Last month, a visitor to the maternity department in an Oregon hospital caused a disturbance, prompting nurses to issue a warning that the guy might try to kidnap his partner's unborn child.

A security guard was killed after the visitor opened fire hours later, sending patients, nurses, and medical staff running for shelter.

In the United States, hospitals and medical facilities have been hit by a surge of gun violence that has made it difficult for them to respond to the mounting dangers. The shooting at Legacy Good Samaritan Medical Center in Portland was one example of this.

Healthcare is now among the most violent industries in the country as a result of these assaults. According to data, American healthcare employees are now more likely than workers in any other industry, including law enforcement, to sustain nonfatal injuries at work.

"Health care workers don’t even think about that when they decide they want to be a nurse or a doctor. But as far as actual violence goes, statistically, health care is four or five times more dangerous than any other profession," said Michael D’Angelo, a former police officer who focuses on health care and workplace violence as a security consultant in Florida.

In terms of overall risk, including fatalities, several businesses surpass the healthcare sector. Identical shootings have occurred in hospitals across the nation.

A guy shot and killed two hospital employees in Dallas last year while attending the birth of his child. In Atlanta's hospital waiting room in May, a man opened fire, leaving one woman dead and four others injured. Also late last month, a guy shot and injured a doctor at a Dallas health center. In June 2022, at a Tulsa, Oklahoma, medical facility, a patient shot and killed his surgeon and three other people because he held the physician responsible for his continuous post-operative pain.

Health care workers

According to data from 2018, the most recent year for which figures are available, healthcare employees accounted for 73% of all nonfatal workplace violence injuries.

A nurse with direct knowledge of the briefing told The Associated Press that hospital staff members were warned during meetings the day before the shooting on July 22 in Portland to be ready for a potential "code amber" announcement in case the visitor attempted to kidnap the child. She talked under the condition of anonymity out of concern about workplace retaliation.

According to a timeline released by Portland police, a hospital employee contacted 911 fifteen minutes prior to the shooting to report that a visitor was endangering staff members.

Within minutes, police arrived at the maternity ward, but it was already too late. In order to cover for the understaffed security crew at Good Samaritan, Bobby Smallwood, a security guard from another Legacy hospital, had been shot and killed. A second healthcare worker was hurt by shrapnel. Police shot and killed the guy in a neighboring community after he ran away.

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In Portland, Legacy Health intends to add more metal detectors, mandate bag checks at every hospital, and direct patients and visitors to specific entrances. According to the hospital, more security personnel will be given stun guns, and the bullet-slowing film is being applied to certain inside glass and at important doors.

According to the American Nurses Association, laws raising or adding new punishments for violence against healthcare workers have been passed in almost 40 states. While states like Indiana, Ohio, and Georgia, permit hospitals to establish their own police forces, most hospitals employ armed security personnel with batons, stun guns, or firearms.

The health care and policing disparities Black people already face can be exacerbated, according to critics of private hospital police. Additionally, they claim that private police forces frequently are not required to reveal information on whether they disproportionately detain people from minority groups.

According to Deborah Burger, a registered nurse and the leader of National Nurses United, many of the causes of violence are brought on by a broken healthcare system, therefore security forces cannot address all of the issues that contribute to violence.

According to Burger, patients and their families are frequently shuttled between emergency rooms and their homes and are irritated by the exorbitant expenses, the lack of treatment options, or the lengthy wait periods.

Nursing staff shortages make it necessary for them to care for more patients while giving them less time to check each one for behavioral issues. If nurses haven't had time to develop relationships with patients, Burger said, attempts to de-escalate anger won't be as successful.

Workplace violence

According to Burger, some hospital managers encourage personnel to appease violent patients and visitors out of concern for their reputation. This is due to the Affordable Care Act, which attached a portion of federal reimbursement rates to consumer satisfaction surveys. Low satisfaction results in a hit to the bottom line financially.

The rates of workplace violence attributable to healthcare facilities, according to Eric Sean Clay, vice president of security at Memorial Hermann Health in Houston and the incoming president of the International Association for Healthcare Security & Safety, are "grossly underreported."

Security guards at Clay's hospital are both armed and unarmed, though he eventually wants to equip them all.

"We actually have our own firing range that we use," Clay said. Since there has been an increase in gun violence, none of his security guards have pulled their firearms while on duty in recent years, but he still wants them to be prepared.

Concerning whether an armed security force may adversely impact access to healthcare or current inequities, Clay and Memorial Hermann Health declined to comment.

The Portland hospital's nurse reported that the shooting caused her coworkers to become frightened and unusually solemn. Because it costs money to hire, train, and retain security personnel, she worries that Legacy Health's assurances of greater safety would only be temporary.

"You know, we always say these patients and their families are so vulnerable, because they’re having the worst day of their life here," the nurse said, and that makes many staffers reluctant to demand better behavior.

"We have to stop that narrative," she said. "Being vulnerable is bleeding out from a bullet wound in your chest. Being vulnerable is having to barricade yourself and your patients in a room because of a code silver."