Hospital could face fine over terrorism drill

A Las Vegas Hospital is under heavy criticism and could be fined for a misguided terrorism training exercise. In the scenario, unaware and panicked nurses, doctors and other employees were herded into a break room by an armed intruder, leaving critically ill patients unattended. The hospital’s COO told state investigators that the three employees who cooked up the exercise failed to tell administrators or anyone in the intensive care unit. Two of the employees involved in planning the drill were suspended and the security director was terminated.

STORY LINK: http://www.lasvegassun.com/news/2010/jul/03/drill-left-staff-fearing-lives/

You see someone being taken hostage. Should you:

A) Assume it is a real event.

B) Assume it is an exercise.

C) Assume you are seeing a movie being made.

D) Assume you are next.

If you don’t know what is happening, you will react as in A) and D) above. Unless it was a real hostage situation, no good can come from that. Exercises need to be planned, vetted, coordinated, and communicated.

Well, the employees did complain about previous drills being not realistic...

"Hostage taker" is lucky someone didn't lay a smackdown on him.

I've been in this type of event, both as a bad guy and as a good guy. Much more fun to be a baddy TBH. We were all on the same sheet of music, surrounding people were warned and/or recruited for roles. Even then, we had "umpires" in full uniform stationed around to tell people what went on.

Still there are failures. Most notably, a police officer shot two soldiers going through SF training, not knowing they were playacting, and they didn't know he wasn't playacting. A tragedy which caused several lawsuits and many rules and procedures being changed.

The best laid plans... and it's even worse when you plan and don't tell anyone.

Test exercises have great value. They can be a learning experience for all involved. Weaknesses and breakdowns are identified in advance. Obviously, this example demonstrates the failure of communication. If you surprise people, whether employees or the public, problems will occur. Exercises need to be documented and planned.

Also, anyone looking for a Director of Security position at a hospital in LV? The article links back to the job posting

http://www.recruitingnevada.com/jobposting.aspx?ID=25c590d8-bc8c-442a-8e19-def31e386728

Of all the departments in the hospital, why did they hit Intensive Care, where the sickest people are?

If that chain is anything like the Providence one, they will rehire the person they fired, and give him a promotion and raise.

The local Providence chain hospital near me enacted a disaster drill that involved the hospital, fire department and law enforcement. The employees were warned but the neighborhood wasn't, and they started a fair panic. They now advertise in the newspaper ahead of time.

Dumb.

Sue

I went back and completed the article, as I have some business interests in the HC market. I would suggest the reporter was a little bit under informed in choosing the words "terrorism drills", as the more probable likelihood would better fit under "workplace violence". That being said, the ICU is probably a "higher potential drama" department than say the cardiovascular outpatient area, where rival gang bangers get to be treated side by side, interspersed with other end of life scenarios.

What is interesting is the COO tossed the Security director under the bus almost as quickly as he would have tossed the Security Director under the bus if a law suit emerged that was built around an incident that illustrated a lack of drilling as the root cause of a poor incident outcome.

That was a Very Lucky Bad Guy & Hospital!What if there were people present ,of whom had the Right to Carry?

Hopefully they would be smart enough to hold their fire. I can't imagine ICU patients would do well if gunfire started exploding outside their room. Just what you need - an entire unit that suddendly has a simultaneous heart attack.

A scare would harm the pts less than being shot in their beds! If I was armed in that situations I'd readily assess that I was surrounded by the most vulnerable people imaginable. Would you not be spurred to immediate action? Assuming of course that you believed you were in genuine peril?

Going back to the "accountability" aspect, it would be interesting to hear the Security Directors version of the story.
The HC industry is pretty specific in its requirements for preventing workplace violence:

http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_45.htm

My guess is 30% compliance from about 80% of the HC facilities would be the norm!

I wonder if the SD was trying to do a DIY incident preparedness drill since the same administrator who dumped him didn't give him any budget to hire some professional training and advice on how to properly run a critical incident exercise.

Seems to me that every organization has a Barney Fife. You know the type, a little too enthusiastic, and with a warped sense of priority and proportion.

That sort of guy makes a good sidekick and functionary as long as they are tightly supervised and kept away from anything that might cause harm.

The issue isn't so much a matter of a security guy going too far. It is a matter of who put him in a position where his lack of judgment was allowed to play out.

If the fake gunman had gotten shot or if a patient had gotten hurt, then things would have gotten super weird. It's a good thing they didn't try that nonsense in Texas, Kentucky or Utah, where someone would have been armed probably.

Why not? I've been peripherally involved with the planning of drills, and I see long lists of things that can't be hit. Sometimes the only legal exercise target is the vending machine by the loading dock becuase everyone is afraid of potentially interfering with normal operations. Same kind of thinking says "well, it's just a firedrill, we won't evacuate anyone becuase we've never had a real fire before."

The only thing I'd say is off limits for this kind of drill is ED, OR and pediatrics. Although those are other places where a nut is likely to crack.

But from what I've seen of this, there is plenty of blame to go around. Sounds like the security director was a twit, but they guy who was telling him to run a drill without training or budget needs to go to.

"The only thing I'd say is off limits for this kind of drill is ED, OR and pediatrics."

OR, sure, but ED and Pediatrics? I am curious why you think those two should be off limits, but IC shouldn't be. ED: a few broken bones, a dog bite and junkies trying to connive a fix. Pediatrics? That's just babies, they're either crying or sleeping, and they wouldn't know a terrorist from banana.

It isn't like all the patients in ICU are supremely stable. One had a blocked airway at the time.

And it didn't sound like that off-duty cop did his homework, either.

Sue

Be honest... Are you the guy who masterminded the drill in the article?

I'm so irritated by the blatant negligence of this drill that I can't even critique the response of the nurses.

"Sometimes the only legal exercise target is the vending machine by the loading dock because everyone is afraid of potentially interfering with normal operations."

Actually drills involving the receiving/loading dock/ mail centers are good ideas- these areas are frequently "passed through" in workplace violence incidents. Shipping companies, vendors coming and going, employees passing through the area on the way to fastest outside smoking area. Goblins and other "disgruntled"s prefer the less restricted areas than coming through the front door reception.

And from a timing standpoint, shift change is one of the higher vulnerability timeframes.

The shooting this morning in Albuquerque first 911 call in was at 9:26AM- It is being described as an ex boyfriend relationship and something tells me that a Monday morning shooter works themselves up over a weekend and strikes early in the day.

So that we don't get too far off the "urban preparedness" theme, what can you do to protect yourself if a "pitched gun-battle" starts breaking out over in accounting? :-)

You'd have to go to one of the gun sites I frequent to see my honest response.

Lock the door and hope they did your payroll already?

Yes and no. I've seen a lot more people survive a gunshot than a cardiac arrest.

And sometimes, the best action is no action. "Don't just do something, stand there!" Why do a shoot out in the middle of the ICU, when you can do it at any time up to the point he starts shooting? Let the day ride out a little and see where you may end up.

Hit the concrete floor and start digging.

Keep an eye on Dallas. If the schmucks in my company's payroll department don't clean up their sloppy work, someone is going to get mad. TX is one of those gun places.

Sue

One of these days police will be called to check out an office building where none of the people working there came home. Inside they find:
Four armed security guards who were conducting a realistic training exercise simulating heavily armed Arab radicals taking over an office building.

Five armed citizens who thought they were under attack by terrorists and each 'took action' to defend themselves on their own.

Two malcontents who, as the sound of shooting echoed, independently decided this was the time to act out their last stand fantasies.

Twelve people who seemed to have got caught in the cross-fire.

One goof who knew about the drill but figured he could play a joke on the armed bully who worked across the hall by stumbling into his office with his shirt streaked with catchup and staging a death scene and ranting about how the Muslims were after him times to coincide with the guards wearing turbans and fake beards storming into the room firing blanks.

Here are some real cases involving armed citizens and real criminals/terrorists:

http://www.youtube.com/user/iq201#p/c/93E74FDD63F3C3C0/1/f7k_12sNcio

http://www.youtube.com/user/iq201#p/c/93E74FDD63F3C3C0/0/SCeqa65pxos

http://www.youtube.com/user/iq201#p/c/93E74FDD63F3C3C0/7/EtLa6rpPp1E

http://www.youtube.com/user/iq201#p/c/93E74FDD63F3C3C0/3/RKVAy0hb7I4

http://www.youtube.com/user/iq201#p/c/93E74FDD63F3C3C0/5/Wq-CwV3XMDE

http://www.youtube.com/user/iq201#p/c/93E74FDD63F3C3C0/6/-oF_5pirACY

http://www.youtube.com/user/iq201#p/c/93E74FDD63F3C3C0/4/MNNz5IUQaH4

http://www.youtube.com/user/iq201#p/c/CE7A798BB1987116/0/FfDB1eVIgZw

http://www.youtube.com/user/iq201#p/c/CE7A798BB1987116/2/CzGY3sQbeJk

http://www.youtube.com/user/iq201#p/c/CE7A798BB1987116/3/OtrgFtf8QY0

http://www.youtube.com/user/iq201#p/c/CE7A798BB1987116/1/oDpGQKfnkVg

http://www.youtube.com/user/iq201#p/c/CE7A798BB1987116/4/2mmnnOV1ZYc

Given that a I'm very selective as to what videos I download, more a matter of a slow connection than a refined pallet, could you sum up your point in, words, print?

http://www.youtube.com/watch?v=NAQy8v0d_qo

Kinda puts the BBC Brass eye comedy sketch into perspective...

The point is to provide real cases involving armed citizens who faced criminals/terrorists. The videos are relevant to the topic at hand. Each video has its own summary in words if you don't want to download/view the video. There is no inappropriate content.

Given that the discussion at hand involves an inappropriate exercise gone wrong and your videos involve "armed citizens who faced criminals/terrorists" they aren't IMHO really "relevant to the topic at hand". But I think I can your foursquare behind the standard, NRA approved, 'guns are good' stand.

I'm not really concerned, so much, with viruses, I've got fairly good protection, and "inappropriate content" doesn't worry me at all because I'm not easily offended.

People grounded in reality would prefer to learn from real cases, rather than from a fantasy written by an anonymous anti-gun dude on the Internet...just sayin'.

What real cases? Those are nothing but self serving hearsay. Right up there with the 'there I was' stories you hear drinking beer down at the VFW.

People are going to see and say what inherently makes them look good and whatever aligns with their preconceived assumptions. Careful investigation and physical evidence seldom fully supports such claims. Your framing of the cases as 'citizens versus criminals/terrorists' overlooking that both sides are usually citizens and the accounts only reference one side of the story.

People grounded in reality realize they are more likely to come home one day and find a relative has shot themselves, or to accidentally shoot their relative, or blow their own brains out than use any firearm to defend themselves again anything but their own inner demons.

... just sayin'

An overemphasis on firearms is always a sign of weakness.

Anyway, back to the reality of the topic at hand...

The language of violent criminals is physical strength. Historically, violent criminals don't respond to pontificating, reasoning, standing still or whatever other strategy you may be fantasizing. A highly effective way to handle a violent aggressor is with overwhelming force. That's why cops and the military carry guns. A well-trained person with a gun is physically strong, and they are equipped to speak a violent criminal's language. It's really that simple.

If my mom were in intensive care, helpless, then I hope someone there would be equipped to counter a violent criminal who was terrorizing my mom's living space.



LOL...Wha?

Guns are not the only useful weapons in existence. The original scenario could have gone really bad if one or more of the 'victims' had acted defensively. Suppose one or more of the people involved had been ex-cops or recent ex-military?

An unexpected ending like that certainly would have been a puzzle for the lawyers to sort out, wouldn't it?

Sue

Well, yeah, that's exactly my point actually.



OK, please discuss other weapons that are useful against a violent criminal wielding a gun. I'm not being a smart-ass. I'm open to hearing what your ideas here. The next best idea I've heard here for countering a violent criminal is "stand still" or "duck".



Yes, but I'll complete that line of thinking. I'm saying that guns are effective for countering a violent criminal, and that there should be no reckless security drills. Ever.

OK, I'll bite. A knife or a bat, or anything that can be used to the same effect. But the situation would be pretty desperate for you to try that. And it would require you a) to be up close and personal with the bad guys, b) physically agile (in which case you probably wouldn't be in the hospital in the first place?). Is it suicide to attack someone with a bat or a knife while they are aiming a gun at your chest? Yes, but trying to wield your gun would under those circumstances would be just as suicidal. Gaining the element of surprise would be important, gun or no gun.

Up close (within 6 feeet) I view knives as much more dangerous and lethal than guns. The statistics of survivability of knife wounds is substantially worse than gun wounds. You don't have to have any skills to do lethal damage, and it never jams or runs out of bullets.

A violent confrontation means a very high probability that you will end up hurt or dead, gun or no gun. In most cases a gun would be preferable, but it does not in any way guarantee you will be winning. It just improves the odds.

Modern terrorists have demonstrated one thing, and one thing only, repeatedly. Which is that you are going to be murdered, sorry, "executed" by them for your "crimes".

Fighting back, instantly, is the only hope for any of the hostages to survive. Even at the sacrifice of your own, and other people's lives.

Reconcile yourself to that.

Teach those SOAB'S that taking your kind hostage is a losing game.

And die well.

If there is one person with a gun and several victims, it is difficult for the perp to watch them all, at least in the beginning, before he groups them all together. This could be a good time to strike, if there is an oppportunity.

People tend to think 'trained terrorists' when the perp might be a strung-out junkie. How clearly is that person thinking in terms of tactics? Maybe not so well.

Weapons can be anything at hand. When I lived in SoCal, a man with a gun tried to rob a small store, and a group of people pelted him with canned goods. Of course, this was long ago, before current times when the other customers would probably join the perp and split the take.

Oh-oh, sounding cynical again, huh?

Sue

Well, I started this thread, and although it has wandered off into the ditch a couple of times, I appreciate every one's comments.

I have been working on some workplace violence related issues, more on the risk management side and less on the personal survival side, but I see a couple of common denominators:

-The goblins are usually "tough guys" in the mirror before they leave to do their dirty deed, but out on the field, they turn rather cowardly and avoid conflict. (That is why my 2 daughters, school teachers with strict protocols to follow, each know where the closest fire extinguishers are to their class rooms, because a control freak shooter will most often walk away from uncontrolled situations like my crazy kids with fire extinguishers! I also followed the advice of a random email blast that said in lieu of pepper spray, a good blast of wasp spray to the eyes will rock a goblins world, while not drawing attention like pepper spray would.

Secondly, it looks like the flip side risk to improper drilling is not having an established workplace violence plan in force:

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=NEWS_RELEASES&p_id=18000

BRIDGEPORT, Conn. - The U.S. Department of Labor's Occupational Safety and Health Administration has cited Danbury Hospital in Danbury, Conn., for failing to provide its employees with adequate safeguards against workplace violence. OSHA's action follows an inspection begun in January 2010, in response to worker complaints.

OSHA's inspection identified several instances during the past 18 months in which employees in the hospital's psychiatric ward, emergency ward and general medical floors were injured by violent patients. In addition, there have been about 25 cases over the past five years in which hospital employees lost workdays or were put on restricted duty after being injured by patients. OSHA found that the hospital's workplace violence program was incomplete and ineffective at preventing these incidents.

Any comments?