Deadly Weapons Have No Place in Hospitals

来源:搜狐教育 2016-10-11 15:57:00

Ifyouwereinahospital,wouldyouwantarmedguardsroamingthecorridors?

It'sanincreasinglyrelevantquestionforpatients.Today,medicalcareisoftendeliveredincloseproximitywithdeadlyweapons.Fromregionalmedicalcenterstochildren'shospitalstoworld-renownedinstitutionsliketheClevelandClinic,armedsecurityguardsarebecomingmorecommoninhealthcare.Accordingtoa2014study,anestimated52percentofhospitalsnowhavehandgunsavailableforsecuritypersonneland47percentprovideTasersforuse.Thesenumbersareconsiderablyhighercomparedtopriorsurveysfrom2009and2011.

Earlierthisyear,theproliferationofweaponsinclinicalsettingsdrewnationalattentionwhentheNewYorkTimesandNPR'sThisAmericanLifereportedonthe2015shootingofAlanPean.A26year-oldpatientatthetime,Mr.PeanwasadmittedtoaHoustonhospitalwhileexperiencinganacutepsychiatriccrisis.Duringhishospitalstay,hewasnotedtobeconfused,dancingwithoutclotheson,andwanderingoutofhisroom.

Afternursingcalledhospitalsecurityforassistance,Mr.Peanallegedlyassaultedthesecurityofficers.HewassubsequentlyshockedwithaTaserandthenshotinthechest.

Mr.Peanfortunatelysurvivedthistragedy,buthisstoryraisesalargerquestion:whyhavehospitalstakenuparms?

Advocatespointtotheneedforself-defense.Afterall,hospitalscanbesurprisinglyviolentworkplaces.AccordingtotheDepartmentofLabor,healthcareworkerssufferbetween15,000and20,000annualinjuriesthatrequiretimeoffasaresultofworkplaceviolence;thenumberofseriousviolentinjuriesinhealthcarenearlymatcheseveryotherindustrycombined.

Inmyfield—mentalhealth—cliniciansareatevengreaterriskofworkplaceviolence.Weoftencareforpatientsagitatedbypsychosis,mania,substanceabuse,orotherconditionsthatcancausethemtolashout.I’mcurrentlypursuingresidencytraininginpsychiatry,andresearchsuggestsbetweenaquartertohalfofmypeerswillbephysicallyassaultedduringourtraining.

Fromthisperspective,itmightmakesensethentohaveweaponsinhospitals.Securityofficersmightbetterensureasafeworkplaceiftheyhavethetoolstodoso.

Yet,asMr.Pean'sexperienceshowsus,thecombinationofweaponsandpatientcarecanhaveseriousconsequences.Securityofficerswhomaynotbetrainedtodealwithsymptomsofmentalillnessmayactrashly,harmingtheverypeoplewhocametothehospitalforcare.

Thewronghandscouldgetonthoseweapons.AsnotedintheTimesarticle,a2012studyfound23percentofemergencydepartmentshootingsinvolvedaperpetratortakingagunfromasecurityofficer.Inmultiplestates,patientshavestolengunsfromguardsandescapedfromhospitals,disappearingwithlethalweaponsandterrifyingsurroundingcommunities.

Finally,thepresenceofgunsinhospitalsettingscastsapervasiveshadowoverpatientcare.Cliniciansshouldn'thavetoworryabouttheirownstaffshootingpatients.Patientsshouldn'thavetoreceivecareinweaponizedenvironments,wherearmedguardsmightexacerbateparanoia,anxiety,andahostofothersymptomsforwhichpatientsarereceivingtreatment.

Recognizingtheseconcerns,anumberofhospitalshaveoptedforarmingsecurityguardswithlessdeadlymeans,suchasTasers.Butthesearestilldangerousweapons.Whileoftenviewedasnon-lethal,Tasershavebeenfoundtocausecardiacarrestandevendeath.Theuseoftheseinstrumentsalsoraisesdoubtsaboutthequalityofcareprovidedwhenhospitalsresorttoelectrocutingtheirpatientswithweapons.

Extremesituationslikeactiveshootersmaynecessitatetheuseoffirearmsandotherweaponstoprotecthospitalpatientsandstaff.Howeverthesesituationsarerareandunpredictable.Policeforcescanbetterhandlethesescenarios,andresearchhasn'tyetshownarminghospitalsecurityofficerstoconsistentlysavelivesorimprovepatientoutcomes.

Inthemeantime,manyinthemedicalcommunityhavespokenoutagainstthemilitarizationofpatientcare.Thissummer,theAmericanMedicalAssociationpassedaresolutionurginghospitalstolimittheuseofgunsandTasersonunitswheretherearepatientswithmentalillness.ApetitionexpressingoutrageattheshootingofMr.PeaninHoustongatheredthousandsofsignatures,largelyfromhealthcareworkers.Doctorsandjournalistsarecallingformoretransparencyandresearchintotheuseofweaponsinclinicalsettings.

Hospitalsshouldinsteademploynon-lethalsecuritymeasures,suchaspeppersprayorphysicalrestraints.Activeshooterplanscanpreparehospitalstaffforemergencysituations.Inhigh-riskareaslikeemergencydepartments,somemedicalcentershaveturnedtometaldetectorsinsteadforpreventativepurposes.Clinicianscandelivermedicationstotreatagitatedpatients,andnationalmedicalorganizationshavereleasedguidelinesformanagingthesetypesofsituations.

In2010,amannamedPaulWarrenPardusbroughtasemi-automatichandgunintoJohnsHopkinsHospital.Distraughtoverhismother'scare,heshotasurgeon,hisownmother,andthenhimself.Thedoctorsurvived,butMr.Pardusandhismotherdiedfromtheirwounds.Afterunarmedhospitalguardsandlocalpolicesecuredthescene,Hopkinsofficialsreleasedastatementwiththeseprofoundwords:

"Hospitalsareandmustremainplacesofhopeandhealingthatareopentothepublic.Theycannotbeturnedintoarmedcitadels."

Asayoungdoctor,Ican'thelpbutagree.

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