..and I don’t mean shooting oneself in the foot, which many people, including doctors may do at some time or other ;-). Yesterday’s shooting of a doctor by an irate relative in one of the world’s top hospitals, Johns Hopkin’s, has shocked many and raised the call of whether there is adequate security in today’s healthcare facilities.
About the shooting – it appears that the dictum “Don’t shoot me, I’m only the messenger” was not adhered to. It turned out that the assailant had been looking after his bed-ridden mother for months in the hospital and had consented for the mother to be operated on to fulfil her wish to be able to walk again. The operation did not go according to plan and the doctor, an orthopaedic surgeon, was in the process of explaining that she might not be able to walk again when all hell broke loose and he was shot. Later, police found the assailant and his mother both dead, the consequence of a murder-suicide theory.
In actual fact, the shooting incident is on a long list of hospital shootings or attacks on health-workers (see here). It appears that hospitals are fast becoming a hostile environment, not least of which because a large number of people are highly stressed. More than half of the 3,465 health workers surveyed last year by the US Emergency Nurses Association reported they’d been hit, spat on or physically assaulted while on the job.
The high-risk locations in hospitals where security issues are common include:
– the emergency/trauma department (gang fights, vendettas, domestic conflicts, child custody conflicts, VIP patients);
– infant care area (infant abduction);
– pharmacy/drug storage area (narcotic theft);
– operating rooms (opportunistic thefts),
– psychiatric care area (staff/patient violence);
Already, in the aftermath of this high-profile shooting incident, there are calls for airport-style screening with metal detectors but this will present a logistic problem, as hospitals have several doors and entrances with a few thousand visitors a day. As it stands, most large hospitals already use alarm systems, access control systems, photo identification, CCTV, two-way voice communications which many consider more than adequate, taking into account also the cost implications.
Perhaps a more practical approach would be to have scenario planning and implementing emergency drills, so that medical staff are better-prepared to handle such emergencies. This appears to have been the case in the Baltimore incident.
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