Case Study: Hurricane Katrina's Aftermath
The tips described here are part of a comprehensive approach that can help staff minimize or defuse aggressive behavior or assaults. A Certified Instructor of CPI's Nonviolent Crisis Intervention®
training program shared a true story from a hospital in Gulfport, Miss., in the days after Hurricane Katrina ravaged the area. It provides a powerful illustration of how preventive strategies, embedded in a workplace culture, translate to practice.
A hospital educator was faced with a number of local residents who were understandably distraught because their family members were either missing or injured. Some of these residents were trying to gain access to the already overwhelmed hospital, seeking information about their family members who may or may not have been inside. In an effort to prevent looting and vandalism, the hospital's disaster response procedures limited access to the facility. Additionally, members of the Mississippi National Guard were called to the scene to help maintain order.
Using the principles learned through training, the hospital staff member continually reminded himself that this was an otherwise normal group of people who had been thrown into an unbelievably difficult situation. He empathized with their frustration and worry, and tried to remain calm, ensuring that his body position did not send cues that were challenging or threatening. He allowed individuals to release some of their frustration through venting and did not take their angry comments personally. As he listened to the verbal tirades, it was clear the underlying message was the fear of not knowing where relatives were, not knowing if they were receiving necessary medical care, and worst of all, not knowing if they were alive.
When some of the individuals began to make threatening comments and attempted to intimidate the staff member, he took those threats seriously and set appropriate limits. He told the people that if they could wait patiently and calmly, he would be able to fill their requests for information more quickly. On the other hand, if they could not control their anger, the next person they would be speaking to would be "that gentleman over there, dressed in green"—an armed member of the Mississippi National Guard.
By using a number of the approaches described above, the staff member provided a positive influence on the behavior of the group—a group that could easily have turned into an unruly mob. Instead, the angry, aggressive behavior abated, and the staff member was able to turn his attention to finding out the names and condition of those in the hospital.
Basic Prevention Strategies for Hospitals
The National Institute for Occupational Safety and Health recommends healthcare facilities apply these general security tactics:
- Develop emergency signaling, alarms and monitoring systems
- Install security devices such as metal detectors to prevent armed persons from entering the hospital
- Install other security devices such as cameras and good lighting in hallways
- Provide security escorts to the parking lots at night
- Design waiting areas to accommodate and assist visitors and patients who may have a delay in service
- Design the triage area and other public areas to minimize the risk of assault:
- Provide staff restrooms and emergency exits
- Install enclosed nurses stations
- Install deep service counters or bulletresistant and shatterproof glass enclosures in reception areas
- Arrange furniture and other objects to minimize their use as weapons
- Design staffing patterns to prevent personnel from working alone and to minimize patient waiting time
- Restrict the movement of the public in hospitals by card-controlled access
- Develop a system for alerting security personnel when violence is threatened
Provide all workers with training in recognizing and managing assaults, resolving conflicts and maintaining hazard awareness.