To understand the hazard, one has to be aware of the different types of workplace violence. Is it a spontaneous event involving two people who know each other, (shooting incidence) or is this a preplanned shooting incident designed to kill many people (active shooter). When an active shooter incident is taking place in a health care facility, it is important to know what type of violence is taking place. Most people attempt to hide rather than confront the shooter to determine the reason. Unfortunately, when a shooting incident occurs in a health care facility, it is impossible to know whether it is a spontaneous event or something that has been preplanned. In those situations which are pre-planned, the active shooter may have had a grudge, may have been terminated or treated harshly, and in return, the individual plans of taking revenge. While some active shooter incidents are spontaneous and driven by emotions, most are preplanned. The spontaneous shooting events in healthcare facilities usually involve one or two shots from a gun and may be involved in a shooting between two or more individuals, for example, a spouse, manager, or colleague. The unplanned or spontaneous events may occur because of impulsive action, extreme anger or loss of control.

Or a healthcare worker may be upset at the manager for refusing to pay him overtime and may pull out a gun. The surgeon may unjustly blame the patient, and the latter shoots the surgeon. For example, a patient may have been unhappy with the surgeon following a surgical complication. On the other hand, a shooting incident is a spontaneous, unplanned event that may involve two participants who either know or do not know each other. Data show that multiple people can be shot within a few minutes and at least two-thirds of active shooter incidents are over by the time law enforcement arrives. However, within these 10 minutes, the shooter can do a lot of damage. The active shooter events usually do not last long most are over within 19 minutes, either because law enforcement stops the shooter, the guns jam, or the person runs out of bullets. In most cases, the active shooter has already accepted the fact that he or she may also die during this shootout. The majority of active shooter events are preplanned the shooter usually has prepared himself well with the aim of killing as many individuals as possible. According to the US Department of Homeland Security, an active shooter is 'someone who is actively engaged in killing or attempting to kill people in a confined and populated area.” (DHS, 2013) An active shooter is a term used by law enforcement to describe a situation where a shooting is in progress, and this particular crime requires a set of protocol when responding to the incident. It is important to make the distinction between a shooting incident and an active shooter. ,, Īctive Shooter versus Shooting Incident: What is the Difference? Thus, during the initial phase of an active shooter at a health care facility, intervention by bystanders, hospital personnel, and other civilians may be necessary if one is going to develop a preventive plan. Further adding to the complexity of an active shooter is the fact that most events occur without any hindsight and end quickly often before law enforcement even arrives.

Moreover, hospitals have many entrances and exits, and this makes planning for an active shooter incident very complex.

in the emergency department) so the firearm is not necessarily brought into the institution, it is the officers weapon. Some events have police already on scene (i.e. Hospitals actively see thousands of patients every day in many different departments. The one major problem with active shooter events in a healthcare institution is that unlike other businesses, there are unique challenges in planning and response. Active shooter incidents are just as likely to occur in both rural and urban healthcare facilities at any time. The general belief today is that no profession is immune from an active shooter, including healthcare establishments. In the past, most active shooter incidents took place in businesses like the postal service, factories, and corporations. It has happened most recently in the hospital of Wright air force base. From 2000 to 2011 there were 154 hospital-related shootings and since 2010 an additional 7 events. There was a time when it was thought that an active shooter in a healthcare facility would never occur, but this notion is no longer held. Almost on a weekly basis, there are reports of an active shooter in the workplace.

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