Is Your Hospital Prepared for Gang Violence and Injuries?
A South Los Angeles hospital VP shares three crucial steps to managing gang member patients admitted for gang-related injuries.
Westall describes a time while working at a hospital in Pasadena, Calif., when there was a drive-by shooting at a memorial for a murdered gang member. Since the memorial was two blocks away from the hospital, all of those who were shot were brought over in cars before an ambulance could respond to the scene.
“About 100 people who were at the memorial came to the emergency department at two in the morning and kind of overran it. It was a scary situation,” Westall recalls. “Everybody is out in the parking lot wanting to know who got shot, and its all active gang members from this memorial, plus the family. We had to get support from three neighboring law enforcement agencies to do crowd control and parse out who should be here, who shouldn’t be here and who is a family member that we can let into the hospital.”
This chaotic instance emphasizes the importance of working with law enforcement. At MLKCH, there is a radio room in the ER that monitors radio traffic coming from ambulances, the sheriff’s department and local law enforcement agencies.
“And they’ll call in and say, ‘I’m bringing a combative person,’ or a gunshot victim, or a stabbing victim,” says Westall. “So, we’re prepared to lock down the area and keep the folks who should be in the hospital, in the hospital, and the folks who should be out of the hospital, out of the hospital.”
MLKCH also does its part to effectively establish an open line of communication with community leaders, as IAHSS recommends.
Every week, staff from the community benefit and security departments attend a meeting hosted by the Watts Gang Task Force. The task force consists of members from the Los Angeles Police Department, the Los Angeles County Sheriff’s Department, the Los Angeles Unified School District, service providers, gang intervention workers, local elected officials and community members.
“Watts is the section of Compton that we operate in, so we meet with them and they tell us what’s going on in the neighborhood and we tell them what we know,” says Westall, adding that additional outreach programs have come out of these meetings.
In January, Westall spoke at Career Day at Los Angeles’ King Drew Magnet High School of Medicine and Science.
“I went to [the] high school to talk to kids about careers and how they don’t have to join gangs – you don’t have to go to jail,” he says. “There’s plenty of opportunities out there. Start out on LinkedIn and build a network. We have a ton of community outreach.”
Westall explains gang members often start young, and the high school is only four blocks away from the hospital.
“They have to walk by these gang members,” he says. “They know who they are. Their brothers are in the gang or their uncles or their dad. It’s definitely ingrained in them at a younger age.”
The hospital also recently started a program where employees go into barber shops to talk about healthcare screenings and what’s going on in the area.
“Barbershops are kind of the community meeting place around here,” he says.
2. Staff Training
At MLKCH, staff have an annual 40-hour in-service training and also participate in quarterly trainings. Although not completely focused on gangs, both contain a significant piece on the topic.
There are also briefings before each shift change, which Westall believes to be the most important.
“We’ll pass down pertinent information from the different shifts: what we’re expecting, what happened in the last 24 hours for people coming in,” he says. “Getting a good briefing is important because if the information doesn’t flow between the shifts, then it can cause problems.”
Training staff members to also be able to identify potential issues significantly helps to reduce gang-related incidents, says Mark Reed, Director of Support Services at MLKCH, who oversees security, safety, emergency management, parking and other programs.
“There are numerous gangs in the surrounding area of MLKCH and they don’t always get along, which can cause incidents at the hospital,” Reed says.
One way to prevent potential confrontations between gang members is to understand how gangs in the area operate.
Reed provided Campus Safety with a Google Maps link*, which gives updated information on Los Angeles County gangs and their territories. Clicking on each block provides the name of the gang that runs that area, along with a brief description, including who they feud with or who they have an alliance with.
(*Please excuse some of the language within the map. Although Reed is unsure who maintains the map, he and his team have reviewed it and believe it accurately depicts what they see in the community on a daily basis.)
Additionally, clinical staff should be trained to look for gang identifiers. Many gang members can be identified by tattoos or clothing. For instance, Blood members might tattoo the initials “CK” on their bodies, an acronym for “Crips Killers.” Crips will often wear Dallas Cowboys jerseys while Bloods will wear Chicago Bulls jerseys.
Charles Moore, the director of security at Northwest Hospital in Randallstown, Md., also suggests employees have a strong understanding of the three “R’s” associated with gang culture: reputation, respect and retaliation.
- Reputation is crucial for the endurance and promotion of the gang as a viable criminal enterprise. The fear of reprisal and violence is created through reputation. Members gain their reputation by their willingness to do whatever it takes to achieve a good reputation.
- Respect is wanted by all gang members. They seek respect and demand it in return for themselves and their affiliated gang.
- Retaliation is a common occurrence when a gang member doesn’t feel they are being respected. Many are willing to risk serious injury or death to ensure they receive it.
Due to the potential consequences associated with three “R’s,” staff should be trained on how to speak to and interact with gang members.
“If you come off too medical or too clinical, you don’t relate to them – you build no rapport,” says Westall. “You get a lot more cooperation when they think they’re talking to a friend or to someone they have something in common with. I think that’s been my most successful tactic around it. Just sit down and have a conversation.”
3. Treat Gang Members As Patients, Above All Else
Westall and Reed both agree that treating all patients with respect and care is of the utmost importance.
“At MLKCH, we want to provide compassionate, collaborative, quality care, regardless of our patient’s background or affiliation,” says Reed.
Staff members are trained not to acknowledge if a patient is a known gang member.
“We try to keep it even-keel and treat everybody as a patient before anything else,” Westall says. “We kind of try to ignore those outside influences. Obviously, that becomes a challenge, depending on the individual, but the rule of thumb is to ignore all of that.”
At the end of the day, it’s about communication.
“You want to avoid any kind of altercation or confrontation,” Westall adds. “They don’t come in spitting and fighting and kicking just because they’re gang members.”
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