the shootings at the johns hopkins hospital made national news. maybe i'm cynical, but i think it was because a doctor was shot. news reports say that dr. david cohen was updating the patient's son about her condition, and the man was increasingly unhappy with what he was hearing. after threatening to jump out of a window, he pulled out a gun and shot the surgeon in the abdomen. he was taken to the er -- and whoever went and removed him from the scene is certainly heroic! -- and then to surgery. latest reports are that he is doing well and expected to make a full recovery.
the visitor shot his mother and then himself.
this may seem like an isolated incident, but really it's just a progression of what we nurses put up with on a regular basis. shooting a doctor makes the news. threatening to shoot the nurse, even if you're armed and dangerous, does not. decking a doctor makes the news. beating up on mother's nurse does not. threatening a doctor gets attention; threatening a nurse is business as usual.
i've been kicked, bitten, slapped, punched and threatened with knives, guns and an "attack dog" while in the course of taking care of patients. once i was in the center of an armed confrontation between law enforcement personnel who carried guns and were unhappy with their relative's care and hospital security personnel. the situation was resolved without formal charges, and the visitors were back the next day. another time, when taking care of a prison inmate who was dying i was nearly knifed by his son (also an inmate) with a homemade machete he'd smuggled out of prison and into the hospital. withdrawing care on the patient was illegal -- it would be shortening the convict's life sentence. the son was intent on shortening the life sentence, although it's unclear whether he was doing it to ensure dad was indeed on his way to hell or if it would have been a mercy killing. (i wasn't particularly brave. i had my back to the visitor and was tackled by a prison guard to get me out of danger while two other guards wrestled the son to the ground and disarmed him.) it's made me reluctant to turn my back on visitors.
in some states, threatening or attacking a health care worker performing her job is a crime on the same level as assaulting a police officer. not in our state. the visitors are free to insult, assault and batter nurses and then come back to visit. in one incident, a patient's husband threatened me and another nurse with a handgun at 6 pm. it was 9pm before the police were notified, and midnight before the visitor -- who was in plain sight the entire time -- was in custody. he was back visiting by 6 am. our manager, bless her heart, wasn't concerned about the gun-toting husband because "he's from texas. everyone carries a gun there."
we need stiffer penalties for attacks on nursing staff, managers who will stand up for us and a visitor's code of conduct prominently posted in hospital entrances and waiting rooms and strictly enforced. (metal detectors and locked units would be nice, too, but i'm not holding my breath.) and we need it sooner, rather than later.
Cultural issues with searching and scanning? So what! Only in America we are not allowed to protect ourselves. Whats your answer then?
Culture issues was one afterthought that was added to a list of valid points. You just extracted one tiny part of what she said and completely ignored the rest. What's your answer to the rest?
We're collecting it now from this thread since it is not commonly reported because we are not worth it. Why are you doubting others experiences? Can't you take us at our word?
No, we can't just take you for your word. It's like saying "Here, take this pill, it's good for you. Can't you take me at my word?" Your anecdotal evidence is not statistical data. In additional to what anything you say being purely anecdotal, in a thread like this people that feel "victimized" are more likely to post Can't you take me at my word that what you guys are saying is so commonplace really is not and that other people who agree are just not posting?
Do we really want to demonize all hospital administrations and physicians? I once had a verbally abusive patient in med/surg. She alternated between being mildly rude to venemous with the staff. Of course, we complained to management. Her physician was upset when he heard about her behavior. He had a serious talk with the patient. Not sure what he said, but it worked. She calmed down to a point that we could work with her and eventually formed a reasonable nurse/patient relationship.
I also don't believe the public views us nurses as expendable or unskilled. Again this year, a national poll showed that the profession most trusted by the public is...TahDah!...Nurses! So let's go forward and be proud of our profession, remembering that we are ALL part of the healthcare team.
our manager, bless her heart, wasn't concerned about the gun-toting husband because "he's from texas. everyone carries a gun there."
just fyi: to your manager, i'm from texas (born and raised) and i nor anyone in my family own a gun. guns are not the answer to everything, just as money is not the answer to everything. oh yeah, and not everyone in texas owns a horse, much less ride a horse to work (lol :rotfl:), as so many people from other states think so. nothing personal, just thought i shared a tid-bit of information about texans.
"fierce practice management" (a website i appreciate) reported this from a study:
"in 39 percent of the cases, the patient had no support person present when receiving the news" (about having cancer).
that does reflect some deficiency in doctor-patient communication. doctors seem to believe that they offer sufficient support for theit patients, yet they don't check that out with their patients. in fact they often turn heel after a terse mention of "malignancy" and other terms that aren't usually in lay persons' knowledge.
the article also mentioned that doctors gave no in formation about how the cancer can be treated, after giving patients their cancer diagnosis.
it seems that medical schools have some remedial work to do., and that communication could be the topic of a conference at a lovely place.
the article mentioned that dr. cohen put an arm around his patient's son's shoulders after telling him her diagnosis, which was when he was shot. it was mentioned that boundaries need to be respected, and that there had to have been some clues as to the son's mood and degree of hostility before....
the article mentioned that dr. cohen put an arm around his patient's son's shoulders after telling him her diagnosis,
i well remember the notion of behavioral "triggers" in the mentally unstable psyche from readings during the psych rotation nearly 20 years ago. it made an impression enough to commit to memory, and to this day, i stay out of arms range when waking a sleeping patient, and use caution in what i say to visitors.
still, there's little chance of escaping harm from a surprise firearm attack from someone so predisposed. even if i were armed.
so since we can't fix the mind of someone so predisposed, take his gun (in a public building or transportation) before he has a chance to use it.
It really sucks to see what the world is coming too! I definitely agree that there should be more protection for nurses and really any healthcare personel. Its very disagreeing when seeing things like this because it seems like the people who are helping and providing the care are the ones who get hurt. That sucks!
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I'm sure there are all sorts of ways of delivering bad news that aren't ideal. I remember hearing a very morbid "joke" years ago about a guy who ordered a singing telegram for his friend's birthday, except that before that occurred as scheduled, a telegram with news of a tragic nature was delivered -- and the surprise-planner insisted it be sung anyway.
My point with that is no matter how badly botched the news delivery, it is 100% unrelated to what happened to Dr. Cohen. When my mother was in her last days, there was a particular nurse liaison-customer service person who was so "huggy-touchy" she practically pulled me out of my chair a couple of times to hug me, to the point I could probably iidentify her brand of fabric softener. Is there even the slightest hint that she could be blamed for a violent act? No, we don't shoot people who overdo it. The issues are not over-lappable in any way.
Ok, if ya all want to do something positive about this maybe you need to get involved. Last I knew the EMS Bike Ride Was Open To All HealthCare Providers. Check It Out.
Doctors usually have much more money, therefore greater social status and seeming value than nurses. While the incident at John Hopkins was as horrific as any other murders have been, there was the picture one got, of a powerful person being taken down by an obviously angry individual whose ire wasn't necessarily valid. We'll never know what his actual relationship with mom was, but conjecture can be fairly accurate, since he killed her after maming her doctor.
Can you see a man (who may have been the victim of long parental abuse) being told by his mother that he shouldn't have shot her doctor (if he told her that)? It didn't seem to me that he was capable of thinking that he was saving her the pain of a terminal illness, in his rage. Killing her may have been a longtime agenda, which he decided to do then, just before killing himself. That was the time to do it, his sick mind may have determined.
I don't think any of us can doubt the emotional instability of a trigger-happy someone who brings a hidden weapon into a hospital, with the intention to use it (or bullets would have been taken out of it). He may have needed to blame someone, and the doctor may have become the target, if his communication skills weren't totally empathic. We don't know if he'd had previous discussions with the son, during which he could have assessed the son's mental health.
However the nurses may have seen the son many times, been nice to him, and therefore weren't targets. Having been a nurse for 50 years, I can say that I've never been threatened by a hospital visitor or patient; and when I did Home Healthcare, I've been in "crack" houses, gone solo into dangerous housing "projects" without a qualm (silly me), and talked down some pretty angry and derranged characters. My first time participating with irrational visitors was as a student, when a young maternity patient died, and her relatives and friends created mayhem in the expensively appointed lobby of the hospital, in the "dark ages" of the late '50s.
A call to our nurses' residence demanded (not a request), that we report immediately to the lobby, after picking up syringes at central supply (glass syringes - nothing was disposable then), and vials of phenobarb were there, to place 1cc of that depressant in the syringes. No written doctors' orders or names of the recipients of the injections were given.
We did as we were told, and grabbed the arms of those expressing their grief inappropriately, and inject the meds therein, to allay their destructive actions. Although it took time for the sc or I.M. med administered (IV injections of meds at that time were hardly ever given), to have effect, some immediate restoration of calm occurred, since just the act of being given a medication for their comfort had a soothing effect on these careening folks. We were telling them that it was for their good, and it would help their grief (explaining the procedure to the patient).
Not one complaint of assault or inappropriate action was received afterward, which actually amazed me. I wasn't sure that the most appropriate action had been taken. Knowing the caliber (not of the gun) of the security "guards" I've known at hospitals, I think they would have been the last helpers I would have contacted although the protocol requires that they be called. Even in the many incidents wherein such wannabe cops participate in TV programs, their abilities have correctly been presented as not too helpful. What they can do, is call for outside help which we can do at least equally well. We're afraid to do that lest it reflect poorly on us and the facility, though.
I do wonder what might have transpired at Johns Hopkins if nurses had spoken respectfully and supportively much earlier about her doctor, to the son regarding his mother. Knowing the history of her condition, might we have inferred to him that her condition wasn't looking good? That might have lessened the sudden impact of that information, and made it more familiar. Well, we may never learn how that situation could have been ameliorated, but hopefully its legacy will be more thoughtful communication practices and detection of early warning signs of aberrant thinking of mentally ill visitors.
Do you work at JHUH?
I speak as someone that does. And I worked as a traveler in some of the best (and worst) facilities. Five have been consistantly rated in the top 20 in the nation.
And I have to say, from what I have seen, the security here is THE best (barring the NIH that scans/searches all cars and visitors and staff not federally cleared at their parameter before enterrng the campus) that I have worked with. The facilities have 80 entrances and over 80,000 visitors (that's visitors, not including staff, visiting professors, patients (some of whom have daily visits), students, etc. And they do a phenomonal job, especially given the area surrounding the facility.
The reputation of the facility is earned, and not merely from research. The MDs and nurses, from what I have seen, are very well schooled in behavior, empathy and communication to pts and family, more so than most. We don't have great food, some of the facilities in the older parts are archaic, the TV service is a pain to deal with - the rep comes from its training of excellent care givers. And if you review the injured MD's reviews, even pts/families that have not had good outcomes have defended him as an excellent and empathetic MD.
There is also no evidence presented that the son was abused.
As a JHUH employee, one of the bigger problems is that people come here expecting "The Miracle". They get sent here from MDs that have tried all treatments that have not given satisfactory results. Families bring in their 70-90 year old loved ones, tell us that have never been sick a day in their lives, yet have had 2 MIs, emphysema from smoking for 60 years, multiple comorbidities, refractory to numerous therapies for their conditions, and then get ticked and livid when we cannot offer anything but a research protocol with no established statistics for success available.
People want guarantees of successful outcome, and often are angry that we cannot offer that.
I have also dealt with serious, serious denial. I have been present at numerous repeated, 1-2 hour long discussions with MDs, SW, support personnel present in CLEAR, LAYMAN'S language and family/pt still deny that they were told X or that the MD does not talk to them enough. I routinely used to see pts with clearly terminal disease that were told that what they had was incurable, that get angry at the MD's "failure" when they relapse.
The MD was shot because he was convenient. In JHUH, MDs spend more time with their pts than in the average community hospital and that made him a easier target.
I find appalling that some would blame the victim and the staff.
Specializes in ICU, PICU, School Nursing, Case Mgt.
Dear Grandma,
I have agreed with many of your POVs on other topics, but I think you might be a little off base here.
Or at least a little "sheltered".
I worked in the main "trauma" center/urban hospital in West Palm Beach, Fl. We are about 6 miles from Palm Beach, proper... about as "high end" as you can get.
I worked in several areas of ICU and PICU--during that time, (8 years ) we had to go on "lock down" at least 5 times because a charming family member tried to smuggle a weapon in AND *it was a locked unit, btw* AND there is an actual substation of the WPB police department on site.
Also, during my tenure there, an Emergency room nurse was taken hostage and held at knife point for several hours.
THank God she was not harmed--at least physically...
It did not make national news....
I have been verbally threatened in response to nicely asking a family member to leave for 5 minutes while a procedure was being performed.
Oh, and it does go on and on....'
I am just saying, I find it difficult to believe that you have NOT encountered any threats or some degree of perceived violence in all of those years.
morphed
230 Posts
Culture issues was one afterthought that was added to a list of valid points. You just extracted one tiny part of what she said and completely ignored the rest. What's your answer to the rest?