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Hospitals and Guns

​ONE OF THE most difficult decisions hospital administrators have to make is whether or not to arm their security forces. Studies show that the rate of workplace violence at hospitals is much higher than the national average, and hospitals can quickly become dangerous places for staff, patients, and visitors.

“People coming to a hospital don’t come there because they want to,” says Anthony Potter, CPP, senior director for public safety at Novant Health in North Carolina. They come because they have to.

They may be sick, injured, or dying or visiting someone who is. And given the stress of the circumstances, “they become totally focused on the situation to the point where they sometimes get violent when they are told that they can’t do something…or [when they think] their loved one is not getting the care that they want,” Potter explains.

A security officer with a firearm can be a life saver or provide a deterrent against such volatile threats. But the choice to arm can also end in disaster. Tony York, CPP, senior vice president of security at Healthcare Security Services experienced that type of tragedy firsthand earlier in his career when one of his security officers had his gun wrestled away by a patient who shot him. The officer died from his injuries.

If a hospital decides that the risks are justified, it must establish a clear policy, including who will be armed. For example, will all officers be armed or just supervisors? The policy should also describe the circumstances under which firearms should be used.

In some states, candidates for security posts that require a firearm have to go through hiring procedures similar to those applicable to police officers. In other places, it is up to the hospital.

York says that regardless of the state requirements, it’s important to hire people with firearm experience, such as those who have served in the military or law enforcement. But he points out that it can be a difficult balance because people with that job experience might not have the customer service knowledge or mind-set that 90 percent of the job requires.

Sources agree that background checks are also essential when hiring for a position where a firearm will be carried. Tom Smith, CPP, director of hospital police and transportation for the University of North Carolina Healthcare System, said that candidates should have no criminal history and positive psychological evaluations. Another factor to look for, says Smith, is a positive work history as that is generally indicative of attributes you would want in any security officer.

Once personnel are brought on board, they must get adequate training. The training program should not only teach officers how to use and take care of the weapon, but it should also include a judgment component, says Potter. He advocates using a law enforcement firearms training system (FATS), if possible, which provides officers with simulated training scenarios and feedback.

“Most security organizations can’t afford it, but in many cases, if you’ve got a good relationship with local law enforcement, you can be allowed to book training time on their FATS system when they’re not using it…. You can even make arrangements to have them come in and actually film some scenarios in your hospital, which makes it even more realistic for the officers concerned,” says Potter.

Training should be continual, and there must be refreshers. “We actually have training that is twice a year, and it’s a mixture of classroom refresher and…proficiency with the firearm itself at the range,” says York. “We put a tremendous amount of emphasis on weapon retention,” he adds. Retention is key in preventing a weapon from falling into the wrong hands.

Training should also include other skills, such as verbal de-escalation, according to Smith.

Whether arms make sense is a decision that must be made based on an assessment of each hospital’s unique situation. “I think it should be an administrative decision with input from the security professionals out there and proper education, but it needs to be a thoughtful decision and not just one that’s a kneejerk reaction,” says York.

Smith says that the biggest mistake he sees hospitals make in this regard is reacting to a single incident, such as of emergency room violence, for example. Instead, security should focus on the incident history of the area where the hospital is located.

It’s also important to consider other options, such as Tasers. But if a hospital does decide to arm security officers, it must implement the policy with attention to protocol, hiring, and training programs to ensure that everyone is safer, not more imperiled.