Gun violence has blurred the line between healthcare concerns and public health, as recurrent mass shootings now have a nursing group calling for national action to prevent the attacks.

After the recent shooting at a high school in Florida, the American Academy of Nursing (AAN) urged Congress to form a bipartisan National Commission on Mass Shootings. The AAN recommended that healthcare professionals be allowed and empowered to “fulfill their role in preventing firearm injuries by health screening, patient counseling, and referral to mental health services for those with high-risk danger behaviors.” The nursing group noted that increased training of healthcare professionals would let them play “a greater role in preventing firearm injuries by health screening.”

As previously reported in Hospital Employee Health, California’s Occupational Health and Safety Administration (Cal/OSHA) has enacted workplace violence prevention regulations for healthcare settings. (For more information, see the February 2018 issue of HEH.) Cal/OSHA is the first state OSHA plan to adopt such a regulation. Though the current political climate does not favor regulations, federal OSHA announced in January 2017 that it will develop a national standard for violence prevention in healthcare.

Still, OSHA can enforce violence prevention to some extent through its general duty clause. OSHA recently cited Pioneer Health Care Center, a nursing home in Rocky Ford, CO, for failing to protect employees from violence in the workplace. The facility provides residential long-term care and mental health services. According to the OSHA citations, nurses suffered violent acts from residents that included bites, scratches, kicks, punches, and violent grabs. The facility has the right to appeal the citations, but currently faces proposed penalties of $9,054.

“OSHA opened an investigation at Pioneer Health Care Center in response to two complaints related to workplace violence received in August 2017,” the agency reported. “OSHA subsequently identified five documented incidents of workplace violence in 2017 that resulted in employee injuries, along with several unreported incidents. OSHA issued one serious citation for failing to implement adequate measures to protect employees from workplace violence hazards.”

For its part, the AAN echoed other critics after the Florida shooting in issuing a statement that “thoughts and prayers” were not enough. The nursing group could not be reached for additional comment as this issue went to press, but the following actions were among those recommended by the AAN in its statement:

• Create a universal system for background checks.

• Strengthen laws so that high-risk individuals — including those with emergency, temporary, or permanent protective or restraining orders, and those with convictions for family violence, domestic violence, and/or stalking — are prohibited from purchasing firearms.

• Ban the future sale, importation, manufacture, or transfer of assault weapons, incorporating a more carefully crafted definition of the term “semiautomatic assault weapon” to reduce the risk that the law can be evaded.

• Research the cause of and solutions to firearm violence.


1. OSHA. U.S. Department of Labor Cites Colorado Nursing Home For Workplace Violence Hazards. Feb. 5, 2018. Available at: