ORLANDO, Florida — Hospitals have long been considered sacrosanct places for healing and helping, but they are no longer immune to America’s increasing violence, experts say.
“Hospitals at one time were much like churches and schools, and were considered somewhat sacred,” said Bryan Warren, president-elect of the International Association of Healthcare Safety and Security. “Unfortunately, that’s not the case anymore. In this post-Columbine and post-Virginia Tech world, things can happen anywhere.”
In the wake of the murder of Orlando surgeon Dr. Dmitriy Nikitin — shot by a disgruntled patient as he walked from Florida Hospital’s downtown building into the parking garage — security experts say doctors are increasingly the target of patients’ ire.
“Patients do target doctors more. We see case after case of this,” said Russell Colling, a Colorado-based health care-security consultant. “We live in an era where, if I have a problem, it’s not my fault.
“In today’s society, we think, ‘Somebody’s responsible for this, and it’s not me,’”Colling said.
That scenario played out in Orlando on May 26 when Nelson Flecha, a 53-year-old man whom police described as a disgruntled patient, shot the 41-year-old transplant surgeon in Florida Hospital’s parking garage and then killed himself.
In the wake of Nikitin’s murder, Florida Hospital officials say they have “stepped up” the hospital’s security presence but won’t give specifics.
“But certainly if anyone ever needs a police escort, we have additional officers on hand to make sure that takes place,” said hospital spokeswoman Samantha O’Lenick. She added that hospital officials are reminding staffers and patients that the service is available if they feel unsafe.
American hospitals are experiencing more violence on their grounds and inside their corridors than ever before.
Last year, the Joint Commission, a nonprofit organization that accredits U.S. hospitals, reported that since 1995, there have been 256 assaults, rapes or homicides at hospitals and health care facilities. Of those, 110 have occurred since 2007.
“Violence in the hospital environment mirrors society, and health care is one of the largest industries in the U.S. So we’re kind of a microcosm of society itself,” said Colling, author of three textbooks on hospital safety.
In September, Americans were reminded of that when a man walked into Johns Hopkins Hospital in Baltimore and shot a doctor, then his elderly mother, who had been the doctor’s patient, and then himself.
After the multiple shooting, which the doctor survived, Hopkins officials said it would be impossible to install metal detectors at the many entrances to the hospital complex. Instead, security conducts searches and uses metal-detecting wands in the hospital’s emergency department, where gunshot and stabbing victims are often treated. In addition, guards verify medical appointments for all arriving patients and visitors, and place wristbands on everyone.
Although hospitals are now fairly open and accept visitors at many hours, that hasn’t always been the case.
“Thirty years ago, hospitals were better protected than they are now. Back then, most maternity units were locked units. Visiting hours were strict, and the hospitals were locked up pretty tight,” Colling said.
Today’s hospitals should revamp the way they handle visitors, he said.
“We can’t just have people come in the door and wander all over,” Colling said. “We need to monitor them more closely.
“When you go to a hotel and say, ‘Is Mr. Jones registered?’ They say, ‘Yes he is,’ but they don’t tell you what room he’s in. In a hospital, we say, ‘Yes, he is, and here’s a little map to show you how to get there.’”
Instead, Colling thinks hospitals should prepare a temporary badge for visitors, asking them for a photograph and a quick background check.
“There are databases to see if somebody’s wanted or has caused trouble before,” Colling said.
Yet many hospitals remain as open as the nearby public library.
“I work in downtown Cleveland, and I rarely see a security guard,” said Dr. Edmund Sanchez, a transplant surgeon and former colleague of Nikitin’s. “It’s just one of those things you don’t think about it until it happens to one of your colleagues or your friends.”
Nikitin’s murder represents a challenge to even security experts. The shooter targeted the surgeon in the hospital’s parking garage, where it’s difficult to stop him.
Security cameras may be in place in the hospital and on the grounds, but most health care facilities have hundreds of visitors each day, making it nearly impossible to flag someone as suspicious.
That’s why many security experts say the most important step hospitals can take is to educate employees to alert security if they think they’re in danger, whether from a patient, former spouse or someone else. On a temporary basis, security may change a worker’s schedule or assign a person to a new parking area closer to a security entrance.
In addition, hospital workers — from clerks and housekeepers to doctors and nurses — should undergo training to recognize when a patient’s behavior is escalating toward violence, said Ben Scaglione, a New York-based security consultant.
“That’s the key going into the future,” Scaglione said. “At many hospitals, this kind of training has been limited to security and the emergency room staff. But everyone in the hospital should go through it.”