Imagine waking up one morning not feeling so great. After hours of hemming and hawing, you finally decide to go to the emergency room for evaluation. In the waiting room, you are comforted knowing you’ll soon be in the care of medical professionals. Then you overhear another patient arguing with someone. Seconds later, he is firing a gun, and you are running for your life.
Such was the reality for dozens of patients awaiting care at New York’s Jacobi Medical Center in January: What was meant to be a place of relief and healing turned into a source of terror.
Gun violence in hospitals and health care facilities is horrifyingly common. It was just past midnight on Oct. 4, 2021, when an employee of Thomas Jefferson University Hospital, armed with an AR-15 and a handgun, killed a colleague who was seated at his workstation. In 2018, four people were killed at Mercy Hospital in Chicago; in 2010, a distraught family member shot a surgeon at Johns Hopkins Hospital. The list goes on. Moreover, during the pandemic, gun violence rates were reportedly 30% higher.
During the pandemic, both patients and staff have experienced increasing fatigue and frustration, leading to chronically elevated levels of stress in the hospital setting. Even in pre-pandemic conditions, hospitals were stressful, to say the least. Pressure on health-care workers is high while the emotions of patients and their families are often at full-tilt toward despair. This pressure-cooker environment makes the hospital setting prone to episodic violence — fueled by the ongoing epidemic of gun violence in our country.
Violence in health-care settings disrupts the delivery of timely therapeutics and interventions. These incidents incur real costs: Even if permanent physical injury is avoided, gun violence in hospitals increases the risks of PTSD and burnout already faced by health-care professionals. Institutions themselves also face costs, as thousands of health-care practitioners take days off from work as a result of violent events.
According to the Occupational Health and Safety Administration (OSHA), almost 75% of workplace violence victims are employed in a health-care setting, and health-care workers are five times more likely to face attacks than those in other industries. It is stunning that the World Health Organization (WHO) reports that 38% of physicians can expect to suffer physical violence during their careers. Although these numbers are alarming, they likely shield the truth: Studies show that fewer than one-third of nurses or physicians report such acts.
In the meantime, laws protecting health-care institutions from violence, such as those requiring institutional security plans or mandating incident reporting, exist in only 26 states, and many of these laws are limited to particular departments or staff. In addition, there are no federal requirements that hospitals implement prevention plans.
We can and must do more to protect health-care workers and the vulnerable patients they serve. We must return hospitals to being places of relief and healing, and we know where to start:
We need to financially incentivize and thoughtfully design facility upgrades, such as unimposing metal detectors and panic buttons, that enhance security while not deterring patients from seeking care.
We need to require medical record warnings, which document history of disruptive patients, family members, and hospital staff.
We need to return to one of the primary pillars of public health: prevention. Studying statistics surrounding the risk factors that contribute to gun violence, harnessing empirical approaches for tracking and addressing improvement, and communicating with the public, are essential to increase support for federal policy changes promoting responsible gun ownership.
Hospitals should be places of hope, not fear. By supporting common sense gun laws, you can help us reverse the trend of gun violence in hospital settings and let health-care workers and their patients get back to the business of healing.
Yash B. Shah is a medical student at Sidney Kimmel Medical College, Thomas Jefferson University; Robert Glatter M.D, (@DrRobertGlatter) is an emergency medicine doctor at Lenox Hill Hospital who focuses on public policy and efforts to address the epidemic of gun violence; Joseph V. Sakran, M.D., (@JosephSakran) is a survivor of gun violence, a trauma surgeon, and vice chair of clinical operations for surgery at Johns Hopkins Hospital. He is also a senior fellow at the Satcher Health Leadership Institute at Morehouse School of Medicine.