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Gun Violence

A Terrible Day in Colorado – Terrorism by Twenty-Something

Posted on July 20, 2012 2:46 pm by Caroline Ramsey-Hamilton Comment

Just saw that now 71 people were shot at the Aurora, Colorado theatre, and 12 have died, including children.

This is exactly the kind of incident that I used to think would wake everyone up to the dangers of NOT doing annual security reviews, and  NOT allowing everyone on the planet to stock their attic with automatic assault rifles, and instead, we are at an intersection in the national dialogue where talking about assault rifles, OR security controls, is something people would rather ignore.

Whether it’s the hospital security administrator who thinks posting a simple “NO WEAPONS” sign is too much security, to the facilities who deny the security officers any weapons bigger than a purse-size pepper spray, they are actually ENABLING security incidents of this type.

I heard these officials in CNN saying, “It’s not terrorism”!   It certainly IS terrorism.  It’s just domestic terrorism, but it shows you how easy it would be for a terrorist to walk into the US, buy some AK-47s and walk into a regional mall, a batting cage, a mega-church, a hospital, a sports arena, and proceed to kill dozens of innocent people in just a few minutes.

With 71 shot, and 12 dead, it is more deadly than your typical IED in Afghanistan!  It’s more deadly because their is human ‘intelligence’ (and I use the word loosely) behind the attack.  Instead of a simple detenation event, the shooter can choose victims, look them in the eyes and then kill them.

This is an intentional event by someone so lost that he didn’t even put up any resistance to police.  Why should he, he’s already made his statement and now has his 15 minutes of fame.   That is 5.5 people killed or injured for each 1 minute of fame.

If you are reading this today, you should do a quick risk assessment of your organization and make sure your staff are developing situational awareness, watching and evaluating what is going on around them.  It may make the difference between life and death someday.



Another Look at OSHA & Workplace Violence

Posted on February 1, 2012 7:45 pm by Caroline Ramsey-Hamilton Comment

I just finished reading a new book called HALT THE VIOLENCE, written and edited by Patricia Biles and her Alliance Against Workplace Violence group.  Here are some of my thoughts on it, if your organization has been evaluating workplace violence issues:

Here’s my review and why I think you should get it (Amazon) and take a look – it’s a short read — less than 150 pages.

I like the insider perspective on how to prevent violence in the workplace. Patricia Biles was a former OSHA (U.S Occupational Safety and Health Administration) employee and their guru on violence issues.  Her work with industry groups and individuals has given her rare insight on the subject of stopping the epidemic of violence, and she gives practical solutions that employers and individuals can use to halt the violence.

The book covers the escalation of violence in the workplace and how OSHA reacted to the problem, which came to the forefront in 1989.  She identifies the groups most affected by violent events at work, including nurses, healthcare workers, taxi drivers, convenience stores, and late night retail establishments in particular.

As well as covering a complete history of the issue, she also weaves together input from other experts who specialize in aspects of the overall workplace violence problem, including the problem of violence in hospitals,  the increased incidents of bullying in the workplace, the importance of early intervention and practical strategies for diffusing angy, aggressive individuals.

The important of risk management procedures, such as performing regular threat assessments is identified as one of the few ways to identify individuals who may pose a threat, although the authors point out that both the Virginia Tech shooter and Jared Loughner, the diagnosed schizophrenic who shot Gabby Giffords, her staff, and innocent bystanders in Tucson, were both examined, and had psychological profiles which stated they were ‘unlikely’ to be a threat to others.

Specific violence-prone workplaces are also identified and specific recommendations given for hospitals, home health and social workers, and educational institutions such as schools, colleges and universities.

In some ways, this is an insider’s book because it gives you the behind-the-headlines details, not only of major workplace violence incidents, but also a look at what it takes to create new laws and encourage congress and federal agencies to recognize the problem and take concrete steps to ‘halt the violence’!

All in all, this is a very insightful and practical look at a problem that affects every workplace and every person who goes to work and counts on returning home in the same condition.  Employers will want to implement the suggestions in the book on how to reduce violence in individual organizations, and it also offers a valuable perspective on how to comply with new OSHA standards and they continue to evolve their approach to this critical issue.

 



Outlook on Risk & Security Compliance in 2012 – What to Expect.

Posted on January 1, 2012 6:59 pm by Caroline Ramsey-Hamilton Comment

This New Year’s Eve, I thought at times my neighbors were using a rocket launcher and several assault rifles to shoot up the New Year.  Lucky for me,  I spent the awake time to contemplate the outlook for risk, threat and security issues for 2012 and here’s what I see for 2012.

1.  Government-Mandated Compliance Is Here to Stay for the Healthcare Industry.

I remember when the IT departments are many hospitals thought George W. was going to revoke the HIPAA Security Rule.  It never happened, and this year, for the first time, there is a regulatory body in place that is intent on REAL ENFORCEMENT.

The Dept. of Health & Human Services, Office of Civil Rights,  has expanded HIPAA Security and Privacy Rules to include “Business Associates” including lawyers working in healthcare, and the infamous “3rd Party Providers” who do everything from warehouse data to taking over the IT function of a hospital, and this trend will continue as pressure builds from consumers who’s medical and financial data continues to be compromised.

2.  Workplace Violence Prevention will become an OSHA mandate, if not in 2012, at least by 2015.  Based on the slug-like pace of OSHA, who only recently provided directives for high risk industries, and the pressure from the more than 30 states who have passed their own regulations,  the pressure to stop the number of incidents and to lower their intensities will increase and management will be forced to address it as a major corporate issue.

3.  Pressure on the financial industry to protect consumer information will increase.  Like many other areas, pressure is increasing to prevent the enormous data breaches we saw in 2011, like Tricare, the recent Stratfor hack by Anonymous, Wikileaks and HealthNet breaches.  Consumers are the squeaky wheel and they want the convenience of plastic and internet use, and they will not tolerate breaches, and they are all registered voters!

The FFIEC has already tightened up on both risk assessment standards, as well as
authentication guidelines for all financial institutions.

 

There will be a increase in requirements for risk assessment as an accountability feature to force managers to maintain better security in all areas of their organizations. 

Accountability means that individual managers will be held responsible for the decisions they make regarding other people’s:

1.  Financial Data

2.  Medical Records

3.  Safety from both Violence & Bullying in their workplaces.

Budgets can be cut, and staff can be reduced but consumers are demanding protection of their information, and themselves, and the regulators will make sure they get it in 2012!



Should Hospital Staff Brings Guns to Work with Them?

Posted on September 3, 2011 5:47 pm by Caroline Ramsey-Hamilton Comment

Should hospital staff bring guns to work with them?

At a time when many hospital security departments have unarmed security officers, and some departments don’t even allow the use of mace, changes in state laws allow hospital staff in some states to bring their guns to work with them.

This turn-around, where the nurses may have guns – and security officers do not, has created a big, contentious debate in the security community.

In a recent paper printed in the Journal of Healthcare Safety and Security, my co-author, Jim Sawyer and I discuss the different elements of this debate and whether this is a constitutional issue, or a real threat-risk issue.

Here’s an excerpt,

Violence is not a concept that people usually associate with hospitals.  For years, hospitals have been seen as almost a sanctuary of care for the sick and wounded in our society.   However, the perception of hospitals has been changing over the last fifteen years due to a variety of factors.

or you can read the entire article (below). 

Critical Issues on Gun Violence in the Hospital Workplace

By James Sawyer and Caroline Ramsey-Hamilton

 Background

 Every reader knows that violence in hospitals is increasing at an increasing rate.  The Joint Commission has issued Sentinel Alerts, the Journal of the American Medical Association, the bastion of the American healthcare system, published an article in October, 2010, written by two doctors about the murder-suicide at Johns Hopkins Hospital in September of 20101.. 

This article started as a guest blog from a security professional at a west coast children’s hospital.  After the blog appeared, we received dozens of notes, letters and angry outbursts, as well as emails arguing for a more reasoned approach.  This article will explore those issues, and includes quotes from the emails themselves.

Why Violence in Hospitals is Increasing

Violence is not a concept that people usually associate with hospitals.  For years, hospitals have been seen as almost a sanctuary of care for the sick and wounded in our society.   However, the perception of hospitals has been changing over the last fifteen years due to a variety of factors.

  1.  Doctors are no longer thought of as “Gods”.  This means they are
          are more easily blamed when a patient’s condition deteriorates.
     
  2. Hospitals are now regarded as businesses.  This perception has been
           been aggravated by television in shows like a recent “60 Minutes”, as well as
           by the effects of the recession on jobs and the loss of health insurance.
  3. Lack of respect and resources (funding) for hospital security departments
       .  Rather than being seen as a crucial protection for the hospital staff and
          patients, many security departments are chronically underfunded and used
          for a variety of non- security functions, such as making bank deposits for
          the hospital gift shop. 

A Dirty Little Secret about Reporting
The U.S. Department of Labor tasks OSHA with workplace violence information, but there is not one sanction against it, it says right on the OSHA web site that this is solely left up to the employer.  It makes it hard for hospitals to justify spending money on workplace violence prevention, if it is not a standard, and a major compliance issue (as it should be).  And here is a dirty little secret for looking at the statistics, OSHA does not count domestic incidents (like homicides) that take place in hospitals as officially “workplace violence incidents”, instead they are counted in another system.  Similarly, many hospitals don’t count staff to patient violence incidents, or patient to patient incidents.  These practices create a false impression of the actual number of violent incidents, by reporting only a fraction of the actual events.

 Gun Violence Represents a Significant Security Challenge

The prevention of gun violence in hospitals and the hospital as workplace may well be the most challenging issue for hospital security professionals in the foreseeable future.  What are some of the reasons for this growing concern?  There are many and they include:

 1.   The sheer numbers and easy availability of guns.  There are over 270 million guns in circulation in theUnited Statesand the numbers continue to grow.  After the 2008 election,  gun ownership surged and in some areas of the country, guns sold at such a pace that retailers literally ran out of ammunition. 

2.  Approximately a 100 people a day die from gunfire in the United States and an individual is shot approximately every twenty-two seconds.

3.  One in four Americans suffer from some form of mental illness, according to the Federal government. 

 4.  The U.S. is living in an era of economic instability, following the 2008 recession and the erosion of the middle class.  The Wall Street-triggered economic meltdown has propelled what was a slow steady decline into economic apocalypse for millions of Americans.  This has resulted in an environment of record home foreclosures, record personal debt, record banktupcy, record unemployment and record numbers of homeless individuals.

5.  The reluctance on the part of many hospitals to install magnetometers and limit entrances to hospitals so that the flow of guns into hospitals can be controlled.

The U.S. gun lobby has been very successful in pushing and supporting state legislation which permits guns in the workplace, and on college campuses.

It is a serious mistake for security professionals to deride,  make light of, or dismiss this surge of pro-gun-at-work-and-school legislation.  These laws are getting passed (see Texas, Indiana, and Tennessee), and the likely result is that we will see an ever greater numbers of guns at work, and if our work is in the hospital, then the guns will be coming to work here, too. 

Guns aren’t just increasing in numbers, but they are getting more lethal and currently 30- shot clips and armor piercing bullets are readily available for the civilian population.  Citizens can now buy weapons that rival what is found in military armories.   These lethal weapons again present a sentinel challenge to security professionals.

 Most security directors remember life when Space Invaders was the only video game around.  Now children are exposed to violent images from a very early age.  Children and teenagers sit entranced watching endless hours of violent programming where gun violence is choreographed in slow motion action scenes where the scripted hero’s miraculously avoid injury even while they are dispatching the prime time  villains while showcasing their amazing gun prowess.  

By the time they show up at your hospital, the average child over 18 years of age will have viewed over 45,000 murders and 200,000 acts of violence just on television! This grim tally does not account for the high octane bloodshed and slaughter that make up the majority of the most popular video games.  

All of these factors suggest that the prevention of gun violence in our hospitals will become our premier challenge.  Many hospitals are already hosting ‘active shooter’ seminars to teach hospital staff how to deal with  “shooters in the workplace”.  This subject promises to become a cottage industry for consultants and violence prevention professionals.

As hospital security professionals, there are some strong, prevention-based practices that we can implement and develop that drastically reduce the chances of gun violence in the workplace.  Some of these best practices include:

 1. Acknowledge the reality and the persuasiveness of the U.S. gun culture.

 2.  Develop a strong, multi-department workplace/domestic violence response team at your facility, and make sure that both Human Resources, and Security are part of this team.

 3.  Develop a written workplace violence plan that is reviewed annually.

 4.  Do an annual  baseline workplace violence assessment that you can build on.

 5.  Have your workplace/domestic violence response team respond and meet within 4 hours of any  reported incident.  Have a response plan/action plan in place within 24 hours.

 6.  Encourage reporting of all workplace/domestic violence incidents to the police – without exception.

 7.  Run background checks of individuals of concern.  Information is light and a background check may provide you with crucial information. Obtain orders of protection – anti-harassment orders against individuals of concern.  Security should take the lead here.

 8.  Flag problem patients – problem families – have a “red alert” or a “red flag” program that alerts – tips off – advises both the care team and security that a potential problem exists.  This is especially important if the patient/family member has a history of violence.

 9.  Build a workplace culture where verbal threats are reported.  Have Security immediately investigate all verbal threats.  Make sure that Human Resources is fully informed of any situation involving threats.

 10.  Post  large, prominent“No-Weapons” signs at your facility – especially in parking lots, perimeter areas and all main entrances.

 11.  Officially prohibit staff from bringing firearms to work.

 12.   Offer annual violence prevention and threat awareness training to all staff.

 13.   Require workplace violence training – either on line or via classroom training for all new staff and annual retraining.

 14.   Have security involved and part of the planning for all “problem” terminations.   Note – Advise Human Resources to never terminate a disgruntled staff without strong pre-planning.

 15.  Screen all hospital patients and visitors.  Develop a major entrance screening program for your institution.  Knowing who is inside your facility is a critical part of any good prevention program.

 These pro-active solutions  will support and enhance a hospital gun violence prevention program.  Let me state again, it is critically important to have a hospital gun violence prevention program in place.

 AND IN RESPONSE

 Here are some of the comments that were received by other hospital security professionals around the country, after the original blog post.

 “Please remove me from your mailing list immediately.  Apparently the letter below blames the firearm and not the person holding it and putting 5-7 lbs of pressure on the trigger with their index finger.  I find it difficult to separate the “Spirit of the Security Community and our commitment to safety and protection” from this attack on my Second Amendment rights.”               

                                                           — Hospital Security Director in the Northwest

“I believe we should focus our attention, and when I say attention I actually mean money, on mental health resources (or the lack there of) and domestic violence issues, which quite often lead to fatal shootings.  Our emergency rooms have become a revolving door for patients with drug abuse, depression and other psychological issues and there appears to be very little our legislators and community/government leaders are doing about it.  To me, that is the real injustice and crime related to the firearm issue!                                              
                                                                   — Hospital Security Director in the Midwest

 “I would agree with the individual that I don’t believe there is a place in hospitals, government buildings and places of worship for guns; however if there had been guns on some of the college campuses, maybe there wouldn’t of been the blood baths they turned into.                                                       
                                                                –  Security Analyst – Washington DC

“As for firearms being banned from the workplace, I agree.  Policies and procedure should dictate along with a severe disciplinary, then handle accordingly.  Just that simple.”
Let’s clean it up, let’s clean up America!  Let’s lessen the need for firearms to be in the hands of thugs as well as those who just want to feel safe.    The FIRST STEP would be to BAN and make it ILLEGAL for businesses to sell paraphernalia, pornographic anything, strip clubs, places that promote alcohol and drug use, etc. 

Let’s Clean That Up!  …something that is tangible and promotes drug and alcohol use as well as many other criminal actions just to run these types of businesses.  Let’s make that illegal.  Let’s get Americans involved in the real issues of illegal firearms and drugs coming into this Country.    All law enforcement know that it takes big money to keep drugs coming into this Country.      Disarming America. RIDICULOUS.    Keeping firearms away from the workplace, understandable.

                                                    — Ex Army, Ex-Police, Hospital Security Officer

 

 Conclusion
While the issue of “gun control” is both a “hot button” and simultaneously,  a topic that is seemingly a forbidden or taboo matter for hospital security professionals.  It should not be this way.  Questioning the wisdom of allowing citizens to buy 30-round clips for semi-automatic handguns and keeping assault rifles at home is not a crazy liberal rant, it is a reasonable, non-political position.

Challenging the wisdom, if not the sanity, of the current flood of legislation that both allows and actually encourages guns in the workplace is neither “liberal” or “radical” – but pragmatic and grounded.   Hospital security professionals are the vanguard for progressive crime prevention education and development in the United States.  This is a mandate and responsibility that we all share.  How we respond and learn to protect our staff, our hospitals and our patients from this senseless violence may prove to be our greatest and most important challenge.

 www.riskwatch.com               www.caroline-hamilton.com



Risk Assessment: How about Giving Guns Back to Former Mental Patients

Posted on July 6, 2011 2:37 pm by Caroline Ramsey-Hamilton Comment

A recent New York Times article explained that a provision tucked in a bill to make it harder for people diagnosed with mental illness to possess firearms, actually restores the rights of mental health patients to get their firearms back. The legislation was passed after the massacre at Virginia Tech in 2007.

One of the main elements of risk assessment is a quantitative (meaning = real numbers) on what has happened in the past. Looking at 2 or 3 years of incident reports, for example, show how many times there has been an incident involving gun violence in a particular neighborhood, city or organization.

Another element is the history of a particular individual to see whether individuals with a diagnosed history of mental illness are MORE OR LESS likely to trigger (forgive the pun) – a violent incident.

If we run that scenario, we will find that individuals who previously had a violent incident with a firearm are MORE LIKELY than the standard population to have another incident.
And that especially holds true if other threat indicators are present, for example:

Termination from a Job
Romantic Difficulties
Foreclosure
Difficult Economy

There is a ‘risk multiplier’ effect that takes place that makes the risk higher. By combining different sets of threat categories with areas of weakness, we are create general predictions on the likelihood of repeated violent incidents.

Do the math – it doesn’t make sense for people with a history of mental illness to
get their guns back!



Arming the Office – What Happens When We Let Employees Bring Guns to Work

Posted on March 30, 2011 12:25 am by Caroline Ramsey-Hamilton Comment

One of my colleagues wrote to me so passionately about the terrible gun violence he witnesses every day, that I wanted to share it with all of you.  You can call it a ‘Guest Blog’ from the Field — a Hospital Security Director in a Major U.S. City.

The gun lobby had several recent legal “wins” for the gun rights advocates in Texas, Indiana, and Tennessee.   Apparently lawmakers and gun rights advocates find it a sane and reasonable  policy to open up the workplace to armed employees.

It t is also clear that our lawmakers are not satisfied with our current national gun carnage. Currently, we shoot to death about a 100 people a day in the United States, including 25 children killed every three days.  And this tally accounts for only those killed by guns.

This doesn’t include all those I see on a daily basis who are shot, crippled, maimed and ruined by the daily shooting gallery in the USA.   In order to continue to make money and sell more guns, the gun rights advocates, and  the legislators they have paid off, corrupted and stripped of reason,  are intent on even greater carnage and human tragedy.

Every day I witness the extreme becoming mainstream, and even commonplace.  
Guns are now finding their way into the workplace, brought into churches, brought into our colleges and universities. They are brought to hospitals, and shot off over highway bridges.

The logic is totally missing.  We are already a nation awash in fear and loathing.  We hate people  we don’t know and don’t understand.  The answer to this problem is NOT to arm EVEN MORE people and have guns readily available to everyone.

Obviously, the recent horrors of Arizona and the slaughter of innocent people in a Safeway parking lot,  has already been forgotten by security professionals and criminologists.  There is no condemnation or follow up  about a terminally troubled young man and the ease in which he purchased a semi-automatic pistol and 30 shot clips.

There has been no rallying cry to address the ease in which tormented and troubled and dangerous individuals on the margins of our society can easily obtain weapons of human mass destruction.   These realities are not relevant and cannot be discussed. And in today’s political climate to even MENTION this makes one a pariah, or a “liberal”, or a “communist”.

 I have been in the Security and Prevention profession for over 35 years, so I can easily dismiss the attacks from gun rights advocates and zealots.  And in fairness,  I have found many gun rights people to be in fact reasoned and decent and willing to engage in reasoned discourse.

What troubles me, and why I wanted to write directly to YOU,  is that the vast majority of professionals in the Security profession totally bypass, ignore and in fact, minimize the reality and tragedy that is our national gun slaughter.   As a profession,  we have done nothing to challenge these trends,  or address them, or at the very least,  debate the current flood of laws designed to turn American work places into armed camps.  

And this in my view is nothing less than a tragedy.




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