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

  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.

Scrubs Editor
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