As appropriate, we share Facebook posts about praying and thinking of victims after mass shootings like last month’s Las Vegas Strip shootings.
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.
What are our responsibilities as nurses in mass shootings?
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.
- Principle 1 states the aim [after a mass casualty event] should be to keep healthcare systems functioning and to deliver acceptable quality of care to preserve as many lives as possible.
- Principle 2 states that planning a health and medical response to a mass casualty must be comprehensive, community based and coordinated at the regional level.
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?
Start the conversation about how to stop mass shootings
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.”
Courses Related to ‘Trauma’
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.
The fundamental question that we all must ask “what changed since the days you remembered as a child” . To address this problem from the root that questions needs an honest answer which I believe we all know but afraid to answer. Afraid because on this days one have to be politically correct. When something is removed, a void is left that will fill with something else. That is pure science. Removing God from our lives, it also removes everything that is good, hope, faith, love for one another, and everything that we as Americans were built on. That void is now filled with what comes when evil moves in despair, hatred, envy and mostly intolerance. As nurses we can prepare ourselves through training to educate our communities in how to quickly respond to a situation, because that will save lives. As community nurses learn how to identify warnings signs of emotional disturbance in the schools and primary care clinics so we can do early intervention without the fear that not been “politically correct” will cause your job. Next we have an obligation to get involve and fight for our constitutional rights that includes the freedom of religion and the right to bear arms. Until we get to the root of the problem all that we can do is react to the problem, until we are willing to named what the real problem and continue dancing around like it does not exist we will continue in this same dark path that we are now…
I am a retired nurse, practice from 1976 to 2017
I agree, you hit it on the head. Our society is infused with violence, movies, video games, etc.that teach children violence is the quick answer to all of their problems. We need to promote other solutions in schools, at work and at home.
Great article I would like all the courses
WE as nurse’s cannot prevent
anything. I think you are saying that we need to be educated for when it happens. This article while may having valid points seems like an endorsement for “Courses RelatRelated to Trauma.” Honestly,I fail to see any value in such a long article just to get to a point. I was looking for the enlightenment from an educated woman who is a Nurse.
Jennifer, you are an intelligent and all – informing author. Your article raises awareness for nurses about the validity of the probability of “the next” mass disaster forthcoming, be it natural, or man made. Thank you for sharing your expertise and knowledge, I am further informed about this matter, and further aware.
I have read and understand how the author point of view of what is going on around us and how we as nurses
can help contribute to this disaster ,preparedness facing this kind of disasters happening around us.
We all know how complex this situations,critical thinking and analysis sometimes is hard to come by in mass
disaster but we must prevail on any emergency situations giving all our might and compassion to save lives
and safety to our community as advocate.
Thank you concrete direction. Most nurse’s want to do something and are simply overwhelmed with their day to day lives. A single step can lead to the next better step, and then we are all better for it.
As a retired RN with significant psych/mental health history and certified by the ANCC for thirty years, I sometimes wonder if I should find a place in the mental health arena in my community. I am not interested in full time work any longer but maybe PRN or part time. Jean
I have a carry license am trained and ready to protect the lives around me Especially the children who are vulnerable I will do what it takes to protect innocent lives my son was murdered by an unprovoked gun shooting from a former co employee I know the pain of loss and the need for support of my daughter in law and her three small girls ages 6 months , 4 yrs and 7 yrs old
Make a plan follow it and pray
The only role of the nurse is in regard to the mental health of the shooters. IMO this is the common denominator. Guns are a tool. A knife can cure or kill depending on the hands and the intent which goes back to the person using it. I really hope nurses don’t sully their role by getting involved in the gun debate. There are millions of Americans who own guns legally and peacefully. The majority of the gun death, according to CDC , are suicide. Suicide is a mental health issue. Many of the shooters have been on Psychotropic drugs. Lets addresss the cause of the problem. Basic Nursing: identify the problem to accurately fix the problem
Mental Health Care in America has been pushed to the background and lives in the shadow world of “how will this paid?” and who is going to “report it.” As Americans become more isolated through voluntary “smart phone” autism and disconnect themselves from the world within 15 feet of them, we are going to see more violent acts as the mentally ill struggle unseen. Awareness is a vital factor in all aspects of life. It is time to look up from the internet and look at your surroundings and the faces of those standing and moving among your crowd. Smart phone autism is a voluntary way to shut the world out, avoid eye contact and the need to notice others. Smart phone autism should be added to the autism spectrum.
Let’s use our voices to push for more funding for research on the root causes. It is not a simple problem. There are other issues that affected us as a society that were studied and steps were taken to protect us. Examples include seat belts and dividers on highways to prevent head on collisions.
Hi Jennifer,
It is true that nurses can make a difference in minimizing the trauma and suffering of victims during such emergencies. I also agree that nurses can also play an important role in educating and engaging community. Thank you for letting us know about our roles and responsibilities during such critical situations. Thank You for sharing.
This pad is hiding things again. This one was dated Dec.14.
I haven’t had time to eead this, but if it’s FOR citizens carrying or owning guns, I’m in. If anyone wants a longer answer or just have a question, drop me a note,
Sandy