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In My Opinion

Patients with Guns

Published December 30, 2013 7:37 AM by Jimmy Thacker

Recent events force us to focus on worker safety in hospitals, especially as it relates to shootings inside and outside the hospital building. Violence is not limited only to hospital workers, either. What about home health nurses? What
about therapists who go into homes in an effort to keep patients at home rather than in a rehab facility, CPAP technicians and asthma educators who meet people at their residences? Times are hard, the economy is just starting to recover, and now this past week unemployment benefits have been cut by the least productive set of politicians to ever hit Washington, D. C. If it was bad before, will it get worse? Do we need more protection for health care workers?
I know of no companies that send employees into patients' homes that ask whether or not the patient has a gun in the house. Should we know that? What do you think?

I keep weapons in my house. I live in the country, and having a gun in the house is much more normal in my part of rural Missouri than a house without a gun. But here, we know what happens when you pull a trigger. We understand that our gun is for defense, hunting food, and use as a tool for surviving. Some people, likely many, do not understand that because guns can be very easy to acquire, with no training at all. If you were a therapist coming to my house to provide whatever service you do, would you want to know about my guns? Should I have to tell you if I have no intention on using them on you?

As someone who deals with CPAP patients, I enter peoples' homes every day, not knowing what lies beyond the front door. Though I have a had a gun and a knife pulled on me in a hospital and have been in an emergency room that was "shot up" by a person, I have yet to encounter a problem at a patient's home. Though most health care workers are well-received, some meet some resistance from their patients and may not be welcomed at all. Are we putting our employees in undue danger by sending them into hostile patients' homes? Do we need ways to protect them better or should we just continue to ignore recent trends and wait for something to happen?

No one talks about this, though it has to be on most people's minds, especially those responsible for the safety of the employees. Is an annual class from human resources enough to make our employees and colleagues safe? What is the human resources persons qualifications? Do they have expertise in talking someone down who may be violent, or reacting appropriately if things escalate? An HR person with no such training or knowledge is as dumb as sending someone who has never smoked to teach a smoking cessation class.

In my opinion, we have a "perfect storm" brewing that will become an issue we may start hearing about soon. The economy is up, as is joblessness. People pay more each day out of their pockets for health insurance than ever. A bigger divide is growing between the "haves" and the "have-nots" in this country. Some people are getting desperate. Remember the 2002 movie "John Q?" Have we evolved to a place where that scenario, played out by Denzel Washington, is more realistic than we would like to believe? If so, we need a plan. Not just a hospital procedure we pull out when it happens, but a real plan, written and practiced by all those who may be affected, particularly by those in high risk areas, such as emergency rooms. Whether that person is a respiratory therapist in an emergency room, a home health nurse, or someone in a clinic, can you honestly say if it happened at your place of employment you would survive? If not, what are you going to do about it?

What safety assurances do we owe the respiratory therapists or other health care workers going into a patient's home? What due diligence should employers pursue to ensure the safety of our people? Do we give our employees the ability to make decisions about entering a residence based on what they see, hear, or feel? Sadly, some organizations will only make those decisions once something has already happened, rather than formulate a plan before a life is lost, and I think losing one life because of poor planning is one life too many.

That's just my opinion,
Jim Thacker, MBA, MHA, CRT, AE-C
Windsor, Mo.


Michael, in the closest metropolitan area to me, Kansas City, gun violence is at an all time high. And, as someone who has been shot, it really doesn't matter what the gun violence report is once the bullet hits you. I'm happy you have obviously never had to worry about it, but I have been in two emergency rooms that got shot up, and had guns pulled on me routinely by people who didn't know who I was until I identified myself. I wouldn't call that excessive paranoia, I would call that cautious. If you ever find yourself looking down the barrel of a 44 magnum, you will likely change your tune. The point is, as Mark brought up, awareness. Gun violence is down, but gun ownership is up, as is suicide. When someone is ready to kill him or herself, there is no telling if they may decide to take you with them. Just food for thought. I hope you never experience it. Thanks for reading and commenting.

Jim Thacker, Rt - MBA, MHA, CRT, AE-C January 15, 2014 5:21 PM
Windsor MO

Good point, Mark. Where I live, the deer are likely to be more of a hazard than the patients. And the other drivers! Everyone here has guns. The difference is that people here use them for self defense and to hunt, not to hurt those trying to be helpful or just walking through town. It is why I love the country life. You are absolutely correct in stating that awareness will save you, both on the road and at the patient's house. Thanks for reading and commenting!

Jim Thacker, RT - MBA, MHA, CRT, AE-C January 15, 2014 5:15 PM
Windsor MO

Gun violence in America is down. Don't you guys read the newspapers? There is treatment for excessive paranoia.

Michael McCarthy, RT - MBA, BS, RRT-NPS December 31, 2013 5:21 PM

I too enter people homes to provide health care. i do not worry about being shot here in rural MO at least. The chances of death on the job, are far greater on the way to the patients home. Could hit a deer. Could be in a wreck. Could go off in a ditch on a icy road. The best thing any of us can do, is just be aware. Awareness will save you. Follow your instincts. The chances of being shot by a patient while making a house call are about even with those of winning the lottery. I don't worry about winning the lottery either.

Mark, Respiratory Therapy - RT December 31, 2013 11:09 AM
Gower MO

Checkout www.DT4EMS.com. This is an ever present monster for all in health care.

Drew Drake, EMS - NREMT-P / RRT December 31, 2013 10:09 AM
Ft. Myers FL

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