In the aftermath, some people demanded stricter gun laws. Others stated it was too soon to discuss any action, that first Americans needed to pause and reflect — and respect the mourning period.
On Sunday, it happened again. A shooter opened fire, killing 26 innocents and wounding 20 others who were attending church services. The victims ranged in age from 18 months to 77 years old. It’s obvious that there’s no time to wait before we dig into finding solutions.
Growing up in the state of Washington, I was around guns often. I remember kids at my high school traveled with rifles in their trucks so they could go hunting after class — at least until the ban on guns at school started in the 1990s. What I don’t remember is there being a large number of mass shootings.
Churches, concerts, schools, shopping malls, nightclubs. These days, no one is completely safe from becoming a victim of a mass shooting in any venue. So, what do we do? Do we pray and think about the victims and their families? Yes. Prayer and thoughts are part of compassion.
In the “Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application, 2nd Edition,” Margreet Van der Cingel is quoted as saying “compassion is an answer to suffering despite the fact that suffering will not disappear by it … compassion is the morally right thing to express.”
Do we need to act? Yes. Between now and the next event, we all need to prepare for when a shooting happens in our own community. The ANA Code of Ethics addresses mass casualty events, whether it’s a mass shooting or a natural disaster.
Five guiding principles were developed in the face of increased mass casualty events for altered standards, or care that is outside normal day-to-day type, according to the guide. While all five principles are very important, it is imperative that I point out two specific principles.
What is your hospital, clinic, nursing home or home health agency doing to prepare to help if your community is next? Do you know what you would do? Who would you call? Can you go in and help on short notice? Who will watch your kids, animals or elders?
The American Red Cross and the Federal Emergency Management Agency under the Department of Homeland Security have disaster-training materials, which are great resources to give you a place to start professionally and personally. Continuing education courses also are a good way to prepare in conjunction with drills conducted in your healthcare organization.
But what else can we do? We must engage our community in a conversation on how we prevent mass shootings. There will not be one clear action or step, but many. We must all leave our biases and judgments at the door.
Do we need a policy to address this? Yes. According to the Guide to the Code of Ethics, “Policies are linked to problems or issues and contain strategies to address or resolve them.”
Policies occur at all levels, from local hospitals to organizations that govern national health matters. The ANA Code of Ethics states, “Nurses are, can and should be involved in policy at any and all of these levels.”
Nurses are great at evidence-based practice. Nurses can and should share or lead the policy-making process in our communities as we look for answers and solutions. Using an evidence-informed approach, which is more all-encompassing than evidence-based practice, will utilize diverse forms of knowledge, including clinical expertise, ethical understanding, patient and family (community) values, beliefs and preferences and theories, among others.
As most individuals have what they believe is the one answer, whether it is gun control or improved mental health services, this process will allow a rich dialogue where everyone is heard and acknowledged, and together we can form a solution.
This issue may seem too large and complex for us to answer — too political, too polarizing or maybe even too confusing on where to even begin. But remember what Florence Nightingale once said: “How very little can be done under the spirit of fear.”
Every time we do not act, we strengthen the conviction of the person who is currently planning the next mass shooting. Based on this country’s recent history, we know there’s a good chance that someone may be planning the next mass shooting right now. This person knows, based on recent similar heinous acts, that we — nurses, legislators and the general public — haven’t figured out how to prevent this from happening.
Some of us are too afraid to alienate family, friends, loved ones or colleagues by having an evidence-informed conversation, which can go a long way to figuring out how to prevent or predict this type of violent behavior. While we may not be able to stop the next one, by continuing these conversations we can slow this down, ultimately stopping most of them.
But, we must do something. “The health of the nation, and of the globe, necessitates nursing involvement at every level of program and policy; it cannot improve without us.”
CE346-60: Abdominal Trauma: A Major Cause of Morbidity and Mortality
(1 contact hr)
Patients with abdominal trauma can rapidly progress to hypovolemic shock or death, making it an ED priority. This module provides healthcare providers with information about the incidence, etiology, identification, and treatment of abdominal trauma. The most common mechanisms of injury are reviewed, as is the need for rapid diagnosis and stabilization. In addition, this module discusses the important role nurses and other healthcare professionals have during this critical period in managing patients and families in crisis.
CE471: What’s on the Inside: An Overview of Blunt Chest Trauma (1 contact hr)
In the clinical setting, a variety of diagnostic tools and laboratory studies are useful in evaluating trauma patients. But in the initial phase of treatment, the most crucial steps involve conducting a thorough physical examination and obtaining a patient history. The initial assessment and management of patients with blunt chest injury is essential to ensuring the best possible outcomes.
CE571: Traumatic Brain Injury
(1 contact hr)
Traumatic brain injury, also called acquired brain injury or head injury, occurs when a sudden trauma causes some level of injury to the brain. The leading cause of TBI in civilians is falls, accounting for 35% of TBIs, with another 17% related to motor vehicle crashes. With TBI, visible injuries may be present, but unseen injuries can pose the greatest threat. TBI affects about 1.7 million people a year in the U.S. This module provides healthcare providers with information about traumatic brain injuries, including epidemiology, types of injuries, signs and symptoms, and nursing assessment, interventions, and evaluation.