Violence in Healthcare: When is Enough Really Enough?

Melissa Mills, BSN

You go to work each day to save lives. You face obstacles like short staffing and high patient workloads because it's your job. Your family knows you'll be gone for 12+ hours a day and not to hug you until you take off your work clothes, so they aren't exposed to germs. You deal with death, coworkers who aren't always kind, and ongoing operational issues because these things pale compared to the good you know you can do as a healthcare worker. However, having to worry about whether or not you'll come home at the end of a long shift is something nurses (or anyone) shouldn't have to worry about to do their job.

Recent Violent Events

Within a span of five days, the healthcare community lost three staff members to workplace violence.

On October 18th, June Onkundi was stabbed to death by James Gones at the Freedom House Recovery Center in Raleigh, North Carolina. Onkundi was a Psychiatric Mental Health Nurse Practitioner, a wife, and a mother of four. She was starting a doctorate program in January 2023 and was said to make any gloomy day bright by her colleagues, according to an October 26 article on People.com. While Onkundi was no stranger to the dangers of working in a mental health and alcohol treatment facility, she had only been employed by Freedom House Recovery Center for a short time. Gones is charged with first-degree murder and held without bail.

While nurses across the country paused to consider how such a terrible crime happens in a healthcare setting, a second violent attack occurred on October 22 at Methodist Dallas Medical Center. Nurse Jaqueline Pokuaa entered the room of her patient to deliver care. Instead, she was met with gunfire and killed by Nestor Hernandez, the boyfriend of her patient. After hearing gunshots, a Social Worker, Katie Flowers, looked into the room and was shot to death. Hernadez was visiting his girlfriend and newborn when he became angry and accused her of cheating. He allegedly hit his girlfriend with the weapon before shooting Pokkua and Flowers. Robert Rangel, a Methodist hospital police Sergeant, heard the shots and was able to shoot Hernandez in the leg while he reloaded his gun during an attempt to flee the scene. Hernandez was taken into custody and treated for his injuries. He is charged with capital murder.

To make this story even worse, it was revealed that Hernandez was paroled in October 2021 after serving time for aggravated robbery. As a result of his parole, Hernandez was permitted to visit the hospital even though he was under electronic monitoring. It was unknown that Hernandez entered the building armed.

These events have made many in the healthcare community wonder how to make healthcare facilities safer for staff and visitors. It's time to do something about these horrific events before other healthcare heroes die. But what can we do?

Implement Metal Detector Use

If you do a Google search on "metal detectors in hospitals,” you'll be greeted by pros and cons. For example, some articles question if the benefits of using metal detectors outweigh the costs. Other articles ask what kind of message a facility sends visitors if they have to go through metal detectors to visit hospitalized family and friends. Some even question if healthcare workers want to work in facilities where they go through metal detectors before each shift.

These arguments might make sense to some. However, others may ask how this differs from going through metal detectors at airports or sporting events. These systems create safety for visitors and people working in these venues, just as they would for nurses, other healthcare professionals, patients, and visitors. So isn't it time to keep healthcare heroes safe?

Offer Continued Training

No one enjoys attending workplace shooter or violence training. However, it's one tool you can use to keep yourself, your coworkers, and your patients safe at work. Employers must conduct worksite analyses to identify the areas of highest risk and implement measures to protect healthcare professionals so they can do their work knowing they are safe. This information creates comprehensive plans that seek to control and minimize events once they happen. However, it's critical to note that training doesn't prevent workplace violence.

Speak Out

If you work in a healthcare facility, start the conversation with the administration now. Please don't wait until it's too late and another incident of workplace violence threatens your safety. Organize a meeting with administration, create a workplace violence committee, or host open forum discussions about areas of the facility that are most vulnerable, like the emergency department. Taking a stand might be the only way to ensure you're safe and go home to your family after your next shift.

How Do You Feel?

Admittedly, I don't work in a healthcare facility. My emotions over this topic come from past experiences working in Medical-Oncology and Neonatal Intensive Care Units years ago. I remember feeling mostly safe working in a facility in the late 90s and early 2000s. However, thinking about what happens in hospitals and other healthcare facilities makes you realize that many people there are going through emotional events and may not be thinking clearly.

How do you feel about these events if you work in a facility?

What measures need to be implemented to keep you safe at work?

What steps have your employers implemented that make you feel safe or unsafe?

Put your thoughts in the comments below and start this crucial conversation.

References/Resources

Dedicated, Compassionate' N.C. Nurse Allegedly Stabbed to Death at Work by Psychiatric Patient

2 health care workers killed in Dallas maternity ward shooting identified

Psychiatric Nurse Practitioner Stabbed To Death By Patient, Family Says

Public perception of safety and metal detectors in an urban emergency department

TRACIE: ASPR TRACIE Technical Assistance Request

Health care security experts weigh in on metal detector usage