The recent shooting death of a Barnes-Jewish Hospital patient wielding knives has renewed a debate over armed guards in health care settings.
As many as half of U.S. hospitals employ security guards armed with handguns, according to one national survey. The estimate in Missouri is much lower — about 14 percent, said a spokesman for the state hospital association.
Some hospital executives believe that having armed guards sends a conflicting message and adds danger to an already tense and emotional setting. Others say the threat of workplace violence should be handled the same as in any other setting, and that armed guards act as a deterrent.
Security guards at Barnes-Jewish on Jan. 11 shot and killed a patient who refused to drop two knives after pushing his way out of a treatment room. Police said the man, Andrew Merryman, 46, of Ballwin, had been suicidal, but they declined to say why he was being treated at the Center for Advanced Medicine.
The death comes as violence in the health care setting has soared. With more than 11,000 reported assaults a year, health care workers account for about 75 percent of the victims of workplace violence, according to the U.S. Department of Labor.
Several local hospital officials declined to be interviewed on the subject of security. An informal tally shows that aside from Barnes-Jewish, BJC HealthCare hospitals do not equip their guards with guns. Guards at SSM Health hospitals carry Tasers but not handguns. Some Mercy hospital guards have Tasers or handguns. At St. Luke’s Hospital in Chesterfield, security guards carry handguns and are trained by St. Louis County police.
“In a perfect world, a hospital would be the antithesis of where you would think guns would be necessary,” said Dave Dillon, spokesman for the Missouri Hospital Association.
Hospitals are for healing, by their “first, do no harm” tenet. But sometimes protecting both staff and patients comes into conflict, Dillon said.
“These are hard conversations with ourselves,” Dillon said. “There’s no line in the sand on the appropriate intervention.”
The labor department has general guidelines for preventing workplace violence in health care settings, but does not take a stance on armed guards. Emergency preparedness requirements from the Centers for Medicare and Medicaid Services, which inspects hospitals, mainly focus on natural disasters and disease outbreaks.
The stressors that can spark violence include a lack of mental health care options, long wait times in the emergency room and the delivery of bad news about a medical condition.
“We’ve got patients and families who come to the hospital under the influence of substances or seeking drugs, domestic conflicts, patients coming in escorted by police,” Dillon said. “There are a lot of things that create an environment where individuals are feeling more comfortable physically harming or verbally abusing health care workers.”
While assaults against health care workers are increasingly common, shootings in hospitals remain relatively rare. There are an average of 14 shootings on hospital grounds in the U.S. each year. The emergency room is the most common site for shootings, followed by parking lots and patient rooms, according to researchers at Johns Hopkins University.