A hypothetical question

[bearcreek]

There would have to be policy changes to make concealment practical. Our uniform policy makes it impractical at best. I think next contract negotiations this should be addressed.

I figured as much. Honest question, do you have any say about policy changes? I kind of get the impression that you don't. If not, why ask these questions? If you do, I feel like there would be better sources for improved TTP's than a free internet forum.

 

[Telekinesis]

I would get a copy of the procedures from each correctional facility that your hospital plans to contract with, as well as procedures from any other hospitals in the area that treat inmates. While hospitals can be (rightfully) reluctant to share information about strategy, most in my experience will be willing to share patient/staff safety policies. If your local hospitals won't play ball, talk to some facilities in your state but outside your immediate market.

Compare all of these policies (from the correctional side and the hospital side) and chances are you will be able to create a good policy that addresses concerns from all stakeholders.

It's been a few years since I've looked at these types of policies, but this stuff will be situationally dependent. For example, there's no way an armed officer is getting into a sterile surgical suite. Having a "no guns visible" policy for uniformed correctional officers may be a deal killer for this type of thing if the correctional institution's policy requires uniformed & armed security.

Additionally, make sure that you have the ability to specifically exclude certain correctional officers from being able to transport/guard prisoners at your facility. If you find a guard sleeping or being inattentive to their duties, you should be able to ban that individual from working at your facility.

I previously worked in corporate strategy for a region of a national healthcare group and my team dealt with these policies from time to time. The stories we had would make your head spin. Guards falling asleep, leaving their guns laying around unattended, listening to music while on duty, failing to monitor the inmate... things that sound laughable were unfortunately common place. We had a number of individual officers who weren't allowed to accompany inmates to our facility.

 

[Balrog]

For example, there's no way an armed officer is getting into a sterile surgical suite.

We have armed officers escorting prisoners into the OR fairly often.

 

[Telekinesis]

We have armed officers escorting prisoners into the OR fairly often.

Really? I can understand a viewing room or right outside the door, but I'm not aware of any officers (at least at the facilities I used to work with) that were actually in the sterile area during surgery.

Maybe I missed it at our facilities or it could just be a difference in facility policies.

 

[Odd Job]

Police or correction officers in the hospital...I seem to have dealt with this before, but not in the US. I've dealt with it in the UK and SA.

Generally, it has been my experience that the LEOs have to take direction about where they CANNOT be, from the hospital staff. It's more of a case of being restricted from accessing an area, instead of saying "you have to be over here, mate."

Some examples:

1) A highly dangerous detainee was brought to me for X-ray in Johannesburg. He was escorted by two guys, each one had a loaded rifle (R5, which is a Galil variant). One guy (with my permission, and he did ask first) went into the X-ray room first and checked out the room as well as an adjoining patient changing cubicle before the detainee was brought into the room. An X-ray room is a controlled area: if there is power to the unit, the radiographer is king and can deny access or kick ANYONE out. It's non-negotiable.

2) Corrections officers brought a detainee for X-ray here in London at a fracture clinic. By the nature of the imaging, the detainee could not be kept on a short chain because then the officer would be subject to too much scattered radiation for that procedure, even with a lead apron.
I explained the situation and recommended the detainee was transferred to a long chain. One officer called base and got permission for a chain change which was duly done. Job done!

3) Two individuals were shot as I left the hospital in London back in 2004. One was the intended target, the other was collateral damage. Both survived but both were admitted (handy to be shot outside the ER!). Armed police were soon on the scene, but they did not interfere at any stage.
They took up the best positions they could, based on the limitations placed on them by the trauma team. The same thing was evident when I spoke to the relief team up on ICU. They were in a protective role at that point but still, there are private conversations and private procedures which happen between the patient and the healthcare team. Regardless of what the patient has done, the police cannot inject themselves into that situation to the detriment of the patient's confidential treatment.

Any time you have infection, radiation or even an encumbrance risk, the LEO is going to find himself acting at the direction of the hospital staff.
Having said that, in all but one case I have found the LEOs to be polite and understanding. I and my colleagues were as accommodating as we could be, because if there's trouble at some point in the future, that guy might be the one I rely on for help.

It's a two-way street, that LEO might be glad he knows some people in the hospital, if he should come in with a gunshot wound.

 

[luzyfuerza]

Although I don't know the best answer to this question, it reminded me of this local case that emphasizes the importance of the discussion:


Corrections Officer Shot and Killed, Suspect Arrested
By , | Posted - Jun 25th, 2007 @ 6:00pm
John Daley Reporting

A Utah prison inmate is back in jail after he allegedly shot and killed a corrections officer while at the University of Utah for a medical exam.

The inmate was at the University Orthopaedic Center for an exam at about 7:45 Monday morning, alone in a room with a corrections officer. Somehow, he stole the gun of that corrections officer, Stephen Anderson, shot and killed him. Exactly how that happened is unclear.

The heavily-tattooed 27-year-old Curtis Allgier was there for an MRI. He had complained of lower back pain. The procedure requires an officer to replace the prisoner's metal restraints with a plastic "flex cuff." This time, something went wrong.

https://www.ksl.com/article/1393844/corrections-officer-shot-and-killed-suspect-arrested


Scroll to the bottom of the story in the link to see a photo of Allgier.

COs don't get paid nearly enough to have to deal with this kind of individual one-on-one.

 

[Balrog]

Really? I can understand a viewing room or right outside the door, but I'm not aware of any officers (at least at the facilities I used to work with) that were actually in the sterile area during surgery.

Maybe I missed it at our facilities or it could just be a difference in facility policies.

Yep. They put scrubs on over their uniforms and sit in the corner of the room while I operate.

 

[Trunk Monkey]

I guess it's possible, but impractical. We are talking about a full size duty weapon, two reloads, on a duty belt. Maybe there is a gear change in our future. That would be up to administration.

I think this whole thing is going to be up to administration. They'll make the decision and you'll roll with it.

 

[IlikeSA]

I used to work in a hospital, and we kept the armed security officers outside the ER treatment area. Taser and unarmed officers were allowed in the ER. This was with a private security company contracted to the hospital.

LE prisoners were brought at times, and LE was tasked with watching them. We had certain rooms in an off side section set up with non-recording cameras and heavy duty doors/windows for them as well as mental health patients. LE would usually sit with us and watch the cameras at a desk outside the rooms. Prisoners and mental health patients on a mental health hold were searched and given a special colored gown, so that they could be readily identified by staff.

 

[JohnKSa]

Probably the fact that the officers are in their hospital, utilizing their services.

The officers must allow the inmate access to medical care, by law, and the officers must control the inmate during the time they are out of the facility, including at the hospital. I can't see how the hospital gets to tell them what they can and can't do (other than safety rules--metal in MRI areas, etc.) the officers have rules they must follow that aren't really negotiable.

 

[LiveLife]

Let's say hypothetically that where you work has a policy change, that on hospital duty you have one armed officer, and one unarmed officer(handler). The discussion amongst the coworkers is where should the armed officer be positioned, in the room, or outside the room. What is your opinions on this.

Correction officers, the hospital wants to dictate officer placement.

Now retired but for almost 7 years, one of my several jobs with CA state government was working for Licensing & Certifications as federally certified Health Care Facilities Surveyor and conducted state licensing and federal certification surveys (I was trained and certified to survey hospitals, ambulatory surgical centers, clinics, nursing homes, intermediate care facilities, dialysis centers and hospice - Yeah, I was busy).

About 10 years ago, after hurricane Katrina and other bad hurricanes/natural disasters where hospitals and healthcare facilities were found without adequate emergency response plans/supplies/training, a federal mandate came down requiring surveying agencies to check and verify adequacy of emergency response of the health care facility, including security and armed intruder/active shooter response, to ensure the safety/security/food/water not only to the patients/residents but also to the staff and visitors and to issue an "Immediate Jeopardy" to the facility if there were any deficiencies found. The feds were serious as many people died because of it (or lack there of).

I was a survey team leader of a Critical Access Hospital where the hospital disbanded the security staff (To save money, likely) and expected the hospital/nursing staff to respond to intruder/disruptive patient/active shooter emergencies (And who's going to watch their patients?). When I questioned the hospital managers/staff what they were trained to do, their responses were not adequate/acceptable. There were many other critical deficiencies found and the survey team declared an Immediate Jeopardy where the hospital had to immediately respond and correct the identified deficiencies. Their response was to reestablish hospital security staff and proper gear/equipment. The hospital administrator was fired soon after the survey.

Long story short, several months later a coworker who lived by the hospital told me that an active shooter with a shotgun barged into the hospital lobby. Imagine if nurses had to respond to the active shooter?

Anyway, as to OP's question, during a survey the hospital administrator or designee has to provide evidence of all emergency plans, procedures, inventory list and training records, to include contingency plans, etc. to prove the hospital is adequately prepared to ensure the safety and security of the patients, staff and visitors. The policy change should be in response to any deficiency found during QA/self audit or after a survey finding but sounds like that may not be the case.

Usually, when police department or prison provide security/escort to suspects/inmates inside the hospital, a prior written agreement is made between the hospital and prison (Which the survey team can review if necessary) but the details of suspect/inmate handling and control procedures including use of force/chemical agents are delegated to the police/prison staff according to their departmental policies and procedures and training. But ultimately, it's the responsibility of the officers to ensure the safety and security of the area they are assigned to, according to their department's policy and procedures, so they should be allowed to determine how best to secure the area/inmate.

If the hospital wanted to dictate officer placement, they may not wanted correctional officers visible outside the inmate's room (My guess) but if I was surveying the hospital, I would pose the worst case scenario possible and ask for the agreement between hospital and prison and interview staff/correctional officers to see if adequacy existed to ensure safety and security of the area/inmate. If changes were made to improve "appearance" but sacrificed safety and security of the area/inmate, this concern would be brought to the hospital administrator or designee for them to explain why. While surveyors are tasked to identify "actual" problems, we also look for "potential" problems and when found, will bring to hospital's attention on a "FYI" basis and not include in the written report of findings.

I always surveyed with the notion that staff working at the lowest level often know more than management and hold the solutions/answers to the problems and conveyed their concerns/understanding of problems to management as potential problem FYIs as I would sometimes return later to the same facility to find these "potential" problems have indeed become "actual" problems.

Admin's stance is, it's their building so we follow their rules.

The hospital we use has decided that they don't want firearms to be seen by the public.

OK, just read this.

Well, is that going to help or not help the goal of ensuring the safety and security of the hospital?

I would pose the worst case scenario and have hospital management explain as open display of firearms can work to deter "potential" problems. I would pose external threats in additional to internal threat of the inmate getting loose. If inmate's presence was leaked (people talk) and his homies/fellow gang members wanted to break him out, how would armed officers inside the room help deter the attack? It would seem armed officers outside the room could provide not only deterrence but quicker armed response (if necessary).

Due to this and other reasons, many hospitals have built isolated high security wings where inmates are housed like inside the prison and correctional officers are free to move without being seen by the public (requires authorized access for anyone to enter the high security wing).

Sounds like the correctional officers need to elevate the issue to prison management and have them talk with the hospital management.

I hope this helped.

 

[Balrog]

Long story short, several months later a coworker who lived by the hospital told me that an active shooter with a shotgun barged into the hospital lobby. Imagine if nurses had to respond to the active shooter?

Yea, I am sure the unarmed security guards would do much better in an active shooter situation...

 

[LiveLife]

Yea, I am sure the unarmed security guards would do much better in an active shooter situation...

https://www.securitymagazine.com/articles/88998-is-armed-security-the-key-to-better-hospital-safety

 

[Rifleman173]

We had that discussion one time with some hospital people about us guarding an inmate. They didn't like it because we kept a murderer cuffed. We nicely told them that they work on his wound and we would work on securing him so that he didn't kill any of THEM. They thought about that for a minute and decided to shut up.

 

[Balrog]

We had that discussion one time with some hospital people about us guarding an inmate. They didn't like it because we kept a murderer cuffed. We nicely told them that they work on his wound and we would work on securing him so that he didn't kill any of THEM. They thought about that for a minute and decided to shut up.

Their reaction was probably due to the fact that hospitals are heavily regulated about restraining patients only for certain reasons, and then usually for only short amounts of time.

 

[Balrog]

https://www.securitymagazine.com/articles/88998-is-armed-security-the-key-to-better-hospital-safety

The security guards at our hospital are armed only with a pot belly and a taser.

 

[LiveLife]

The security guards at our hospital are armed only with a pot belly and a taser.

All the hospitals that receive federal funding and federally certified are now required to ensure the safety and security of hospital patients/staff/visitors in response to internal/external natural/man-made disasters and active shooter situations, etc. and must have emergency/contingency plans in place along with food/water and emergency power for an extended period of time/days.

Your hospital's disaster/contingency plan may be where firearms are placed in locked cabinets/safes available/accessible during emergencies as feds found police/LE response may not be available during widespread disasters and hospital staff MUST fend for themselves until law and order can be established again in the community.

Things have changed since the aftermath of hurricane Andrew/Katrina where wide-spread looting took place along with rape and murder (Which are obviously suppressed and under reported by the media but they happen with every hurricane where police/LE cannot maintain law and order). First place looters/gang bangers hit are high-dollar stores and any place where narcotics are stored (pharmacies, hospitals, etc.).

During our initial training of new federal mandate for all healthcare facilities to have emergency plans and supplies in place, our district administrator emphasized to declare "Immediate Jeopardy" even when one part of emergency plan/supply was inadequate as new mandate requires ALL emergency plans, equipment, supplies and training must be in place. I asked, "Are you serious?" and the response was "Absolutely! The feds want this done and checked right now because too many people have already died."

 

[Balrog]

All the hospitals that receive federal funding and federally certified are now required to ensure the safety and security of hospital patients/staff/visitors in response to internal/external natural/man-made disasters and active shooter situations, etc. and must have emergency/contingency plans in place along with food/water and emergency power for an extended period of time/days.

Your hospital's disaster/contingency plan may be where firearms are placed in locked cabinets/safes available/accessible during emergencies as feds found police/LE response may not be available during widespread disasters and hospital staff MUST fend for themselves until law and order can be established again in the community.

Things have changed since the aftermath of hurricane Andrew/Katrina where wide-spread looting took place along with rape and murder (Which are obviously suppressed and under reported by the media but they happen with every hurricane where police/LE cannot maintain law and order). First place looters/gang bangers hit are high-dollar stores and any place where narcotics are stored (pharmacies, hospitals, etc.).

During our initial training of new federal mandate for all healthcare facilities to have emergency plans and supplies in place, our district administrator emphasized to declare "Immediate Jeopardy" even when one part of emergency plan/supply was inadequate as new mandate requires ALL emergency plans, equipment, supplies and training must be in place. I asked, "Are you serious?" and the response was "Absolutely! The feds want this done and checked right now because too many people have already died."

Are you saying hospitals have firearms stored in safes and locked cabinets?

 

[LiveLife]

Some hospitals we surveyed had hospital staff's guns in safes and gun cabinets readily accessible in case of emergencies.

Some even had bullet proof vests and tactical gear all set up to deploy, depending on the location of the hospital.

 

[Balrog]

Some hospitals we surveyed had hospital staff's guns in safes and gun cabinets.

Interesting. Most hospitals have a no guns on campus policy, and having a firearm on campus can result in termination. Where was this?

 

[LiveLife]

That's usually the policy for "visitors" and "non-designated staff".

Licensing and Certification agency I worked for covered the entire state of California. We surveyed all types of health care facilities (Hospitals, nursing homes, etc.) located in metropolitan cities and in rural areas. Critical Access Hospitals in remote areas were particularly expected to be self sufficient due to their remoteness.

Keep in mind, certain aspects of hospital's emergency/contingency plans may not be available to all staff, only to those "designated" response staff trained and equipped such as hospital security staff and back up contingency staff.

The Critical Access Hospital I surveyed as survey team leader where we declared Immediate Jeopardy for multiple non-compliance findings including emergency/disaster plan due to hospital disbanding security staff to save money experienced active shooter with a shotgun several months after the survey. Thankfully, the hospital administrator who disbanded the security staff was fired shortly after the survey and hospital reinstated the armed security staff who effectively responded and disarmed the active shooter before anyone was shot/injured. BTW, many upper management managers of the hospital were trained CCW permit holders and armed but hospital needed 24/7 coverage and not having 24/7 security staff meant there was no security coverage during outside of normal "business hours". FYI, survey of this hospital was done shortly after the fed's new emergency/disaster preparedness requirement.

 

[Balrog]

That's usually the policy for "visitors" and "non-designated staff".

Licensing and Certification agency I worked for covered the entire state of California. We surveyed all types of health care facilities (Hospitals, nursing homes, etc.) located in metropolitan cities and in rural areas. Critical Access Hospitals in remote areas were particularly expected to be self sufficient due to their remoteness.

Keep in mind, certain aspects of hospital's emergency/contingency plans may not be available to all staff, only to those "designated" response staff trained and equipped such as hospital security staff and back up contingency staff.

The Critical Access Hospital I surveyed as survey team leader where we declared Immediate Jeopardy for multiple non-compliance findings including emergency/disaster plan due to hospital disbanding security staff to save money experienced active shooter with a shotgun several months after the survey. Thankfully, the hospital administrator who disbanded the security staff was fired shortly after the survey and hospital reinstated the armed security staff who effectively responded and disarmed the active shooter before anyone was shot/injured. BTW, many upper management managers of the hospital were trained CCW permit holders and armed but hospital needed 24/7 coverage and not having 24/7 security staff meant there was no security coverage during outside of normal "business hours". FYI, survey of this hospital was done shortly after the fed's new emergency/disaster preparedness requirement.

I have never heard of a hospital in this area with designated armed response staff. I am pretty sure in my position at the hospital I would have.

 

[newfalguy101]

Weapon outside of the room UNTIL needed.

Armed guy controls environment.

 

[LiveLife]

I have never heard of a hospital in this area with designated armed response staff. I am pretty sure in my position at the hospital I would have.

https://www.beckershospitalreview.c...ng-so-is-the-debate-over-their-necessity.html

"The number of armed security guards in hospitals is growing ... There's been a significant increase in the number of armed security guards at hospitals across the nation in recent years ... In 2014, 52 percent of hospitals reported their security personnel carried handguns, while 47 percent reported arming them with Tasers, according to a national survey cited by The New York Times. Those numbers are more than double the estimates from just three years prior.

... Some major healthcare institutions choose to arm security guards. For example, Cleveland Clinic hires off-duty officers and has its own fully armed police force, according to The New York Times. Other hospitals, such as University of California medical centers at Irvine and San Diego, provide their guards with stun guns produced by Taser International.

... Last fall, CMS warned St. Joseph Medical Center that it would be terminated from the Medicare program unless it corrected safety problems that put patients in 'immediate jeopardy.'"

 

[Balrog]

https://www.beckershospitalreview.c...ng-so-is-the-debate-over-their-necessity.html

"The number of armed security guards in hospitals is growing ... There's been a significant increase in the number of armed security guards at hospitals across the nation in recent years ... In 2014, 52 percent of hospitals reported their security personnel carried handguns, while 47 percent reported arming them with Tasers, according to a national survey cited by The New York Times. Those numbers are more than double the estimates from just three years prior.

... Some major healthcare institutions choose to arm security guards. For example, Cleveland Clinic hires off-duty officers and has its own fully armed police force, according to The New York Times. Other hospitals, such as University of California medical centers at Irvine and San Diego, provide their guards with stun guns produced by Taser International.

... Last fall, CMS warned St. Joseph Medical Center that it would be terminated from the Medicare program unless it corrected safety problems that put patients in 'immediate jeopardy.'"

Armed guards is one thing. A hospital taking on liability for storing guns for its employees is another. I am not sure the article is talking about what I thought you were talking about.