Hours later, the visitor opened fire, killing a security guard and sending patients, nurses and doctors running for cover.
The shooting at Legacy Good Samaritan Medical Center in Portland was part of a wave of gun violence at hospitals and medical centers across the United States, which have had trouble adjusting to the growing threats.
Those attacks have helped make health care one of the most violent sectors in the country. Data shows that healthcare workers suffer more non-fatal injuries from workplace violence than employees in any other profession, including law enforcement.
“Health care workers don’t even think about it when they decide they want to be a nurse or a doctor. But in terms of actual violence, statistically, healthcare is four to five times more dangerous than any other profession,” said Michael D’Antelo, a former police officer and specialist in healthcare and workplace violence as a safety consultant in Florida. .
Other sectors are ahead of health in general danger, including the risk of death.
Similar shootings have taken place in hospitals across the country.
Last year, a man killed two workers at a Dallas hospital when he was there to watch the birth of his son. In May, another man opened fire in the waiting room of a medical center in Atlanta, killing one woman and wounding four. Late last month, an assailant fatally shot a doctor at a medical center in Dallas. In June 2022, a gunman killed his surgeon and three others at a doctor’s office in Tulsa, Oklahoma, because he blamed the doctor for lingering pain after an operation.
It’s not just deadly shootings. Healthcare workers accounted for 73% of non-fatal workplace violence injuries in 2018, the most recent year for which statistics were available, according to the US Bureau of Employment Statistics.
The day before the July 22 shooting in Portland, center employees were told in meetings to prepare for a possible “code Amber” in case the visitor attempted to abduct the baby, according to a nurse with direct knowledge of the incidents. ads and that he spoke to The Associated Press. She spoke on condition of anonymity because she feared reprisals for her work.
Fifteen minutes before the shooting, someone at the hospital called 911 to report that the visitor was threatening staff, according to a timeline released by Portland police.
“I don’t know how many chances he got. There came a time when the staff didn’t know what to do, or what they could or couldn’t do with it,” the nurse recalled.
The police arrived at the maternity ward within minutes, but it was too late. Bobby Smallwood, a security guard transferred from another Legacy hospital to cover shifts on Good Samaritan’s depleted security team, had been fatally shot. Another hospital employee suffered a shrapnel wound. The suspect fled, and was later shot to death by police in a nearby neighborhood.
The hospital declined to respond to the nurse’s comments because the case was still being investigated.
“Events like this are unpredictable, but our team showed professionalism and considerable courage in the face of extraordinarily difficult circumstances that day.” Legacy Health said in a statement to AP:
Legacy Health plans to install additional metal detectors in Portland, check the bags in all its hospitals and send visitors and patients to controlled access. More security guards will be issued tasers, the center said, and bullet-slowing cloaks will be installed on some interior windows and main entrances.
Some 40 states have passed laws creating or increasing penalties for violence against healthcare workers, according to the American Nurses Association. Hospitals have security guards armed with batons, tasers or firearms, while some states, such as Indiana, Ohio and Georgia, allow hospitals to create their own police forces.
Critics say private hospital policing can exacerbate the inequality in health and treatment with police that black people already experience. They also point out that private police forces often do not have to disclose information such as how often they use force or whether they disproportionately detain members of minority groups.
Security teams can’t solve all the factors that lead to violence because many are due to a dysfunctional health system, said Deborah Burger, a registered nurse and president of National Nurses United.
Patients and families often have to go home and back from emergency rooms multiple times, becoming frustrated by high costs, limited treatment options or long waits, Burger said.
“Hospitals don’t really have a complaints department, so the only real target they have is the nurse or staff right in front of them,” she explained.
Lack of staff forces nurses to care for more patients and gives them less time to assess potential behavioral problems in patients. Efforts to de-escalate a violent situation are less effective if nurses haven’t had time to connect with patients, Burger said.
Rising patient-to-nurse ratios are “an absolutely catastrophic formula for increased violence in the workplace,” D’Angelo said. “Now you don’t even have the old system of two partners taking care of each other.”
Some hospital managers urge staff to calm down aggressive visitors and patients because they’re worried about getting bad reviews, Burger said. That’s because the Affordable Care Act tied a portion of the federal reimbursement rate to patient satisfaction surveys, and low satisfaction hits the bottom line.
“The results of those surveys should never take precedence over the safety of personnel,” D’Angelo said.
Eric Sean Clay, president-elect of the International Association for Healthcare Security and vice president of security at Houston’s Hermann Health Memorial, said workplace violence rates for medical facilities are “grossly underrepresented.”
“I think a lot of it stems from the staff being very tolerant and coming to see it as part of the job,” he said. “If they’re not hurt, sometimes they don’t want to report it, and sometimes they don’t think it’s going to change anything.”
Clay’s hospital has armed and unarmed security guards, though he hopes that in the future they will all be armed.
“We actually have our own shooting range,” Clay said. None of his guards have drawn their weapons on the job in recent years, but he wants them to be prepared due to the rise in gun violence.
Clay and Memorial Hermann Health declined to answer questions about whether an armed security guard could negatively affect access to care or existing inequities.
The nurse at the Portland hospital said the shooting left her colleagues terrified and unusually solemn. She worries that the company’s heightened security promises are temporary because of the cost of finding, training and keeping security guards.
Some of her co-workers have left because they don’t want to face another “silver code,” the alert that is issued when someone is armed in the hospital.
“We always say that these patients and their families are very vulnerable, because they are having the worst day of their lives,” the nurse said, and that makes many workers reluctant to demand better behavior.
“We have to stop that idea,” he said. “To be vulnerable is to bleed to death from a gunshot wound to the chest. Being vulnerable is having to entrench yourself with your patients in a room for a silver code ”.
