How the Florida hospital handled aftermath of tragic shooting in pharmacy

Entire hospital pulled together to help

Hospital staff deal with other people's tragedies every day, but when something horrific happens in the hospital, it pushes the site into disaster mode.

This is what happened two years ago when a hospital pharmacy manager at Shands Jacksonville in Jacksonville, FL, was shot and killed while at work. The killer was a pharmacy client.

Pharmacists who had worked with the victim for years and were her friends suddenly found themselves in the bewildering role of grieving victims, who still had hundreds of clients to consider, even as they were overwhelmed by their own feelings.

Here's how the hospital leadership and the pharmacy staff handled the crisis:

  • Provide leadership from the start.

As soon as a crisis, tragedy, or disaster happens, hospital leaders need to have a prompt response. This lesson was driven home to administrators at Shands Jacksonville when one of their employees was murdered at the hospital pharmacy.

"We learn from every disaster response, and whether it's a mock disaster or real disaster, we have found as an organization that we learn from each one," says Thanh Hogan, PharmD, director of pharmacy at Shands Jacksonville.

Hospital administrators immediately met with staff at the pharmacy and had the hospital's employee assistance program (EAP) make it to the site to provide support. A hospital chaplain and certified grief counselors also met with employees within an hour of the shooting, Hogan says.

"Immediately, the employees were sequestered together and were in a group together, and the ones who needed independent support were one on one with the counselors," she adds.

  • Find out what the staff need to continue their work.

The hospital might have considered shutting the pharmacy for a week, but the pharmacy team said, "No," Hogan says.

"We couldn't get to the point of thinking about it because the team was so compassionate about what they needed to do, and they were so committed to their patient care mission that they came to me first, saying they needed to have the pharmacy open tomorrow," Hogan explains.

Hospital administrators briefly considered switching the pharmacy staff, to allow the traumatized pharmacists to work in a different area for a while, but the pharmacists also rejected that idea, Hogan notes.

"We thought about it, but before we could think any further, the team said, 'We need to be open for our patients,'" Hogan says. "They felt strongly that they needed to take care of these patients, some of whom they had treated for years."

One pharmacist even said, "Mrs. X is coming tomorrow to get her insulin, and we have to be here to give her the insulin," she recalls.

So hospital leaders tried to find out how they could help.

"We asked the pharmacy team what it would take for them to walk through the doors tomorrow to do what they needed to do to get prescriptions to patients," Hogan says.

"They said, 'We could walk through the door if we had someone out front who would triage for us the patients who truly needed to come in and the patients who could wait a day or two,'" Hogan adds. "There was no way they could handle 1,500 patients the next day."

So the hospital leadership stepped up and had nurses, case managers, and even the vice president of nursing at the pharmacy on the day after the tragedy, Hogan says.

"They were doing triage in shifts with the rest of us," she adds. "It was an all-out organization-wide effort."

Also, there was hospital security at the front door, and the facilities crew put in an extra telephone to improve the pharmacy's communication, Hogan says.

"We had the information technologies (IT) staff put up a portable computer so we could look up things in the make-shift triage area," Hogan adds.

Many of the hospital's inpatient pharmacists and pharmacy technicians would finish their shifts and then walk over to the ambulatory pharmacy to help out, Hogan notes.

"Some pharmacy employees have different days off during the week, so they'd come in and work in the ambulatory pharmacy at that time," she adds. "They worked in all areas of the outpatient pharmacy, wherever they were needed."

The inpatient pharmacy staff helped fill prescriptions and checked for drug interactions, as well as for duplications and overdoses, Hogan says.

"We couldn't work at 100% capacity the next day, but we were all there, and we were all together," Hogan adds.

  • The small gestures matter a great deal.

When the pharmacy's staff decided to reopen the ambulatory pharmacy the day after their colleague was killed, the senior leadership provided them with the support they needed to make this happen.

Senior leadership saw to it that the pharmacy staff had breakfast and lunch for a month, says Karen Malcolm, PharmD, manager of ambulatory pharmacy at Shands Jacksonville.

Hospital laboratory and radiology staff provided the lunch, continuing it longer than planned once they saw how important it was to the pharmacy staff's morale, Hogan notes.

While this seems like a small detail, it made a huge difference to the pharmacists, Malcolm says.

This simple act made it possible for the pharmacy team to stay together in the pharmacy. It relieved them of the emotional burden of having to interact with the rest of the hospital staff, who — while well-meaning — would make comments or ask questions that the pharmacists weren't ready to answer.

"We didn't have to go out in the hall and have people say, 'I can't believe that happened,'" Malcolm explains.

"We were like in a cocoon almost," Malcolm says.

The hospital's support helped keep the pharmacy staff intact.

"We did not have any employees quit directly after this," Hogan says.