priority

The Feb. 15 early morning shooting inside the emergency department of Scotland Memorial Hospital in Laurinburg, NC, provides an unwelcomed, frightening, and extreme example of the violence that healthcare professionals too often confront.

If you want to read the details of the report, here's a local news link. Bottom line: some jerk allegedly brought a gun into a hospital and started shooting people. I really don't care what his motive was, although I was gratified—but not surprised—to read that the healthcare professionals on duty acted heroically to secure the safety of their patients.

When the attack was over, one patient at the hospital had suffered multiple critical gunshot wounds to the chest, his alleged attacker was in police custody, the hospital was in lockdown, and a number of healthcare professionals and their patients—though not physically injured-were badly shaken.

The story got little play nationally and not that much play around North Carolina—a couple of news cycles and then nothing. That left me wondering if hospital violence has become so commonplace that it no longer warrants extensive news coverage. Had a similar shooting occurred in a school, for example, it likely would have generated much more media coverage. Is this a sign that we are becoming inured to the idea of violence in the ED? Let's hope not.

From everything I've heard and read so far, it appears that Scotland Memorial CEO/President Greg Wood and his staff did a good job responding to the shooting, and then keeping the public informed. SMH issued two press releases in the hours immediately after the shooting—doing their best to explain the convoluted chain of events and the hospital's response, even as the police investigation was still underway.

"We have never experienced anything like this in our hospital before," Wood said in a media release. "The safety of our patients, visitors, and staff is of paramount importance to us, and we have extensive security measures in place to minimize the likelihood of such a horrific incident as this."

Wood understands the importance of keeping the public informed on this critical issue. He could have simply referred inquiries to the local police. You'd be amazed at how many hospitals do. SMH is still assessing its reaction to the shooting, what worked, what could be improved upon, etc. I hope to speak with Wood when that review is complete.

When will hospital violence get the attention it deserves? This is not a new phenomenon. HealthLeaders Media and other healthcare media have reported on it, but you don't see it talked about much anywhere else. An Emergency Nurses Association survey last year found that more than half of emergency nurses say they've been "spit on," "hit," "pushed or shoved," "scratched," and "kicked" while on the job. One in four of the 3,465 emergency nurses surveyed for Violence Against Nurses Working in U.S. Emergency Departments say they've been assaulted more than 20 times in the past three years, and one in five nurses have been verbally abused more than 200 times during the same period.

A report from the National Advisory Council on Nurse Education and Practice also found "considerable evidence that workers in the healthcare sector are at greater risk of violence than workers in any other sector." The report cites Bureau of Labor Statistics data which show that 48% of all non-fatal injuries from occupational assaults and violent acts occurred in healthcare and social services settings. BLS data also show that 9.3 in 10,000 employees in the health services sector suffer injuries that require time off from work, compared with two in every 10,000 workers overall in the private sector.

There are cost big factors at work here too. How much are hospitals paying in workers' compensation claims, or litigation for unsafe work environments, or for missed work, or for overtime or hiring temps to cover those missed shifts? How will a shooting in your emergency department affect recruiting and retention?

These are grave questions that deserve immediate attention. First and foremost, however, this is a human resources issue. This is about providing dedicated healing professionals with a safe working environment. They have enough stress in their work already. They shouldn't have to worry about getting shot, or stabbed, or kicked, or slapped, or scratched, or punched, or spit upon, or pushed, or cursed at, or intimidated. That sort of abusive conduct is not tolerated almost anywhere else. Why are hospitals the exception?

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