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.
Worked at a hospital where they took the guns away from the security people, gave them nice blazers, laid off half of them, and installed lots of cameras. Gotta love it! 2 weeks later the CEO's car was stolen from the hospitals lot. Security was able to show him nice pictures of it, too.
Worked at a hospital where they took the guns away from the security people, gave them nice blazers, laid off half of them, and installed lots of cameras. Gotta love it! 2 weeks later the CEO's car was stolen from the hospitals lot. Security was able to show him nice pictures of it, too.
Some people are slow to learn. They slowly rehired so people could patrol the lots. CEO's car was found in Mexico being used by the police there, still with the US plates on it.
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. :)
Oh, but to get to the original point... one option unionize. Now I'm not an unquestioning for or against them, but this sounds like a perfect use. How do the other staff feel?
Try talking - perhaps anonymously, in case of HIPPA issues - to local news outlets. Health care is a big topic, and it sounds to me like a reporter could stay for a few hours and see fairly quickly what the problems are. Nothing riles a lazy administration like bad media.
If you can't do that, I hope you do get out soon. My last stint in ED (as an emergency responder for a private company, not actually with the hospital) was before a lot of the higher tech incidents, but they stayed on lockdown for anything like gunshot wounds, and kept multiple security guards on staff at all times - theres just no way to be sure one or two will be enough, because 'when it rains, it pours'.
>What do other ED's do for safety? How can we lock the ambulance
> bay to thugs but not to squads?
OK, here's the deal on the ED with which I am familiar:
The main entrance to the hospital closes at (I think) 8:30PM. That is the latest ward visiting time. (Although ICU is 24hrs.) The hospital's After-Hours entrance has the orderlies office looking at it. I guess they need to buzz you in(?)
The door from the emergency carpark is always open. But only goes to the ED waiting room. You might go round to a hallway to Short Stay and the rest of the hospital, though. This would be down a hallway with cameras.
The triage desk, and front desk with clerks, has a few thick horizontal wires blocking it. Just to keep people from reaching over.
Getting from the waiting room to the interior of ED needs a magstripe security card. Or a button-push by the triage/clerk folks.
Getting into the internal rear entrance to ED needs a proximity/contactless card.
Getting from the internal hallway to Short Stay needs a magstripe card.
The ambulance door needs a security card to open. I don't know if it is the old magstripe or the new proximity/contactless type. (I will poke my head out this week.) The ambulance crews - we have exactly one company here - have cards to get in.
Oddly, the ambulance crews don't seem to have a card for Short Stay, because I once had to let them in.
On other safety...
Our orderlies double as security. Their office is just down the hall, and I have seen four of them appear almost instantly, when someone was acting up. They are large and tough.
There are many cameras at intersections of hallways - not sure where else.
There are panic buttons in ED, Short Stay, and the fracture clinic (right upstairs.)
Some psych patients who are acting up also get sedated, and sleep for a few hours while waiting for the mental health team. Others get a minder - an assistant, or an orderly. There is a locked, quiet room where they can have their interviews.
The drunks - well, they are usually rather mellow by the time they get there. Occasionally adding their own urine and vomit. And being unconscious. And generally very glamorous and cool.
I only know of two people who have been given official trespass orders. One smashed the toilet with his cane. And the other was a very frequent flyer (pysch, hypochondriac) who got too obnoxious.
Gang jackets are officially off-limits. Although, one time, there was a quiet standoff at the main entrance. A bunch of gang dudes amd a couple of cops with rifles pointed up. (They were visiting their own member in ICU.) I feel compassion for people who risk wasting their lives on that gang $#(^ but they just go all pathetic and I don't wanna deal.
So, anyway...
Get together with your local ambulance company, and look into a lock situation with contactless cards. It seems to be very common.
Call the police every time you need security and they are unable to come.
Patients in restraints need a chemical time out. Put them to sleep and they usually wake up with better manners, or a clearer picture of what is causing the behavior.
Keep your cell in your pocket.
A "code" for violent behavior in the institution could be instituted and bring a staff member from each unit to assist. A day of training physical techniques to get away from/restrain patients safely for every ER staffperson would also help.
First, go in and talk with your manager, making sure to remain level-headed and try not to let fear exaggerate reality. Find out if they perceive a problem, and if so, what will be done about it, and when. Find out from the horse's mouth what response is expected of you if/when there is a threat to safety in the ER.
If they really seem like safety/security is not a problem at your facility and have no plans to improve this situation, you need to start looking for another job, IMO. Why? Because if they can deny that a completely unlocked ER is a tragedy waiting to happen, they have serious issues of not valuing their employees in general (or their patients!) - and THAT is not a corporate attitude that you can change.
Keep calling the local PD for any potential/actual problems. Once the PD responds to a few calls, they will certainly say something to the administration fo your hospital.
Plus, your call will be logged and recorded, God forbid someone gets hurt and documentation is needed.
I'm not saying call 911 for silly things, but unruly guests/patients/staff certainly warrant a call in your scenario.
:lol2:
dthfytr, ADN, LPN, RN, EMT-B, EMT-I
1,163 Posts
Worked at a hospital where they took the guns away from the security people, gave them nice blazers, laid off half of them, and installed lots of cameras. Gotta love it! 2 weeks later the CEO's car was stolen from the hospitals lot. Security was able to show him nice pictures of it, too.