Hospital security staff have long been in the difficult position of trying to keep an emergency department approachable as a valued service to the community, and yet protect staff and patients from those who are capable of extreme violence. This conundrum was at the core of a recent blog post appearing on the Joint Commission Leadership blog, titled Hospital Security – Different Approaches to Mitigating Violence, by Mark Crafton. The piece centered on discussion of the pros and cons of arming hospital security guards with deadly force weapons.
However, there is a third option beyond armed and unarmed: “intermediate response.” This response category encompasses highly capable enhanced non-lethal (ENL) devices and needs to be a part of this conversation. Why?
Because the enhanced choice of defensive devices allows an officer to avoid going hands-on with an aggressor in order to gain control, thereby reducing injuries to both. Non-lethal devices are more compatible with the Hippocratic Oath than firearms. Furthermore, a government report offers proof that they work – and that unarmed officers are a disability claim or patient lawsuit waiting to happen.
The data cited below comes from a report published by the U.S. Department of Justice on the effectiveness of non-lethal devices. The most salient aspect of this report is the data table on page 53, which compares 12 different non-lethal technologies for effectiveness in their first iteration, or first use, of force. This aspect – first iteration effectiveness – is essential to security staff and hospital administrators who wish to demonstrate reasonableness when force is required.
Consider the effectiveness of the typical unarmed security officer. He or she relies on a combination of verbal skills and physical grappling skills to control a violent person. However, the report finds these skills are marginally effective in resolving the conflict. As seen in Table 15, if an empty hand strike (punch) only works 27 percent of the time in ending an incident, and compliance holds limp in at 16 percent effectiveness, why do we tolerate an unarmed response to violence? Success rates this low are literally setting up the officer to apply force again and again.
The tools found on an Intermediate response officer’s duty belt include some of the most effective means of discontinuing a violent incident: electronic stun devices; and precise delivery of OC, also known as pepper spray. In fact, according to the report, these account for two of the three most effective non-lethal technologies (the third being canines). All three of these life safety capabilities are a virtual tie for ending a violent incident nearly 70 percent of the time, the first time they are used. Naturally, the cost of each technology, community reaction and other practicalities need to be carefully addressed by risk management and legal advisors.
One key lesson from the report is that altercations which end quickly result in fewer injuries to officers and the aggressor. Enhanced non-lethal devices are thereby central to the safety ambitions of hospitals administrators and their security officers. Intermediate response officers carrying tools with the highest probability of ending conflicts are arguably the only approach hospitals should be considering as a means of mitigating risk of injury, lawsuits, federal citations and OSHA fines.