How HR Can Help Prevent Hospital Gun Violence

Violence can erupt anywhere on a hospital campus. Human resources professionals play a vital role in preventing on-the-job violence by setting policies and training employees in techniques to keep everyone safer.

It's been a violent week. Shootings—and killings—at a restaurant in Las Vegas, and a college campus in Seattle have made big headlines over the last few days. In Canada, three police officers were shot dead in a residential area last week before the alleged shooter was apprehended.

These are just the latest wave of seemingly random shootings and no public space or workplace can truly be considered safe.

Not even hospitals.

Violence can happen anywhere and sadly, is not news to most people in healthcare. According to the Centers for Disease Control, 63% of all nonfatal assaults and violent acts in the workplace occurred within the healthcare and social assistance industry.

Emergency departments typically see the most violence. "We have people who come in under the influence of substances, or they're sick or scared," says Jason Berenstein, director of security at Oakland Regional Hospital in Southfield, MI.

But violence can erupt anywhere on a hospital campus. Patients will frequently lash out against doctors, nurses and other ED staff. Berenstein also remembers an incident where two clinicians got into a physical fight on the ED floor. "Given the stressful situations staff go through at times, they push each other's buttons," he says.

The Role of HR
While human resources professionals are not on the front lines, they can be active partners in preventing on-the-job violence, says Marilyn Hollier, president of theInternational Association for Healthcare Safety and Security and director of hospital health center security at the University of Michigan.

Just the threat of workplace violence has been associated with reduced productivity, decreased retention, absenteeism and a decrease in quality of care for patients.

"A lot of times, employees report incidents to Human Resources, not security or the police," says Hollier. "They don't want to get their coworkers or patients in [legal] trouble, so they go to HR. It's real important HR establishes that they are a partner in hospital security," Hollier adds.

It is often up to HR to set policies and train employees in techniques that can keep everyone safer. "Train managers and supervisors to handle aggressive employees and patients," urges Hollier. She suggests training managers to watch employees for sudden personality changes and to confront them. If employees are feeling anxious due to a colleague or patient threatening them, or are having other problems that could lead to violence, there will likely be signs before the situation comes to a head.

Also, she cautions, "human resources should be taking additional steps to be sure we're not hiring the problem." Hospitals must be diligent to scrutinize the backgrounds of potential employees carefully, as healthcare employees work with a vulnerable population.

Often, hospital staff don't feel comfortable reporting abusive patients, but Hollier urges them to call it in.

"We'll determine whether [there's] a legitimate threat. In a hospital, people act out because they are stressed. People are not themselves. But we're looking for the needle in the haystack—the person who is actually going to follow through [on threats]."

Hollier also suggests training all front line employees to diffuse conflicts. "We train all of [them] in non-violent crisis intervention and how to use keywords to deescalate the behavior. Empathy skills are key."

If You See Something, Say Something
The best hospital violence policy, according to Berenstein, is "zero tolerance."

His advice: "Know your surroundings, and train [your employees]. Educate them about workplace violence and how to handle difficult patients. Teach them to recognize warning signs," he says, echoing Hollier.

"Always be observant. Report to your supervisors and staff anything that's not right immediately. That's what keeps you safe. By not saying anything or taking action, it can be detrimental to your safety, and that of others."

Hollier agrees, but adds that HR staff must realize that no hospital is immune to violence. "Hospitals… with maintenance people doubling as security are the ones I worry about," she says, pointing out that many incidents with gun violence haven't been happening in big cities, but in rural areas where people wrongly assume they are immune to it.

"They gamble that it won't happen there, and that's when things do happen," she says.

"At a high level, we should be educating our politicians that hospitals should be gun-free zones," she continued, adding that keeping guns in a place where tempers are likely to flair and misunderstandings are likely to happen is a recipe for disaster.

"Everyone needs healthcare. Prisoners, people with drug problems, people with psychiatric problems all need healthcare. It's very a very diverse population, like a little city. A little city with a whole lot of stress," says Hollier.