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Most US nurses ‘expect to protect patients during shootings’ in hospital settings

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Nearly two-thirds of US nurses and doctors believe they have a special duty to protect patients if a shooting incident erupted in their hospital, a survey has suggested.

Likewise, just under two-thirds of the US pubic also expects that healthcare professionals would protect them from harm if a shooting incident occurred while they were in hospital.

“Hospitals need to think about their vulnerability for an active shooter event”

Lenworth Jacobs

But the groups differed on the inherent safety of hospitals, with most people viewing them as safe havens from shootings, while clinicians were more likely to view them as a potentially risky setting.

These beliefs were among key findings from a national survey conducted in March 2017 by the Hartford Consensus – an advisory group set up by the American College of Surgeons – and published in the Journal of the American College of Surgeons.

They noted that the standard US government directive to “run, hide, fight” – adapted to “run, hide and tell” in the UK – in such situations had a different connotation in hospitals, because healthcare professionals were responsible for patient care.

The researchers said their analysis of shooting events in the US, from 2000 to 2011, found 154 incidents occurred on hospital premises, with at least one injured person per incident.

With hospital-based shootings on the rise, the Hartford Consensus assessed the willingness of hospital staff to place themselves at risk to protect patients if an active gunman was on site.

To learn about such events in hospitals, the researchers carried out phone interviews with 1,017 adults and an online survey of 684 healthcare professionals, of which 92% were doctors.

They found 33% of healthcare professionals believed the risk of a shooting event in the hospital to be “high” or “very high”, compared to 18% of the general public.

Meanwhile, 72% of the public believed that hospitals were “somewhat” or “very prepared” for such an event, compared to 55% of healthcare professionals.

Regarding obligations to patients during such events, 61% of the public and 62% of clinicians thought that health professionals had a special duty to protect patients.

But these strong beliefs dropped when it came to putting themselves personally in the firing line, with only 27% of professionals believing that doctors and nurses should accept a “high” or “very high” degree of personal risk to help patients in harm’s way.

Hartford Consensus

Most US nurses ‘expect to protect patients in shootings’

Lenworth Jacobs

In contrast, in settings where patients were more vulnerable – such as the operating theatre or intensive care unit – more professionals believed they should assume a “high” or “very high” level of risk in these settings to get patients out of harm’s way – 45% and 36%, respectively.

Lead study author Professor Lenworth Jacobs, chair of the Hartford Consensus, recommended that hospitals take steps now to ensure their entire staff was prepared for an “active shooter event”.

“Ten years ago an active shooter event was a non-concept for hospitals, but clearly things have changed,” he said. “Hospitals need to build resilience against such attacks.

“That means hospitals need to think about their vulnerability for an active shooter event, then develop a response plan, and practice it,” he added.

In June last year, a major US nursing union called for tighter laws on firearms in the wake of the Orlando nightclub shooting.

The American Nurses Association issued a declaration calling for “sensible gun control measures”.

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