Mass casualty shootings affect the lives of everyone they touch, including nurses who treat the shooting victims. Nancy Bowman, RN, of Tucson, Ariz., and Anka Roberto, MSN, MPH, RN, of Newton, Conn., were not working in hospitals during the horrific shootings in their communities. But the events affected them personally, and drove them to make major life changes. Here are their stories:
Nancy Bowman, RN
Bowman often tells the story of how she and her husband, David, walked into a Safeway in a Tucson-area shopping center on Jan. 8, 2011, passing U.S. Rep. Gabrielle Giffords, who was greeting residents outside. She told him, “You’re lucky I’m not political or I would make you wait while I shook her hand.”
Since that day when a gunman opened fire on the gathering, killing six and injuring 13, including Giffords, Bowman has become a political person. She has gone to Washington to ask members of Congress to support legislation to strengthen background checks for gun buyers. She has supported Ron Barber, Gifford’s district director who was wounded in the shooting, in two runs — one successful and one not — for Giffords’ seat, after she resigned. She has testified about what she saw that day, purchased guns at gun shows to show how easily it can be done and talked to state legislators about passing laws to improve firearm safety and keep guns away from people who shouldn’t have them.
“I started trying to be the voice of the victims and I got involved politically,” said Bowman, clinical director of Surgical Cell Services in Tucson. “You have all this pent-up anger and energy as well as sadness and grief and you have to place it somewhere. If this was West Nile virus killing people, the whole country would be up in arms. Because it’s a bullet, it’s off limits.”
On the day of the shooting, Bowman and her husband, a surgeon, emerged from the Safeway just after the shooter had been subdued by bystanders. They rushed to help those who lay bleeding on the ground. Bowman had never worked in trauma — she was used to having sterilized equipment and a team of providers. “This was just people down on the concrete. I was literally putting my non-sterilized, non-gloved finger into bullet holes.”
The first person she tried to help was gasping for breath. She started CPR, but her husband told her the man could not be saved and she needed to move on to the next person. “For me that was really hard, to just give up,” she said. “When you’re a nurse, you stay with your patient.”
She went on, assessing, telling people to lie still and be calm, applying pressure to wounds. She was crawling in blood, swiveling from one injured person to another. One of the most seriously injured victims being treated by her husband was a 9-year-old girl, Christina Taylor Green, who would not survive. Another was Giffords, shot in the head, who would.
The EMTs arrived and Bowman and her husband let them take over. Bowman went into the Safeway bathroom to wash her hands and clothing. She watched the blood swirl in the sink, then backed up against the bathroom wall and slid down the wall to the floor. “I was in shock,” she said.
In the days following, she and her husband went to counseling. He agonized over his decision about who to send first to the hospital. She thought about Christina’s mother having to identify her daughter’s body. Nurses by training “get much more involved with their patients and the patients’ families” than physicians generally do, she said. “They dwell a bit longer on a death.” She couldn’t stop thinking about the carnage she had witnessed.
“I didn’t want to fall into despair. I didn’t want to look at this event and feel I was depressed and hopeless. I wanted to channel the energy into something positive,” she said. So when she was approached by Mayors Against Illegal Guns, former New York Mayor Michael Bloomberg’s anti-gun violence group, she thought she had found a cause people would want to support. “I thought, this is a public health issue.”
Others joined her, including some who had been shot and survived, family members of those who did not survive and fellow bystanders such as Pat Maisch, who grabbed a magazine of ammunition the gunman dropped while trying to reload. Bowman spent the first year traveling to Washington D.C., meeting with members of Congress, testifying, trying to get people to listen. But she found many balked at any efforts at gun control, and politicians were afraid of powerful gun lobbyists.
Bowman is a gun owner. She grew up on a ranch. But she did not understand why anyone would oppose background checks to stop those who had criminal backgrounds or a history of mental illness from buying guns. “I want to make something happen,” she said. “I thought it would be far easier. I get discouraged and maybe a little depressed.”
Eventually she stopped going to Washington, seeing it as a dead end. But in the process, she developed deep friendships with many of those directly affected by the shooting. They meet for dinners and attend commemorations together. They have supported various projects — a trailhead named for Giffords’ aid, Gabe Zimmerman, who was killed in the shooting. A walking path for Christina. A special fund to help the victims and their families with medical and mental health expenses.
They are working on a Jan. 8 memorial museum to tell the story of the shootings, what contributions those killed might have made had they lived, and “to celebrate the goodness in people and what came out of such a tragedy,” Bowman said.
She still works locally and with the state legislature on gun issues, but has pulled back somewhat to concentrate on her business. Whenever she thinks about giving up altogether, Maisch takes her to the Safeway where it happened. It reminds her of Christina’s parents. She decides to keep fighting. “For me, I feel like I’m the voice of those people who lost their lives,” she said. “I want to be their voice because they’ve been obliterated from this earth.”
Anka Roberto, RN
In the nation’s eyes, “Sandy Hook” has become synonymous with senseless horror. A young man entered an elementary school and gunned down 20 children, searching them out as they hid in a bathroom or under desks. Six adults also died in the shooting at the school on Dec. 14, 2012, the second deadliest in US recent history, after the Virginia Tech massacre in 2007.
The shock and grief that followed the shooting rocked the entire community, said Roberto, director of the learning resource center and the simulation coordinator at Fairfield University School of Nursing in Connecticut and a doctoral student in the psychiatry nurse practitioner track at Fairfield University. She also is the mother of two children, one of whom was at Sandy Hook Elementary School the day of the shooting.
After the shooting, she said, “I felt like it was my personal mission to help get people connected.” It’s a mission that continues, both in her personal life and her career.
Nothing in the country was as atrocious as the Sandy Hook shooting, she said, and no one had any idea how to deal with the aftermath and the trauma experienced by children and adults in the community. The Virginia Tech shootings happened on a college campus, to young adults who mostly came from outside the community. Sandy Hook is a village in a small town, where everyone knows each other. Young children and beloved teachers were killed in front of other young children.
“There’s not one person in Newton that has not had some form of post-traumatic stress disorder,” Roberto said. “We’re still walking in this together” — letting loved ones know “we’re here for them, we’re not going anywhere.”
In the days immediately following the shooting, Roberto, a pediatric nurse, saw how badly people needed help in dealing with the shock, loss and grief. As a nurse and as the mother of a surviving child, she wanted to do everything possible for them. She had just started a DNP program to become a psychiatric nurse practitioner. The Sandy Hook incident showed her the direct effects of secondary trauma on children and families.
She found a babysitter for her children and began looking for ways to help the traumatized members of her community to heal. She organized meetings, worked with other providers to help community members get access to mental health professionals.
At the same time, in a small community, she worried about inadvertently violating people’s privacy. She also found herself so involved in helping others that she was not taking her own advice about self-care after a traumatic event. “I was always, what can I do? How can I help?” she said. “When you are living in the community, it takes on a whole different perspective because you are dealing with your own trauma.”
At a certain point, she realized she’d done all she could and her family needed her. She pulled back from community work and focused on helping her two daughters come to terms with what had happened. She also threw herself into research on secondary trauma and how people heal. A year after the shootings, she wrote an article for American Nurse Today, talking about ways nurses could help a community heal, including forging trust and using therapeutic communication. “I was optimistic, then,” she said.
On the second anniversary of the shooting, she wrote a second article for the publication about the long-term effects of the trauma. Children were still having nightmares. Some were just starting to process what had happened. Some adults were still angry and resentful. “Many live in their own silos, trying to navigate the systems, trying to figure out where to go and what to do,” she wrote in the article, published in February 2015.
Roberto found solace in her family and her faith. She has worked with her children to help them come to terms with the shooting and said they are doing well. She has trained in the use of eye movement desensitization and reprocessing, a psychotherapy used to help with the symptoms of PTSD, and is impressed with how it has helped first responders. Her psychiatric research has aided her in helping her family to cope. Her experiences have helped her connect to her clients as someone who has gone through a traumatic event.
“Our lives will never be the same,” she said of her community. “But it doesn’t mean there is no hope. Trauma is treatable.” Nurses who are trained to watch for signs of trauma can identify adults and children who are suffering from it and work to get them help. At the same time, she said, they need to understand the healing process is complex and everyone has their own path. “My mission has never been to heal the community,” she said. “I’m going to be who I am and if I can help, it’s God’s will.”
Cathryn Domrose is a staff writer.
Read parts one and two of this special series:
The healer’s journey-Part 1: How nurses navigate the wake of a mass casualty shooting
The healer’s journey-Part 2: How a mass casualty shooting affects nurses on the front lines
Take the following CEs to learn more about caring for firearm injuries and helping patients in crisis:
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