How to Keep Nurses and Patients Safe Amid Rising Workplace Violence

Joelle Y. Jean, FNP-C, BSN, RN
Updated December 6, 2022
    The Methodist Dallas Medical Center shooting shocked the healthcare community. Learn more about safety protocols put in place at hospitals for patient and employee safety.
    Featured ImageCredit: SDI Productions / Getty Images
    • On Saturday, October 22, a 63-year-old nurse and a 45-year-old social worker were shot and killed by the boyfriend of a patient at Methodist Dallas Medical Center.
    • Workplace violence against nurses and other healthcare workers is increasing.
    • There needs to be safety protocols in place at hospitals to protect patients and nurses.

    The shooting that shocked the healthcare community comes only a few days after June Onkundi, a psychiatric nurse practitioner, was stabbed and killed at her job by a patient. While safety protocols are put in place at hospitals to prevent incidents like these, the federal government reports healthcare workers are five times more likely to experience workplace violence than any other industry.

    Violent acts against healthcare workers are common, and many go unreported. Find out about safety protocols put in place at hospitals for patient and employee safety.

    Safety Protocols Are in Place at Your Hospital to Prevent This From Happening

    Hospitals have the responsibility of keeping their employees safe. But threats against healthcare workers are increasing, leaving staff vulnerable and potential targets for violent crimes.

    The most recent of these attacks occurred Saturday, October 22, when Katie Annette Flowers, a 63-year-old nurse, and Jacqueline Pokuaa, a 45-year-old social worker, were shot and killed at Methodist Dallas Medical Center.

    The shooter, Nestor Hernandez, 30, was visiting his girlfriend in the hospital after she gave birth to a baby. Hernandez, on parole from prison and wearing an ankle monitor, was granted permission to be at the hospital.

    Hernandez first accused his girlfriend of infidelity and began hitting her with the gun. He then proceeded to shoot Pokuaa before shooting Flowers after she looked into the room upon hearing gunfire. Hospital police Sgt. Robert Rangel shot Hernandez in the leg. After a standoff, Hernandez was taken into custody. Hernandez faces a charge of capital murder.

    According to the Methodist Medical System police, the hospital was never informed of Hernandez’s parole status or tracking device. Authorities are also unaware of how he was able to have possession of a gun while on parole.

    The Centers for Disease Control and Prevention reports the emergency room alone brings in 130 million visits a year. Security must be a top priority. In addition to safety cameras, police presence, frequent communication with patients, and zero tolerance for violence can help foster an environment of trust, which is much needed in healthcare today.

    How Hospitals Play a Role in Protecting Nurses and Patients

    Hospitals must continue pinpointing gaps in security protocols and missed security checks through employee and community engagement, administration, and technology.

    There are many strategies on how to prevent violence against nurses, other healthcare staff, and patients. One strategy that many hospitals enforce is requiring employees to complete mandatory, web-based active shooter training classes. These classes prepare employees on what to do in case they encounter an active shooter.

    Other hospital protocols include postmortems or debriefings that occur after every significant event. Team members and stakeholders analyze and discuss what happened and what improvements need to be made.

    Other protocols in place to ensure the safety of staff and patients include:

    • Installing metal detectors
    • Having ID checkpoints
    • Flagging patient charts
    • Creating de-escalation teams
    • Training teams on how to deal with difficult family members as a nurse or other healthcare staff
    • Identifying risks in security
    • Maintaining police presence in hospitals and facilities
    • Limiting entrances and exists
    • Organizing gun violence campaigns

    Northwell Health, the largest healthcare provider in New York, recently launched a national gun violence awareness campaign. According to their website, they believe that “health systems have a unique ability and responsibility to tackle the epidemic of gun violence.” The campaign aims to “dramatically reduce gun violence so that it is no longer a driver of hospital admissions for injuries or death.”

    Healthcare systems also need to partner with communities to raise mental health awareness. Programs that destigmatize mental disorders will only improve the understanding of mental health. They can also increase access to care that is needed in the community.

    Gun violence and mental health is a public health crisis, and raising awareness can prevent injury and death in hospitals.

    The Nurses’ Role in Patient Safety

    Not only do patients have the right to refuse care, but they also have the right to say who can or cannot visit them in the hospital. This can protect patients and staff from violent individuals seeking contact with patients.

    Empowering patients to talk about safety-related information isn’t easy and can be awkward. But it is better to initiate the conversation so they feel comfortable revealing concerns they may have. For instance, reminding your patients of the Patient’s Bill of Rights can empower them to know and act upon their rights.

    Asking about gun safety at home is another safety measure hospitals can enforce. While filling out a patient’s history and physical, nurses and healthcare providers might ask questions like “Do you own a gun?” and “Are there any unlocked guns in the home?”

    Northwell Health’s gun violence campaign points out that it doesn’t hurt to ask these questions. While interviewing patients, it is a great opportunity to provide information like statistical data about gun violence and the responsibilities of owning a gun as well.

    Empowering patients not only protects their safety, it also protects the healthcare teams. Asking questions and providing resources makes it clear the hospital takes threats and violence seriously.

    It is up to healthcare institutions to consistently uphold and enforce safety rules in hospitals. To continue maintaining a safe environment, hospitals need to have zero tolerance for workplace violence. This can be enforced through:

    • Community newsletters
    • Internal memos
    • Social media
    • Advertising
    • Commercials

    These strategies will inform the public by highlighting security changes in their facilities. Internally, hospitals must continue frequent safety rounds and support management when enforcing zero tolerance for violence and workplace nurse bullying.