Navigating the Increasing Violence in Healthcare:
Mel Cortez
Tactical Healthcare Expert | Bridging the Gap between Clinical and Security | Always Innovating to Reduce Workplace Violence | Security is not the absence of threat, but presence of connection.
A Nurse's Perspective on the Use of Force
The rise in violence within healthcare facilities is an alarming trend that demands urgent attention and appropriate response strategies. As nurses, we are often on the front lines, facing challenging and potentially dangerous situations. Understanding the use of force, especially in high-risk scenarios like weapons detection points or instances of non-compliance and concealed weapon threats, is crucial for ensuring safety. We are partners in safety with our security teams, as clinicians we need to be able to advocate for them, and advocate for their appropriate training.
I will be referencing the above NEWS Story for context throughout this article
My opinions are my own and not that of anyone else on my team, but are informed by advanced education, study and understanding of security and policing principles. I am not law enforcement or military and have not seen the entire footage. I am attempting to give you perspective as an expert in the application of security into clinical environments.
Addressing Violence in Healthcare
The use of force in healthcare involves applying physical or mechanical means to control or manage a patient's behavior. This can range from minimal restraint to more forceful interventions, depending on the severity of the situation. The goal is always to protect patients, staff, and other individuals from harm. I often recommend organizations to utilize a Compliance Assistance approach. Ultimately, if there is a potential for unknown harm, we have to make the scene safe first.
Key Principles for the Use of Force
1. Patient and Staff Safety:
- The primary focus must be on ensuring the safety of both patients and healthcare workers. In scenarios involving potential violence or concealed weapons, quick and decisive action may be necessary.
It may look inappropriate to the onlooker but if she wanted to reach into her bag a weapons detection point, this could easily become a repeat scenario of the shooting that Legacy Health had last year.
2. Appropriate Training:
- Training on the use of force must be conducted by professionals experienced in healthcare settings, not just those with a background in law enforcement. It's critical that the training is tailored to the unique challenges and environments of healthcare facilities. For great training programs that are LICENSED to meet international standards (we do not have standards in the US yet) see the list below.
When we look at weapons detection systems and planning for the adoption of them, this should be a core element of training. How do we communicate compliance steps to people who are walking through who may feel that we are infringing on their liberties. I suggest, "Ma'am we want you to visit your baby, but we cannot have you take out the contents of your bag here. We also do not want you to reach into the bag".
3. Proportional Response:
- The level of force used should be proportionate to the threat posed. Excessive force can lead to legal ramifications and damage the trust between patients and healthcare providers. When weapons are involved, or potential for weapons, we need to understand that while we are in a healing environment, security has a role to make a situation safe first.
In this scenario, I assume she was probably quite defensive and rude. You can see on the officers face he was very upset. He also might have been afraid for his life and the others.
You might ask, "Mel how could he? He's dressed like Robo cop and she's just a woman. "
I can't tell for sure, but based on context of the story she probably refused and then reached into her bag. The minute she began to reach into the bag at a weapons check point, you are not being a prudent officer if you don't assume a weapon could come out. This is why installing weapons detection systems without training and ARMING your staff is so dangerous. He had a hold of her hand incase a weapon came out, firmly no doubt and she probably was triggered by his firm grip. Understandable. But again, why policy and procedure at a weapons detection or bag check are SO IMPORTANT. With proper holding training and use of force he would have been able to calmly redirect her to an area away from her bag and talk to her about why this was all happening.
4. Transparency and Documentation:
- Comprehensive documentation of any use of force is essential. This includes detailing the circumstances, actions taken, and outcomes. Transparency is crucial for accountability and for refining practices.
- Policy and Procedure that is BASED on your training is so critical. DO not hire a training company that does NOT have policy and procedure recommendations. If you have that already, please reach out to me for assistance in policy overview.
If she decides to sue, she said she was undecided, (probably because body cam footage is going to show she was elevating the situation) the only thing saving that officer and the organization is the policy and procedure. Also, just like the New station did, the legal team will pull an "expert" in security to support her case. The guy in this video clearly was not a healthcare security expert and does not know current trends in healthcare. But we don't get to chose who is opposing us. So you better be sure that your officers are well trained enough and you can explain your policy to even "experienced experts". Any security expert worth half their weight will verify that someone reaching into their bag at a check point and non complying would be ground for a hands on approach to prevent a possible shooting.
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Practical Steps for Healthcare Professionals
1. Specialized Training:
- Engage in regular, specialized training focused on Emotional Regulation, De-escalation (you know I HATE that word) techniques, conflict resolution, and appropriate physical interventions. Ensure the training providers have experience in healthcare settings and prioritize patient and staff safety over profit. If its costing you millions, it's not good. Those who have
2. Communication and Empathy:
- Effective communication with patients can often prevent situations from escalating. Explaining procedures, seeking consent, and demonstrating empathy can help in managing potentially violent encounters.
3. Team Coordination:
- Work closely with the healthcare team, including security personnel, to ensure a coordinated and appropriate response to threats. Regular debriefings after incidents can help improve future responses.
4. Ethical and Legal Awareness:
- Stay informed about the ethical guidelines and legal requirements related to the use of force in healthcare. This knowledge helps in making informed decisions that respect patient rights and professional standards.
Balancing Care and Safety
In the face of increasing violence, the use of force in healthcare must be handled with utmost care and professionalism. Our priority is to provide compassionate care while ensuring the safety of everyone in the healthcare environment. By adhering to ethical principles, engaging in continuous education, and fostering open communication, we can effectively manage these challenges. What will save you is in your policies and training is imperative. You must constantly be simulating these scenarios. Once a year is NOT enough.
Mel's Final Words and Recommendations for Training Program;
As violence in healthcare facilities continues to rise, understanding and appropriately managing the use of force is more critical than ever. It requires a balance between care and safety, guided by ethical principles and a commitment to patient-centered care. With the right training and a focus on ethical practices, we can ensure that our actions are defensible and appropriate, even under media scrutiny.
Doug Melia - All Security Forces, Police AND Clinicians
Micah W. Hoevelman, CPP, SAS-AP with the Arcuri Group - Security and Police Training
Keith Butchard MITOL - Training for Pediatric Environments
If your training program is not on this list and you think you have a program that meets international standards, let me know. We can take a look but so far, in the US I have NOT seen one physical tactics course that I would recommend to a client in confidence. I have taken the majority of them in the US and these UK companies far exceed what's currently available by US companies. US companies are
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Author: Mel Cortez, RN
Nurse and Advocate for Ethical Patient Care
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Note to Healthcare Professionals:
Given the increasing violence in healthcare settings, it's essential that any forceful interventions are not only effective but also defensible under public and media scrutiny. Ensure your training and actions can withstand the spotlight of national news and social media platforms like TikTok.
Native Texan | CEO Coastal Armed Services LLC, Our real world proven and reliable performance gives you peace of mind, you have experienced professionals at your disposal.
5 个月Experienced staff that use de-escalation techniques effectively could potentially avoid incidents like these. Coastal Armed Services LLC’s officers are skilled in all disciplines of their duties.