Preparing For The Worst – How Nurses Should Deal With An Active Shooter Situation

Preparing For The Worst - How Nurses Should Deal With An Active Shooter Situation

Hospital shootings are rare. Very few hospitals ever have active shooter situations, and doctors and nurses are very rarely the targets. However, with the deadly mass shootings like the 2016 Orlando nightclub shooting in mind, many hospitals and their staff are becoming wary of mass shootings, and developing plans to deal with them in case they should occur.

So while an active shooter situation is unlikely to develop at a hospital, it’s good to have a basic understanding of what to do if the worst does happen. We’ve put together some basic tips for dealing with an active shooter situation for nurses – how to keep yourself and the rest of your staff and patients safe, and avoid danger if a shooting does occur.

  1. Have An Emergency Evacuation Plan

Having a response plan in case of an active shooter situation is crucial. Generally, these evacuation plans are adapted from other emergency plans that are used in case of fire, earthquakes, or other natural disasters.

An optimal emergency evacuation plan allows for easy evacuation of most personnel and patients, and uses multiple exits – this is crucial for a lone shooter situation, as the shooter will not be able to react to and cover all exits.
Understand your hospital’s emergency evacuation plan, and be ready to carry it out at a moment’s notice. In an active shooter situation, the vast majority of personnel and patients will be able to evacuate safely.

  1. Establish Clear Communication

If you are the first one to notice a shooter situation occurring, or are unsure if law enforcement has been contacted, it’s your duty to inform law enforcement so that proper response measures can be taken. Call 911 and report the situation.

After you have informed authorities, you should begin distributing the facts to any unaware staff members and patients clearly and calmly. It is important that you stay calm – when an active shooter situation occurs, it is essential that you keep a clear head and respond to the situation rationally.

After all staff and patients are informed, you must prioritize your own safety and follow your emergency evacuation procedures.

Visit page 2 for tips 3 and 4.

  1. Escape Or Shelter In Place

After you have been informed about the incident and communicated with all patients and staff members who may not have realized what’s happening, it’s time to follow emergency evacuation procedures and escape.

If you don’t know where the shooter is, try to take a less obvious route out of the building. If you do know where the shooter is, choose the exit that will keep you as far away from them as possible. Doing so will minimize the risk of being attacked while attempting to escape.

Escape is not always possible. Perhaps the shooter is on your floor, or you can’t leave a room because of a critical patient, or another issue. If that’s the case, understand where you should shelter in place.

Rooms with locks are preferred, and rooms without windows on the doors are a good choice – the shooter will likely walk past them, as there is no way to know if they are occupied without breaking in, which takes a long time. You should also turn out the lights in the room you are sheltering in, and hide behind solid objects.

  1. Know What To Do If You Can’t Escape

You’ll want to familiarize yourself with an active shooter response plan. The current individual response plan recommended by the FBI is the Avoid, Deny, Defend plan.


  • Avoid – This is the preferred option. It’s often possible to avoid an active shooter entirely, especially in a large facility like a hospital. If it’s clear where the shooter is, you will have a clear path to escape, especially if you are familiar with the hospital’s emergency evacuation plan.
  • Deny – If you cannot avoid the shooter, or are otherwise unable to escape the building, you should deny access to the room or area you’re in, in any way possible. This includes locking doors, barricading doors with furniture, hiding underneath beds or behind counters – whatever the easiest method is to make yourself inconspicuous or deny entry to the room that you are in.
  • Defend – Defending yourself is your last resort. While defending yourself from an active shooter is difficult, it’s not impossible, and taking surprise against a shooter can give you the opportunity to escape.

Be Prepared – But Don’t Be Paranoid

As mentioned, hospital and medical facilities are generally quite rare, and most shootings are targeted at specific individuals.

Being prepared for a shooter incident doesn’t mean you have to be paranoid. It simply means that should the worst occur, you’ll know how to deal with it.
So take necessary precautions, but remember that a shooting is unlikely to occur at your hospital. And if it does, you’re ready to deal with it, and keep you, your coworkers, and your patients safe. That should give you the confidence and peace of mind you need to work without fear.

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