Reflecting on the Virginia Beach Shooting: Lessons for the Health Care Workplace

Added on Jun 20, 2019

On April 20, 2019, the 20th memorial of the tragedy at Columbine was observed. Columbine seemed to usher in a new era of violence on an epic scale, in quiet communities across the nation. It was the first such massacre in the era of cell phones and 24-hour media coverage. Since then, we’ve seen similar news coverage of horrifying mass shootings far too often. But even when the despair and devastation that we witness on our screens are palpable, the incidents seem to occur far off in the distance—until something bridges the distance and reminds us that we are only a few degrees of separation from those directly in the line of fire, and that “they” are “us.”

As an alumnus of Virginia Tech, the violence at my alma mater on April 16, 2007, in classrooms where I attended class, was impossible to fathom. And as a resident of Hampton Roads, Virginia, the recent Virginia Beach shooting hit even closer to home. The perpetrator walked the halls of a high school that I visited many times while playing sports for a neighboring school in Hampton, and the son of a colleague served as a first responder in the incident.  

pixabayViolent incidents like this are occurring more frequently in the United States. Though many of these tragedies aren’t taking place in our workplace or even our state, we are all part of a community that suffers and grieves together. This shared grief can become a catalyst for problem solving. In the aftermath of such horrific tragedy, we often ask, why didn’t we see this coming? If used to foster learning and mindfulness, rather than to assign blame or punish ourselves, this question can be an important first step in reducing the frequency and severity of such events on campuses and workplaces across the country. 

The health care workplace is one such area to focus our efforts to reduce injuries and assaults. According to a report by the Bureau of Labor Statistics, health care accounts for nearly 20% of all occupational injuries and illnesses across private U.S. industries. Even more alarming, more than half of all nonfatal assaults occur in health care. In other words, a worker in health care is nearly five times more likely to be the victim of a nonfatal assault or violent act than the average worker in all industries combined. Because of this disproportion, it is likely that someone you know has been affected by workplace violence in health care.   

Making the health care workplace safer is imperative not only to protect our loved ones, but to protect every caregiver so that they can provide the best care to patients. I agree with the Virginia Beach Chief of Police’s statement that everyone needs training on what to do in the case of an active shooter, and add that they must be provided additional training to prepare for other possible scenarios. The following are steps that health care leaders can take to reduce the number of and potential for incidents, better protect and prepare staff to handle violence, and more effectively address the aftermath. 

1. Develop communication and response plans for workplace violence. Plans should be specific to situations—ranging from combative patient tendencies to conditions involving a weapon—and should address caregivers and staff who work different shifts and across disciplines. Anyone who might enter a patient’s room or facility should be informed and receive some basic level of training, such as the U.S. Department of Homeland Security’s “Run. Hide. Fight.” Additional resources and support should be provided to managers to prepare for potentially volatile meetings with direct reports, such as terminations, final warnings, or reductions in the workforce. Consider seating arrangements and exits to the meeting room during such conversations, and evaluate policies regarding access to computer networks and badge swipes when employment is severed.   

2. Generate preventive policies and procedures from employee feedback and data. Conduct interviews of workers across care settings, from front-line caregivers to security personnel, in addition to root cause analyses. These stakeholders can identify risks, unmet needs, and improvement opportunities that are unique to each care environment. Combined with data from OSHA logs and workers’ compensation claims, these insights can help leadership identify where assaults are happening most frequently and generate robust action plans and security solutions. Share these with stakeholders to show that their safety is a core value.

3. Conduct a security assessment of your facility to identify any threats, vulnerabilities, and risks. Management and security teams should look for lighting concerns in parking lots and garages and across the perimeter, and for blind spots in security camera coverage; note any exterior doors that need labels to support clear communications with emergency response personnel arriving on scene; verify access points into the facility and entryways between floors and into units, including stairwells; evaluate visitor access, screening processes, and hours of visitation; and develop safe rooms for people to take shelter in when under threat of an active shooter. Organizational leadership should also review and expand the formal training of its security personnel, and ensure they are partnering with local law enforcement to conduct facility walkthroughs and active-shooter drills periodically. 

4. Develop a comprehensive employee assistance program. The program may offer on-site counseling, wellness programming, prevention training, and other benefits that enhance the quality of life for health care workers and support those who experienced workplace violence. Particularly for those who entered the field to heal others, the emotional trauma and fear resulting from a violent incident in the workplace can be devastating. A well-defined care program for the caregiver can also play a strong role in building resiliency in our staff.

We cannot prepare for or anticipate every situation, but we can reduce injuries and assaults in the health care workplace if we continue to seek out and implement measures for protecting our team members, our patients, and ourselves. Hospitals and health care organizations can look to each other as well as other industries to learn how best to prepare, respond to, and prevent violent incidents.

And when we fail, we can support one another. I read recently that grief is love that has no place to go. For now, my grief takes on the form of love for those affected by the tragedy in Virginia Beach. It is shared with my friends and family as well, who might not hear it enough.