Maintaining Security When Gang Members Visit Your ER

Prevent gang violence on your campus by partnering with local law enforcement and training security and clinical staff.

Across the country, gang members enter hospital emergency rooms on a daily basis as victims of shootings, stabbings and beatings, as well as for non-violence related medical needs. Many are admitted for short- or long-term care. Often accompanying these patients are fellow members of their sect. If a rival gang injured the patient, there is always the chance that adversary gang members could come to the hospital to finish the job. While these incidents are rare, they do occur.

All healthcare facilities — not just those hospitals located in the inner cities — need to adopt a gang awareness-training program that incorporates area and regional gangs and identification, workplace violence, obvious warning signs and reporting procedures. This education should be available to all employees, especially ER, ICU and security staffs.

Work With Local Police, FBI for Intel

Local police and the FBI track gang activity. Many police departments have a dedicated gang enforcement unit or officer. It is paramount that hospital security departments utilize these resources to gain pertinent information on gangs operating in the surrounding communities and to be involved in creating a viable gang awareness-training program for hospital employees.

Our facility, which is Northwest Hospital in Randallstown, Md., has kept gang awareness at the forefront, keeping an open line of communications with the Baltimore County Police Department (BCOPD) gang unit. This partnership keeps hospital staff abreast of gang activities in the area and provides gang intelligence to law enforcement, while keeping HIPPA laws in mind.

With the assistance of Sgt. James Conaboy of the BCOPD gang enforcement unit, the Northwest Hospital security department has conducted several gang awareness seminars for the security and clinical staffs. Additionally, gang identification resource books are being created for the security department, emergency room and ICU. These resources will describe the area’s gangs, colors, tattoos, graffiti and potential for violence.

In December 2010, we coordinated an active shooter training drill with the BCOPD, which was centered around a gang member coming to the ICU to kill another rival gang member who was a patient. More than 100 persons attended the drill, including, the entire hospital administration, police executives, local precinct police officers, the BCOPD gang unit, the BCOPD intelligence unit and local emergency medical services personnel. The drill was deemed a huge success. A follow-up drill is scheduled for the near future.

Train Employees How to ID Warning Signs

It is imperative that hospital security staff are thoroughly educated on gang activity, including how to recognize and deal with it. Hospital security departments should have procedures in place to deal with the potential for gang members entering their facility.

At Northwest Hospital, security staff investigates all shootings and stabbings. The patient’s criminal background is checked. Police are interviewed to determine if the incident was possibly gang or drug related, or if the victim or suspect has current or past gang ties. Clinical staff is also asked to look for gang-related tattoos. All information is documented in a security incident report, and if required, an action plan is designed to better protect the patient, staff and visitors.

It is very important that security and clinical staff be trained to recognize warning indicators related to potential gang violence. Some of these signs are:

  • Obvious signs of agitation of patients and/or visitors arriving at the ER or signs that they just came from a fight
  • The staring down of other visitors or staff members may be an indicator of looming violence. Known as “Mad Dogging” this tactic is often used between rival gang members.
  • Gang indicators, whether they are gang colors, identical clothing or sports attire, tattoos or hand signs
  • A patient suffering trauma arriving with a group or posse, or a shooting, stabbing or assault victim being dropped off at the hospital entrance
  • A patient refusing to give up clothing or packages, which could contain weapons or illegal drugs

Staff Must Treat Gang Members With Respect

A workplace violence policy should be in place and all hospital employees should be aware of its content. This policy should be a part of any new employee orientation program and should detail the procedures for incident reporting, not only incidents of violence but also the potential for violence. The LifeBridge Health system, a four-hospital corporation located in Baltimore, has recently designed and implemented an annual workplace violence course, which is mandatory for all employees. This course discusses a wide range of warning signs, tactics and reporting procedures.

The clinical staff should receive education regarding the best methods to employ while interacting with suspected gang members. Should gang members feel disrespected by a nurse or physician, he or she may retaliate and lash out at staff.

Hospital staff should be straightforward and honest with the patient regarding his or her injuries and treatment. Treat the gang member patient respectfully, as you would any other patient. Staff should be cognizant that a gang member’s clothing may represent his gang affiliation, so care should be taken when handling these items.

Gang graffiti found on hospital property should be photographed and reported to police. The graffiti should then be immediately removed. Under no circumstances should the graffiti be crossed out, as this may be seen as a sign of disrespect to the gang and be cause for future violence.

Like all patients, gang members cannot be turned away when seeking emergency medical treatment. Therefore, preparing for incidents of potential gang violence through training, education, cooperation with law enforcement and proper reporting procedures and protocols are the keys to a successful campaign against gang violence in a hospital setting.

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