ED safety... Bit of a rant

[edrn09]

Alright, here's the story... I work in a small community hospital's ED just outside of a major city in Ohio. We are not the level one trauma center in the area however we are about 15 minutes away from it. We are located in a terrible part of town (high crime rates and high drug use) and things are really headed down the toilet lately. I love my job and I don't want to have to quit but my safety comes first.

On thursday our two unarmed security guards heard a gunshot in the parking lot. Police were called since we don't have an officer on duty until sat sun and mon nights. They found a loaded .45mm handgun under our PA's car. T[WIKI][/WIKI]his all unfolded about 100 yards from our unlocked ambulance entrance to the ED. They shot once and would've kept shooting if the gun hadn't jammed. Thank god no one was hurt.

Security came in and warned us, a report was filed with the PD and that was that. I also found out that night that administration had taken away security's access to our reporting system had been taken away because what they see are "observations" not events. (and a month ago we were told security was supposed to be reporting everything in the ED so admin would see how bad things were and we would get locked doors, more police coverage, any other safety measures).

Now fast forward to tonight we had a drunk woman hitting kicking cursing slappig biting etc. Us and one security guard on duty. While placing her in restraints she kicked security. He had another call to go to and he couldn't stay to keep her under control. Our only security guard responded to someone stealing food from the cafeteria. The thief returned the items And as security was eacorting him out the thief picked up a sewer grate and threw it at our guard. Our guard was also punched in the face with only a small police baton to protect himself with. Our police officer showed up and called the PD to arrest the thief.

Meanwhile, while security and our one police officer are tied up with the assault on our security the crazy drunk lady in restraints is getting even more out of hand - even cursing at other patient's visitors as they passed by her bed. Also, a visitor witnessed a patient beating her child and wanted to file a police report oh and we were running a code 3 curtains down from crazy drunk lady.

I guess my question is what can I do? Admin doesn't seem to care if we're safe or not. They don't want security reporting a GUNSHOT in the parking lot yards away from an unlocked door with access to staff, patients, visitors, and the rest of the hospital. Oh and admin just CUT security's hours because we don't need that much. They also want to completely get rid of our PO. oh and our ED is completely unlocked; the only door with a keypad is the Pyxis room.

What do other ED's do for safety? How can we lock the ambulance bay to thugs but not to squads? What about metal detectors? Anyone have luck with those? I am honestly scared to death that someone is going to run through the ambulance bay and start shooting up the place. I don't know what or dept can so to help admin see what a problem this is. I need suggestions.

[SummitRN, BSN, RN]

You seriously don't have a keycode or magnetic card reader lock on your door?

We have those even out in the boonies!

Everyone in the city has it.

And your guard doesn't carry a taser?

[LoveMyBugs, BSN, CNA, RN]

Wow!

all of the doors in to the ED at key pad/magnet with our badges.

Our Ambulance bay is a key pad access garage

We have 3-5 security guards on, with baton, pepper spray, hand cuffs

Our triage desk is surrounded by bullett proof glass

we have 4 pych/ secure rooms, a garage door comes down over all of the medical equipment, TV is behind plexi glass, the door to the room locks (although we have never locked someone in, always need a sitter) restraints can if needed to tie to the floor, and a camera on each room. Those 4 rooms are seperated by door away from the rest of the department so if someone is yelling we can close the door and the other patients do not have to hear it.

Of course this is now after a major remodel of the ED, now during our remodel we were deffientaly worried about our saftey at triage

[lkwashington]

Im not trying to tell you what to do. Your safety is more important than anything. If administration do not think you need more safety at this facility; I would like to know what they are thinking. I bet their families are safe. Now as I was reading, you did not speak about leaving or finding another job. I understand everyone needs care but do you have to look over your shoulder or duck every minute of the day to make sure a gun is not pointed at you or even hearing a gun shot. I would like to know what are you thinking about doing to help protect yourself?

[GHGoonette, BSN, RN]

Firstly, all staff present, including the security guard, need to write statements documenting all these nightmarish events, if you haven't already done so. If you have an Occupational Safety officer in your facility, you need to report the incidents to him/her.

Where I live, such a situation (especially in light of the security staff reduction) would be cause for a grievance procedure against Administration. If you belong to a union, speak to your rep. Do not allow management to sweep this under the carpet, all your lives are at risk.

Question: does management think it's going to work out cheaper to cough up for a legal claim if you or a patient is hurt or killed because of inadequate security measures?

[walk6miles]

Find another job. Why wait for the inevitable?? There is no comfort to your family/loved ones when AFTER the fact, changes are made.

Our level 2 Trauma Center waited for two incidents: first one was a gang-banger who walked through the ER, flipping curtains aside to find the other gang member and finish the job. The man had a gun in his hand!!

The final straw was the crazy woman who sat in the waiting room for hours. She finally opened her handbag and began to load ammo into the gun she held in her lap. After her arrest, they searched her car and found enough ammo to last two weeks.

The hospital finally put a glass door with a security officer sitting in front of it; he buzzes you in.

My issue with that is that the gentleman is a lovely older officer (78 "this birthday"). OMG

By the way, have you heard the latest trick: place a jacket with the word SECURITY across the back on a chair near the door - the illusion of an officer nearby made me feel safer.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

Agree with all of the above. Plus, keep calling the cops. You need help, and if admin wont provide it, they'll have to live with flashing lights outside the ER a lot. Bet that will get their attention. Sounds like you feel helpless. If your gut tells you you're in danger, get out now. Better to walk out today than to wish you had tomorrow. There are other jobs but you only get one life. Via con Dios.

[nicole109]

I would start by putting something in writing to administration, including something from security. I think it's ridiculous that you only have 1 security officer on duty for the entire hospital (did I read that correctly?) and that they are considering cutting hours? Does that mean that there will be times that the hospital will be "unsupervised"? If that doesn't work, then I would start to get the media involved. This is a huge issue, and the public needs to know that this hospital is not safe--EVERYTHING should be under lock and key, including equipment, medication, sharps and staff. I have always considered it a risk to work in the ED, because you are the first line defense, if anything is going to go down--it's going to happen in the ED, but this is absolutely unacceptable. If administration won't answer to it's own staff, you better believe they will have to start answering questions when the news reporters start banging on their doors. And then, I would start looking for a new job--I understand that you may love/need this job right now, but you won't be doing anything to support yourself or your family if something happens to put your well-being in jeopardy because the administration of your hospital is too ignorant to protect their own staff's lives.

[roser13, ASN, RN]

Wonder if your local news outlet would be interested in an undercover investigation into the safety/preparedness of its healthcare facility?

[ImThatGuy, BSN, RN]

I know of a hospital that had to cut funding for off-duty officers (hired as security) so instead they erected to small "towers" giving off an internet signal on either side of the facility so that officers on-duty would make more of a presence, i.e. come there to use their laptops for reports and general playing around. I used to use it, lol.

I'm not a nurse, but I've paramedic'd and policed so I'm familiar with ERs and what goes on. Unless someone has a swipe card, knows the numeric punch code, or is "buzzed in" from the nurses's station a person can't access our emergency department from anywhere. You also need some security cameras in the corridors if you don't already have them. They don't really deter anything, but at least if Mr. Thug causes problems he's easier to find later.

The quality of security guards is analogous to that of a cheeseburger. Sometimes they're awesome and at other times they evoke the "why did I go there" reaction. The baton isn't really a choice weapon for security guards either because that encourages standing and fighting rather than retreating which is generally the preferred option by corporate management. The TASER or pepper spray would be better choices. Of course if the security officer is there to apprehend then they need much more than a baton.

And I can't keep from squirming over this. Sorry, I've gotta do it every time. I'm a gun guy. There is no .45mm. 45 hundredths of a millimeter? Impossible. It's .45 caliber. :)

[Jolie, BSN]

If I were working on your unit, I would carry my cell phone on my person and call 911 each and every time I witnessed a significant safety threat.

The notion that only security can call the police is BS.

Your administration will not act until they are forced to, either by repeated 911 calls or the serious injury/death of someone in your ER.

My best to you.

[happy2learn]

My hospital is also in a not so great area of town.

My ED has a metal detector that they turn on every night. Our security guards have guns.

You can't get anywhere in the ED without a badge.