Part 1: Active Shooters
There has been an increase in the number of shootings in hospitals as well as other institutions around the country (Hospital Employee Health, 2013). The increase in these cases has made institutions to start preparing their employees on how to react if such a shooting occurred in their organization. There are similarities in some of the hospital shooting cases. In St. Vincent’s Hospital, the shooting was unpredictable and could not be prevented. This was similar to the case of the Western Psychiatric Institute shooting in Pittsburgh (Thomas, 2012).
The Joint Commission agrees that there has been an increase of shooting cases in the recent past. Since the law enforcement officers do not always respond on time, the hospital staff should be educated on how to deal with active shooter situations. An article by Security InfoWatch agrees with the Joint Commission in that all non-security staff in a hospital should be properly trained on how to be vigilant about their surroundings and to respond appropriately in case of a security threat such as a shootout (Security InfoWatch, 2013).
The staff members should know what to look for and how to act during such situations regardless of their lack of knowledge on security matters. The paper also addresses the need to create and maintain relationships with law enforcement. For instance, if a hospital is developing and implementing a safety plan, they should seek the advice of law enforcement officers. Relationships with the law enforcement can be developed in other ways apart from security related matters. Health care administrators can take the initiative and welcome law enforcement officers to participate in other health-related programs. Hospitals remain vulnerable to security risks since they allow open visitations and it is often difficult to determine the visitors who can do harm. Access control and the management of visitors to these health care centers should be improved. Access control is not only about locked doors or security screening at the entrances, it includes knowing the aim of the guests’ visit and ensuring they stick to it or that they do not access other places in the hospital during their visit (Security InfoWatch, 2013).
The Joint Commission gives similar suggestions on how hospitals can stay ahead and prepare for hospital shootings. I agree that there is a need for hospitals to conduct drills. However, this drills should not be conducted with live gunfire since this can lead to injuries, both physical and mental, or worse still loss of lives. The participants of the drill can be made to believe that the security threat is real without using live gunfire.
Collaboration with the law enforcement includes providing them with a go kit that has hospital badges with which they can access all areas of the hospital if the need arises. Also, it includes having a contact officer that the organization contacts in case of anything. The development of a communication plan includes the creation of procedures for a "lock down" state in the hospital that stops people from getting in or out. The plan can include the development of a script that guides health officers on how to respond to patients and their family members when in a security crisis (The Joint Commission, 2014).
During the training, the employees should establish a hotline number and phone number they can memorize. The establishment of processes and procedures to handle critical patients in the case of an evacuation and the kind of services that these patients can access during this evacuation is crucial. The provision of training and drills for employees should include how to give reports during the active shooter events and the best way to respond to these cases, what to expect when law enforcement officers arrive on the scene, and how patients can be protected during such security breaches. The training should cover information about mitigation strategies in the high-risk areas of the hospital such as the operating rooms and emergency department. Cases of hospital shootings cause trauma for the involved people that survive these events, as such, it is important to include post-event activities in the preparations. This includes ways to manage fear among the patients and health care professionals even though the effects of their involvement may manifest weeks or days after the incident (The Joint Commission, 2014).
Part 2
Workplace bullying affects both the employees and the overall organization; the organization suffers from declined productivity and turnover. Bullying in the workplace can come in many forms including intimidation, aggression, psychological harassment, emotional abuse, and victimization. In health care, bullying is common since the services require one to interact with different people including families, patients, visitors, supervisors and other co-workers. Given the negative consequences that bullying has on people and performance of organizations, it is important to know the reasons that lead to the development of this phenomenon in the society. To understand bullying, one can focus on five key areas: working environment, subjects, group dynamics, social interaction, and societal, organizational, and political levels.
Studies show that employees who experience bullying at their workplaces are likely to be in similar situations in their relationships with family, friends, and partners. Some studies have identified a group of individual factors in terms of age, gender, and seniority that increase a person’s chance to become a victim of bullying. For instance, some studies have reported that there is a high number of female victims as opposed to male. Past studies have focused on psychological characteristics of bully victims, however, other scholars have shown that there are certain working characteristics of an organization that would increase workplace bullying among its people. Job stability can affect a person's vulnerability to being bullied since temporary jobs are mostly held by people in a low level of employment and this reduces the perceived power, especially with the superiors (Ariza-Montes, Muniz, Montero-Simó, & Araque-Padilla, 2013). The intrinsic characteristics of a job role have played a role in contributing to bullying in the workplace. Some of these variables include role ambiguity, social climate, workload control, leadership behavior and social climate. A study shows workplace bully-victims were associated with distress from their workload, unsatisfactory workplace relationships, and a consistent intention to quit their jobs.
Studies show that there is a relationship between occupation and bullying. For instance, 44 percent of nursing staff are said to have been bullied at one point in their jobs (Ariza-Montes et al., 2013). Other occupations with significantly high bullying incidents include teachers, restaurant employees, transportation workers, business professionals and police officers. In addition to factors about an organization's dynamics, bullying can be dependent on the context in which a company operates. For instance, research shows that the service sector such as health, education, public and financial service experience many cases of workplace bullying. Bullying is said to occur more in the health sector and particularly towards nurses due to their work overload and double supervision from doctors and chief nurses. Organizations with high bureaucracy levels, strict norms, and high job security can create an environment that makes bullies feel invisible and make victims unwilling to resign.
Workplace bullying in the health care sector is four times as worse than the entire private-sector companies put together. The highest cases of these incidences are in the high-dependency unit, psychiatric wards, and emergency departments. Most studies still insist that the understanding of organizational and individual factors are important in handling the bullying phenomenon (Ariza-Montes et al., 2013). As a nurse, it is important that we cover each other and ensure that our colleagues do not suffer in silence. This can include the creation of training programs for the nursing staff on how to deal with these cases effectively.
In conclusion, workplace bullying is a growing problem affecting a high number of medical professionals. Since this phenomenon negatively affects individuals and the performance of the organization, it is important to understand the factors that contribute to the development of bullying in workplaces. As such, a number of research studies should be done on this subject to understand the variations of these factors and a way to reduce the increase of bullying cases. In the health care sector, it is important that organizations value the safety of their practitioners and find ways to mitigate these factors seeing that the sector has the highest number of bullying cases.
References
Ariza-Montes, A., Muniz, N. M., Montero-Simó, M. J., & Araque-Padilla, R. A. (2013). Workplace bullying among healthcare workers. International journal of environmental research and public health, 10(8), 3121-3139.
Hospital Employee Health. (2013, February 1). Most hospital shootings are not preventable. Retrieved from https://www.ahcmedia.com/articles/62762-most-hospital-shootings-are-not-preventable
Security InfoWatch. (2013, August 16). Responding to active shooters in hospitals. SecurityInfoWatch.Com. Retrieved from http://search.proquest.com/docview/1434488744?accountid=34574
The Joint Commission. (2014, July 28). Preparing for active shooter situations. Quick Safety, 4. Retrieved from https://www.jointcommission.org/issues/article.aspx?Article=h1wY0qOAjXjKMD9Np15aXCoh6JDFt4iaFxb%2f%2fTKfNWE%3d
Thomas, L. (2012, March 10). Hospital shootings shock Oakland 2 dead, 7 injured at Western Psych; Police kill gunman in exchange of fire. Pittsburgh Post – Gazette. Retrieved from http://www.post-gazette.com/local/city/2012/03/09/Hospital-shootings-shock-Oakland/stories/201203090151
