What Has an Active Neighborhood Shooter To Do With a University Department of Nursing? Plenty!

Recent tragic events have brought to light the need for preparedness and provision of emergency healthcare measures in almost any setting. Nurses provide 90% of the healthcare services in the world (WHO, 2008) and must be ready for natural disasters, bioterrorism, and man-made events, such as active shooters in the area in which care or education is provided. When the nurse is both a provider and an educator, this may magnify the importance of knowing when and how to act in such emergencies, especially when they take place in and around hospitals, health care agencies, college campuses or other densely-populated locations. The goal is to raise awareness about the ubiquitous nature of disaster and mass-casualty events such as the presence of an active local shooter.

 This purpose of this presentation is to demonstrate to nurse educators and leaders in higher education how a university department of nursing responds to such an event with an emphasis on every-day alertness principles. The department, which is led by the authors, is used as the case study for the successful application of these principles on the day of a mass-shooting in a health-care agency in San Bernardino, California, USA. An examination of how information was obtained through a campus alert system is presented, along with the challenges and stakeholder responses in and around the campus office and Nursing Department in a large urban campus. In addition, the responsibilities of the leaders in investigating student and faculty safety on campus and at clinical sites is detailed, with reflection on the responses needed as the situation and information changes. The unique role of nurse faculty as both provider and educator is examined relative to the needs of both on-campus dwellers as well as those off-campus who are either faculty-peers, colleagues or students.

 The benefits and risks of evacuation versus staying in place are considered, particularly when information about shooter location or other factors such as the extent of collateral damage is dubious. Further, the role of the Nursing Department facilities and personnel (including office staff) is discussed in the context of future planning for emergency preparedness. An easy-to-remember approach is presented for nurses to stay “ALERT” through principles of: awareness of evolving information; legitimacy of the nursing process; emergency procedures and preparation; the 4 R’s of rehearsal, response, recovery, and reflection; and teamwork throughout the difficult events.