It’s a new day here for me and I can feel the satisfaction starting to seep into my bones.  With the announcement that Art Briles has been fired from Baylor University’s football program, I am hopeful that justice will finally be served.  It has been quite apparent to all of those around me that I have been enraged after finding out that Baylor had been protecting predators on their campus for the sole purpose of winning.  I, personally,  love to win.  I am highly competitive and often find myself suppressing that competitive nature in order to maintain interpersonal relationships.  When I was a young child, my parents taught me to win.  They showed me how good it felt to take victory with me in my life endeavors.  What they also taught me was that if I maintained my integrity while winning, then I was truly a champion…that winning “at all cost” was not the answer.  How many true “wins” does Baylor have at this point?  Over the last 3 years, it seems that they did not show the heart of champions and instead were a wicked, deceiving member of our conference. 

In 2013, OU would have been the Big XII Champion.  In 2014, TCU would have prevailed.  But they didn’t.  Their conference titles were stolen from them much like the innocence was stolen from the women who were raped by a university who ignored the truth simply to keep winning.  It is an indecent representation of what a Christian school, or any school, should stand for.  As I have said before, those championship titles should be stripped from BU.

In the “Finding of Facts” document released by Baylor this morning, the infractions are numerous.  The interesting part to me is that THESE ARE THE INFRACTIONS THAT BAYLOR IS WILLING TO RELEASE TO THE PUBLIC.  There is no way to tell how accurate this is until they release the report in its entirety.  In the 13-page document, the word “fail” is used in some form or fashion over 40 times.  Failure was used to describe the actions of football coaching staff, administrators, student conduct investigators, and the Baylor University Police Department. 

Baylor isn’t being fully forthcoming on the way that they will handle this situation.  I guess they are attempting to protect the reputations of those involved.  Baylor media released this statement, “Additional members of the Administration and Athletics program have also been dismissed. Neither these individuals nor the disciplinary actions will be identified publicly.”  For the life of me, I cannot and do not understand this.  Tell us who is being punished or at least tell us that you are sending cards to all of the victims spelling it out for them. 

Also included in the FOF document was, “This informal system of discipline involves multiple coaches and administrators, relies heavily upon individual judgment in lieu of clear standards for discipline, and has resulted in conduct being ignored or players being dismissed from the team based on an informal and subjective process.”  Multiple coaches and administrators.  Multiple.  Not one.  Multiple.  I have only heard one name. You have only heard one name. “In addition to the issues related to student misconduct, the University and Athletics Department failed to take effective action in response to allegations involving misconduct by football staff.”

Please tell me this isn’t over.  Please tell me that engaging in “continuing and robust training before the start of the Fall 2016 semester,” isn’t really all that is happening to these staff members…

 “Actions by University administrators directly discouraged some complainants from reporting or participating in student conduct processes and in one instance constituted retaliation against a complainant for reporting sexual assault.”   The report states that Baylor “created a culture that football was above the rules.”

The fact is that these incidents can be dated back as far as 2009 but Pepper only investigated back to 2013.  Funny, that’s when Baylor started winning.  I hope that the women assaulted before 2013 aren’t hurt by this.  I hope they realize that they matter, too.  I hope they realize that it mattered EVEN when Baylor was losing. 

 The NCAA hasn’t weighed in yet which will be interesting.  Maybe they will put a rush on this but more than likely we won’t be privy to their findings and decision until 2020.

 Shawn Oakman is one of many players involved in the allegations and police reports.  He and several other players tweeted this morning about the injustices being inflicted upon Art Briles.  A true testament of “drinking the Kool-Aid”.  I wonder how many of those players are just praying to God that they aren’t “outed” in all of this mess…

The coverage of this is insane.  My obsession with this is also insane.  I hope that this wound will continue to open and that every ounce of disease is eliminated.  No stone unturned. 

Football fans everywhere are saddened.  To Baylor Nation, I know your heart is broken. Mine would be. I hurt for you guys, I really do. Please know that if it was a cover up at TTU, I would be even MORE passionate about justice. This hasn’t been an "I hate Baylor" thing for me. It has been a "people are more important than football" thing for me. (And you have got to know that I LOVE FOOTBALL) As we say at Texas Tech…Strive for Honor.

And still, lurking under the radar is the Waco Police Department…

 

Here are the links to the finding of facts and also the Baylor Board of Regents article

https://www.baylor.edu/rtsv/doc.php/266596.pdf

http://www.baylor.edu/mediacommunications/news.php?action=story&story=170207

This morning Baylor University took the first of many necessary steps in response to the recent media attention surrounding the sexual assault scandal on their campus. They have “fired” Ken Starr.  Okay, so “fired” is a really strong word.  They have removed him from the position of school president.  Rumor has it that they are offering him a position in the law school while maintaining his current salary.  That punishment is nothing more than a slap on the wrist.  It equates to lifting up the rug and sweeping the dirt under the carpet.  The dirt is still there, but the guests won’t be able to see it unless they look for it.  Apparently, until the clouds opened up and Divine light shined a beacon onto the university, there was no need to “handle” the situation at all.  I say this simply because NOTHING has been done about this until now.  For those of you who have been living in peace without this knowledge, I am providing the timeline below.  Prepare yourselves…It is a lot.  It will take a while to read, which will only amplify why I have been so extremely pissed off for so long that no one has been listening.  I am not a victim.  I do not know any of these victims personally.  However, when I close my eyes, I can see the faces of the women in my life that I have loved dearly that could easily be inserted into any of these scenarios. (i.e.: my sister, my mother, my daughter, my best friend, my patients)

Crazy, Isn’t it? How in the world has this been kept so hush-hush?  Well, apparently if you know what you are doing and have “buddies” on the local PD, it’s pretty easy.  According to ESPN’s Outside the Lines, the Waco PD agreed to take “extra precaution” to ensure that these cases would be kept out of the public eye because they were “high profile”.  Together, they also found a loop-hole in Texas law that states that if cases remain open, they can be shielded to the public eye.  I wonder how many “open” cases there are against Baylor athletes down at the police station?  It’s sickening.  Below, I have taken an excerpt from the “Know your IX” website:

Students and other concerned third parties have the right to report sex discrimination, sexual harassment, and sexual violence to a school. Schools who fail to appropriately respond can suffer consequences under Title IX, such as the loss of federal funding, a non-compliance finding, a voluntary resolution agreement, or a lawsuit. The U.S. Department of Education accepts Title IX complaints, which can be reported to OCR@ed.gov. Additionally, Title IX allows harmed individuals to bring a private civil suit to seek money damages and an injunction to stop discriminatory practices.  http://knowyourix.org/title-ix/title-ix-in-detail/

Although Baylor is a private institution, I assure you the university still receives government funding.  Cut it.  Allocate those funds to other universities in the state and help increase their student population.  I can’t say that I would have ever embraced sending either of my kiddos to BU but I guarantee that at this point, neither of them will EVER attend Baylor University when the time comes.  I cannot allow the safety of my children to be compromised.  Yes, sexual assaults happen everywhere, but not every campus hides behind the police departments and essentially ignores them in an effort to protect a winning football team. All parents should stand up against this.  Yes, this is Texas.  Yes, football is king.  However, we need to remember that winning isn’t truly winning when integrity is pushed to the wayside. 

What else needs to happen? 

1. Fire anyone who knew ANYTHING about this and failed to come forward.  Police.  Coaches.  Professors.  Title IX Officers.  FIRE THEM ALL.

2. The Big XII needs to give Baylor the boot and I encourage all other conferences to boycott their program until justice is truly served.

3. PRESS CHARGES.  There are LAWS that were broken.   Are all educators not held to obligatory reporting? 

I read a quote today in Chip Brown’s article titled, Sources: BU Regents Fire Kenneth Starr, “The feeling is if the board got rid of Art (Briles), they’d be sitting in a $300 million mausoleum instead of that new football stadium.”

Oh, the irony.  It seems that Baylor is still missing the point.  They are STILL choosing football over the safety of their daughters.  I am so sorry that they spent all of that money on a stadium for a program they believe is only strong because of a single coach. 

'At Baylor, we celebrate our distinctive place in higher education - where research, scholarship and faith guide the mind in understanding the complex diversity of God's creation and prepare the whole person for service and leadership.’ 

I don’t believe you Baylor.  You have lost your focus.  “The meek He will guide in judgment.  And the meek He will teach His way.” Psalms 25:9. It is all there in your bible.  MY BIBLE.  Find some humility Baylor.  Stand up and take ownership of your mistakes.  Go to YOUR victims and apologize.  Show them what it really means to be a Christian in these trying times.  Hold yourself and all of those involved accountable.  You can donate money to every poor person in America.  You can sponsor countless mission trips to Uganda.  You can present yourself “In Service” but if you aren’t “walking the walk” it doesn’t really count.  It doesn’t matter what it looks like.

Here’s my message to Baylor: If you are serving prime rib with shit sauce, you are really just serving shit. 

 Timeline:

 October 2009

• A female athlete, who graduated from Baylor in 2010, testified that Tevin Elliott sexually assaulted her after she passed out drunk at her apartment in 2009

November 2011

• Baylor judicial affairs officials were aware of a misdemeanor, sexually-related assault citation against Elliott in November 2011

February 2012

• Oakman is kicked off the Penn State football team for attempting to steal a sandwich and allegedly assaulting a female cashier who tried to stop him – accounts vary from him simply grabbing her wrist to get her card back (his) or more violently shoving her against the wall (hers). He was charged with some misdemeanors and it was reported publicly.

April 2012

• A Baylor freshman (“Tanya”) reported to police being at a party and being raped twice by Elliott, who she hadn’t met before
• Days later, Tanya said she went to Baylor's campus police department, asking officers if there was anything they could do for her, because she'd been assaulted by a fellow student but was told that counseling or other resources were unavailable
• She was placed on probation when her grades dropped, lost her academic scholarship and left Baylor in 2013.
• Two weeks before Tanya filed her police report against Elliott, another Baylor athlete (“Kim”) reported to Waco police that Elliott had forced her to have sex with him. A few weeks later, the woman and her mother said they also reported the assault to Baylor's ombudsman office and were sent to meet with the school's chief judicial officer, Bethany McCraw
• Both women said McCraw's response noted that Kim, also a Baylor athlete, was the sixth woman to report such an incident involving Elliott. Kim alleges that McCraw acknowledged that Art Briles was aware of all the prior accusations
• Baylor coach Art Briles announced that Elliott was suspended indefinitely for violating an unspecified team policy. He didn't elaborate and said he'd have no further comment.
• Later it is reported that Elliott was arrested and charged with sexual assault, which is the first time news of any of the incidents is made public.

July 2012

• Oakman transfers to Baylor, and his past incident was apparently public knowledge.

2012 Football Season

• Oakman sits out at Baylor due to transfer rules
• Sam Ukwuachu has a freshman All-American season for Boise State

January 2013

• Police were called to an incident of alleged domestic violence between Oakman and his ex-girlfriend. A written police report was filed accusing Oakman of assault, noting evidence of bruising and including an account from the victim of being thrown around the apartment. The victim declined to press charges #1#2#3#4
• According to the report that came out today, there is evidence that Baylor was aware of the incident
• No disciplinary actions were taken and the incident did not make it to the media

April 2013

• Ukwuachu had an altercation with his then-girlfriend and roommates, detailed here.
• Ukwuachu is dismissed from the Boise State team and transfers to Baylor (this is when all communications between Peterson and Briles would have occurred -- the debate around which is regarding how much Peterson knew and/or disclosed)

April 2013 (Cont.)

• Tre'Von Armstead and former practice squad player Myke Chatman are accused in a sexual assault report. Police report here.
• Observations by officers at the scene and a rape exam at a hospital revealed bruises, a bite mark and scratches, and witnesses told police they believed they had heard, from downstairs, noises indicative of an assault. But the woman declined to press charges due to her level of intoxication, and Waco police effectively ended the investigation. The police report notes that it informed Baylor officials about the incident.
• Police told the victim that Baylor officials had been contacted and to wait for them to contact her, but she never received a call or email from anyone at Baylor

2013 Football Season

• Ukwuachu is ineligible to play for Baylor in 2013, as Boise State did not support any waivers to allow Ukwuachu to play the 2013 season.
• Oakman played in 13 games as a backup defensive end, recording 33 tackles and 2 sacks
• Armstead saw limited action in the 2013 season

October 2013

• A couple months after Ukwuachu arrived on campus, the sexual assault on Jane Doe occurs; Jane Doe goes to the hospital and a rape kit is performed, reported the incident, and in subsequent months is treated for PTSD
• Sometime in the months following, the Ukwuachu incident is investigated by the school as required. A few interviews are done of the victim, the accused, the accused's roommate, and potentially other friends. The school finds it more likely than not that the incident did not occur. Rape kit is not checked and the school counselor assisting her with PTSD was not interviewed. Baylor PD does not pursue any further

December 2013

• Cordell Dorsey, an Abilene Cooper high school football player who was committed to play for Baylor, was arrested for alleged aggravated sexual assault of a child, an 11-year-old girl who claimed Dorsey molested her multiple times during the summer.
• According to the arrest report, a sexual assault nursing exam supported the girl’s allegations
• Dorsey's charges were later dropped, and was allowed to enroll at Baylor and join the football team in 2014 (transferred to ACU in 2015).

January 2014

• Tevin Elliott is sentenced to 20 years in prison as a result of the incidents with Tanya
• In all, five women who reported to police that they were either raped or assaulted -- in incidents from October 2009 to April 2012 -- by Elliott.

June 2014

• Waco DA deems enough evidence to bring charges and Ukwuachu is indicted on charges of sexual assault; the indictment is sealed and Ukwuachu name is redacted on public indictment reports; the school does not re-open its internal Title IX investigation.
• The indictment is not public knowledge or reported on by any media

Summer/Fall 2014

• Ukwuachu, under indictment, is not playing for the football team, with coaches citing "some issues", but remains on scholarship and attends the university
• Victim is told that it is her responsibility to alter class schedules to avoid Ukwuachu.
• Jane Doe suffered an injury, preventing her from playing soccer, cited difficulties in rehab due to emotional/psychological issues, and saw her scholarship reduced.

2014 Football Season

• Armstead is the starting TE during the 2014 season and earns All-Big 12 honors
• Oakman earns first team Big 12 honors
• Ukwuachu sits out the 2014 season

Spring 2015

• Ukwuachu graduates from Baylor and is accepted into graduate school there; Jane Doe transfers to another school to play soccer because of scholarship reduction and other issues
• Ukwuachu is participating in strength & conditioning workouts with the team and is mentioned in interviews during summer 2015 as expected to return to play the season

August 2015

• Ukwuachu is convicted of sexual assault and sentenced to 10 years of probation.
• The victim files a lawsuit against Baylor for their handling of the case

September 2015

• Baylor's investigation of the allegations against Armstead and Chatman related to the April 2013 incident didn't begin until the alleged victim, encouraged by a friend who had attended a recent sexual assault prevention training program at the school, asked Baylor officials about her case in late 2015.

September 3, 2015

• Ken Starr issues a statement defending Art Briles related to the accusations of prior knowledge of Ukwuachu's alleged history of violence.

2015 Football Season

• Oakman earns 2nd team All Big-12 honors and is Baylor’s all-time sack leader
• Baylor kicked Armstead off its football team early in the 2015 season following the results of the investigation. When Baylor coaches announced his suspension from the team, they said it came as a result of a "team rules violation."

December 31, 2015 (New Years' Eve)

• It is announced that Baylor and the victim in Ukwuachu's case reached a settlement on her lawsuit with the school. No additional details were provided, presumably as a condition of the settlement

February 2016

• Armstead was expelled from school in February 2016 over the 2013 allegations.
• Armstead maintains his innocence and has said he is contemplating a lawsuit against the school for their handling of the incident.

February 7th, 2016 (Super Bowl Sunday)

• Ken Starr issues a statement detailing the measures Baylor is taking to improve the safe-guarding of its students against sexual violence, in light of recent publicized shortcomings

March 31st, 2016

• The rape victim for whom Tevin Elliott was convicted filed a lawsuit against Baylor, naming the school and several officials, including Art Briles.
• The suit claims Baylor did not take any action whatsoever to investigate her claim. It failed to offer her counseling or help as she struggled academically after the assault.

April 7, 2016

• Starr makes his first comments in public since the scandals surrounding the Ukwuachu case broke in August 2015 at the 29th annual Christian Prayer Breakfast Fort Worth/Tarrant County. His comments noted that sometimes there is an uninformed public perception of timelines and what constitutes publicly available information around these incidents, but also said he invites criticism for mistakes and wants transparency
• Just hours after Starr's comments, the reports of the alleged Oakman sexual assault began circulating.

April 2016

• Oakman, having graduated, is arrested in Waco and charged with sexually assaulting a Baylor student who went home from the bar with him

The woman went to the hospital after the alleged assault and was examined by a sexual assault nurse examiner, according to the court records.

(taken from Reddit.com submitted by ken_man)

Once again I find myself on a plane heading home.  As I reflect upon my trip, I feel inspired.  I feel humbled.  I feel loved.  (I also feel a little irritated that the lady who insisted on sitting next to the window now has an eye mask on and is deep in slumber.)  Regardless, the past few days have proven to be good for my soul. 

 

A few years ago, my friend Kimberley gave me a journal.  I hadn’t had one since I was a kid.  On the cover, it has a picture of wonder woman and inscribed on the first page are words of encouragement.  She wrote many words but the ones that stand out to me the most are, “I am proud of your grace and your strength.  You show us all how it’s done.”  In that journal, I don’t write a daily account of my life but instead I jot down ideas…writing ideas.  I love to write.  It is my outlet for frustration, ideas, and inspiration.  It is my most effective means of communication.  I find it much easier to organize my thoughts while writing.  It is as much a part of me as my nursing career.  It is the one thing in my life that is mine…all mine. I probably would have never started writing in my adult life if it wasn’t for Kimberley. She gave me my “pen and paper” so to speak.  She inspired me.

 

As most of you know, on Thursday I was given the opportunity to speak at a conference and give an account of a horrific active shooter incident I was involved in while on shift in an ER.  Although it was the first time that I have publicly given an account of those events, it proved to be something that I have needed to do for 15 years.  It was truly cathartic. During my presentation, I laughed when recounting the staff that I worked with during that time.  I also cried.  I cried A LOT.  I cried in front of a group of 100 people that I didn’t know.  I told them how I felt that night and how I feel today regarding the events of that night.  I revealed things I was proud of and things for which I am ashamed.  While standing at that podium with all of those eyes focused on me, I saw a room full of people I didn’t know.  However, what I saw when I looked closer was a room of people just like me.  People who are trapped somewhere between compassion and fear. They were literally sitting on the edge of their seats listening to me for the ENTIRE 90-minute presentation.  I had been through something that they all fear will happen to them.  It was during this time that I realized that I have a job to do.  We ALL have a job to do. 

 

The California legislators just recently declined a bill that would make it a felony to assault a health care provider.  A resident of California informed me that a person can get in more trouble for kicking a dog in that state than assaulting a nurse.  While I am a huge animal lover, I find myself highly offended by that.  I am there to help you in your darkest hour.  I shouldn’t have to be on red alert for danger while I am at work.   The ENA has been working diligently to make these changes from state to state.  I am embarrassed that I have sat silently on the sidelines while this has been happening.

 

In Texas, where I reside, our state government recently approved the bill to make it a felony to assault a health care provider.  That’s awesome, right?  Well, it’s a step in the right direction.  If you read my blog on a regular basis, you know that I was recently punched in the face at work.  I can also tell you that a I was told that although I could file a report, the chances of it actually making it to court were slim because the prosecutor in Dallas County doesn’t have time to take cases in which no true injury occurred… that the patient was on drugs and he technically wasn’t in his “right mind” when he did it.   That’s horrible.  It’s abuse.  Guess what I got to do after that occurred?  I got to continue taking care of that patient.  It’s ridiculous.  He has a RIGHT to receive healthcare but I don’t have a right to a safe work environment.  Isn’t there an OSHA standard to uphold here?

 

During my presentation, I told my audience that it isn’t enough for us to simply complain.  WE MUST STAND TOGETHER FOR CHANGE.  I realized that because I have not been part of the solution, I have been part of the problem.  I have been inspired.  I encourage each of you reading this to join the Facebook page, ER Nurses: Stop the Violence.  Let’s brainstorm and put this revolution into a call for action.

 

My friend Kimberley gave me my pen and paper.  Her husband Mark, who invited me to speak, gave me my voice.  I thank them humbly and from the bottom of my heart for believing in me.  If you give me a chance, I promise to speak for all of us in the name of safety…in the name of compassion.  For now, please make a pledge to report work place violence to your administrators every single time it happens… Verbal, emotional, and physical abuse.  It should have never been seen as acceptable.  It should have never been ignored. We are all guilty of letting it slide. Together, let’s show the world that we demand a safe environment.  Together, let’s make that change. 

There is a new culture in medicine coming down the pipes.  Hospital reimbursement, from insurance and the government, is beginning to be affected by patient satisfaction scores.   I understand where they are going with this.  Somewhere in an office high in the tops of an office building…far, far from patient care…someone was thinking of a utopic hospital where lab results were immediate...radiology tests were read at the bedside and doctors had only one patient at a time.  A place where nurses smell like sugar plums and look like angels…A place where pain medicine isn’t needed because anything that ails you can be cured with a smile and the touch of a hand.

 

I, too, want to be treated at this facility.  Unfortunately, it doesn’t exist.

 

Hospitals are spending millions of dollars educating staff on how to create the perfect patient experience.  Workshops and conferences are serving up scripts for providers to use.  Scripting that includes using the words “very good” several times to play mind-tricks on patients so that their robotic response on paper to satisfaction surveys will mimic the words that they heard multiple times during their stay in an ER.  The control is in the hands of the patients.  Doctors feel forced to order unwarranted tests for patients who have read on WebMD what the path of their ER visit should look like.  Nurses take physical, mental, and emotional abuse from patients and visitors in hopes that their monthly Press-Ganey scores will improve.  I mean, their raises depend on it after all. It is all smoke and mirrors. 

 

Facilities are spending so many financial resources attempting to coach the staff on how to make patients happy.  This approach is much like putting Neosporin on an infected wound and covering it with a Band-Aid, all the while not removing the festering splinter causing the infection.  All of these efforts are moot if the facility is not doing everything in its power to raise STAFF satisfaction.

 

When you have nurses that feel overworked, underpaid, ignored, undervalued, and disrespected…no amount of training regarding the correct approach to patient satisfaction will work.  People who go into healthcare are for the most part, innately kind.  They are helpers.  They are people pleasers.  Making patients happy is second-nature to most of them. Make the nurses happy and everything will fall into place.

 

Have you ever heard the phrase “happy wife…happy life”?  If not, it simply means that if a man makes his wife happy, everything else will fall into place.  It makes sense, doesn’t it?  She will smile as she’s putting away the dishes, folding your laundry, cooking for you…she’s doing it willfully and happily because she loves you and she wants to do it all.  On the flip side, however, if a man isn’t making his wife happy, his laundry isn’t being done as well, trips to the store aren’t as frequent, sandwiches are frequently served instead of a hot meal…The same can be applied to nurses. 

 

When nurses are paid adequately, given appropriate work loads, and don’t feel taken advantage of, they will absolutely deliver.  When they make suggestions to management that are taken to heart and put into action, they will feel supported.  When patients aren’t allowed to abuse them, they will feel protected.  When their experience is seen clearly and sought out to aid in decision-making processes, they will feel respected.  When they are managed under a transparent administration, they will no longer feel paranoid.  When they are rewarded for their loyalty, they will feel un-expendable.  When doctors see a nurse as more than a “scribe” and instead as an educated person who is either an expert in their field or is striving greatly to become one, amazing things can and will be achieved.

 

The key to patient satisfaction is nurse satisfaction.  Nurse Satisfaction + Patient Satisfaction= Higher Reimbursement… It is a very clear solution.  HAPPY NURSE…GREAT BIG PURSE.

Today I am on a plane heading for California. I have been invited to speak at a conference centered on ER Violence. It saddens me to think that there is even a reason to host a conference focused on a topic that shouldn’t exist. I will never understand why so many patients feel the need to abuse us. I have turned it over in my mind a million times. Every time I am cursed at, spit at, punched, kicked…I will never understand it. ER nursing is dangerous. It is dangerous every day. I work in an inner-city ER and we service a very diverse community ranging from the homeless to the wealthy. In that mix of patients, we also see a very violent sect of the community. Located smack dab in the middle of a gang-infested neighborhood, we commonly (and usually daily), see gunshot wounds, stabbings and deadly aggravated assaults. We care for women who have been kidnapped and forced into the sex-trade, prostitutes who have no other way to make ends meet, drug addicts and prisoners. It is not uncommon for us to remove weapons and drugs from our patients. It is terrifying. I don’t know too many professionals that are wide-open to danger like ER nurses. Law enforcement officers are, however they are armed with the tools necessary to defend themselves and to protect others. The military is but again, we provide them with very large guns, also. The only professions that I know to be under the same umbrella of danger are firefighters and paramedics. I used to work in a community where EMS wore bullet-proof vests under their uniforms to protect them from the danger they faced when responding to 911 calls. I work in a larger and more dangerous community now. I am sure that the reason my local FD and EMS don’t wear Kevlar is because it doesn’t look good…It would hurt the image of the department. Seriously. Think about that for a minute… I have had a patient deliberately throw HIV positive blood at me. I have been punched in the face by a grown man. I have been pinched and scratched. I have been kicked in the lower abdomen so hard that I peed blood. All of these things happened to me while on the clock. If I am not told to “Go F*!* (myself)” at least once in a 12-hour shift, I feel left out. It’s funny to me that hospital administrators don’t feel that all of this deserves some kind of hazard or critical care differential in our pay. We are the mouth of the beast, so to speak. We are on the front-lines. We are that row of continental soldiers that goes first, knowing that we will all be sacrificial lambs if and when it all goes down…and it will. All of the bullet-proof glass in the world won’t make a difference until we start treating the ER like the battle zone that it is. Triage areas around the country are enclosing the triage staff behind cubicles of 4-inch thick glass to protect us but at the same time are letting as many visitors in to see patients with no consideration of possible weapons, no tracking of names, no security checks whatsoever. The triage staff might not get shot in the face but no worries, they WILL get shot in the back. I have to show a driver’s license to enter into my daughter’s school in the name of safety….IN SUBURBIA. However, those same children and adults aren’t safe in an ER that is filled with violence. This is all in the name of image and patient satisfaction. Metal detectors are apparently insulting. If that special sect of patients was found wandering upstairs in the administrators’ offices on a regular basis, I have a feeling things would be handled much differently…and mahogany metal detectors would be installed. Commissioned police officers in the ER are a wonderful thing but until politics and tiptoeing cease to exist, it does very little good. Patients and visitors know that the police can’t do anything to them because the customer is always right. Emergency rooms actually have CLASSES that last an entire afternoon that teach staff members how to smile and nod no matter the situation in hopes that we can score a “Very Good” on a survey from a patient whose opinion really shouldn’t matter. I’m sorry but if you berate and abuse the staff in an ER, your opinion shouldn’t matter. You should also be asked to leave and to seek treatment elsewhere. This doesn’t happen, though. There is very little support from administration with these patients. They can act how they want. Do what they want. Dictate to the physicians the direction of their care. We are all walking around paranoid that the next crack-whore is the one that will get us fired. Not because of the care that we give or the manner in which we act, but instead because a person who wouldn’t be trustworthy enough to hire to mow your grass is suddenly the most credible witness on the planet when reflecting on their visit to your department. Violent and unstable patients are the captains of the ship. That is not okay. Don’t get me wrong. I don’t think that a patient’s ER visit should be the equivalent of visiting Dick’s Last Resort. I believe in customer service. I believe in kindness. I believe in a patient’s right to receive excellent health care from highly skilled professionals. BUT COME ON PEOPLE!!!!! If I went to a restaurant to eat dinner, started yelling, pushing the staff and cursing, I would immediately be asked to exit the premises. The funny thing is that the only pressure the wait staff has is to deliver food and drinks with promptness, accuracy, and a smile. ER staff members are SAVING LIVES and if a patient or a visitor starts in with that behavior, a supervisor will go to the area and attempt to calm the person down. If they are unsuccessful, the patient or visitor is still allowed to stay and the solution becomes one in which a new nurse is assigned to that room. ARE YOU FREAKING KIDDING ME?!?!?! These situations need to be nipped in the bud. Patients and visitors need to understand that it is a privilege to receive medical care and that they need to act as part of the team in their care. Step one is for them to be respectful to the staff. This feeling of entitlement in regards to berating medical personnel will continue to escalate and someone is going to get killed. Yes, I am pretty passionate about this topic and with good reason. You see, my name wasn’t simply drawn out of a hat to speak at this conference. I was specifically chosen because I have been forced to evacuate a Level I Trauma Center during an active shooter incident. I didn’t want to. I had to. I know what can happen when we let our guard down. The person you least suspect, or even the person that you suspect most, can be the one that changes your life forever. If you aren’t ready for it, you will probably walk around for the rest of your life shouldering the blame that people you loved and cared about were injured on your watch. Innocence Lost. That’s the title of my presentation. Until January 3, 2001, it never occurred to me that my life was truly in danger in the ER. I had almost imagined hospitals as safe-zones. A place where the sick and injured could come to be repaired… The goalie box of life…Switzerland…I was wrong. I used to be innocent and look at the ER through rose-colored glasses. I don’t do that anymore. My naiveté was stolen from me 18 days short of 15 years ago. I wish people would listen to me. I wish I could get through to them. I wish I could protect them from the incident that is coming. They shake their heads in agreement, acting as though they are hanging on every word…and yet very little changes. Innocence lost. Mine was stolen from me. Theirs will be stolen, too. It’s just a matter of time.