Hostname: page-component-745bb68f8f-g4j75 Total loading time: 0 Render date: 2025-01-11T23:00:42.405Z Has data issue: false hasContentIssue false
  • English
  • Français

Physicians on the Frontlines: Understanding the Lived Experience of Physicians Working in Communities That Experienced a Mass Casualty Shooting

Published online by Cambridge University Press:  28 January 2021

Kathleen M. O'Neill ,
Blake N. Shultz ,
Carolyn T. Lye ,
Megan L. Ranney ,
Gail D'Onofrio  and
Edouard Coupet Jr.
Get access Rights & Permissions [Opens in a new window]

Abstract

This qualitative study describes the lived experience of physicians who work in communities that have experienced a public mass shooting. Semi-structured interviews were conducted with seventeen physicians involved in eight separate mass casualty shooting incidents in the United States. Four major themes emerged from constant comparative analysis: (1) The psychological toll on physicians: “I wonder if I'm broken”; (2) the importance of and need for mass casualty shooting preparedness: “[We need to] recognize this as a public health concern and train physicians to manage it”; (3) massive media attention: “The media onslaught was unbelievable”; and (4) commitment to advocacy for a public health approach to firearm violence: “I want to do whatever I can to prevent some of these terrible events.”

Type
Symposium Articles
Information
Journal of Law, Medicine & Ethics , Volume 48 , Issue S4: Gun Violence in America: An Interdisciplinary Examination , Winter 2020 , pp. 55 - 66
Copyright
Copyright © American Society of Law, Medicine and Ethics 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Grinshteyn, E. and Hemenway, D., “Violent Death Rates: The US Compared with Other High-Income OECD Countries, 2010,” American Journal of Medicine 129, no. 3 (2016): 266-273; Bjelopera, J.P., Bagalman, E., Caldwell, S.W., Finklea, K.M., and McCallion, G., Public Mass Shootings in the United States: Selected Implications for Federal Public Health and Safety Policy (2013), available at <https://fas.org/sgp/crs/misc/R43004.pdf> (last visited August 21, 2020).CrossRefGoogle ScholarPubMed
Id. (Bielopera et al.).Google Scholar
Cohen, A.P., Azrael, D., and Miller, M., “Rate of Mass Shootings Has Triples Since 2011,” Harvard Research Shows, 2014, available at <https://www.motherjones.com/politics/2014/10/mass-shootings-increasing-harvard-research> (last visited August 21, 2020).+(last+visited+August+21,+2020).>Google Scholar
See Grinshteyn et al., supra note 1; H. Bauchner et al. ibid; Swanson, J.W., Mc, E.E.Ginty, , Fazel, S., and Mays, V.M., “Mental Illness and Reduction of Gun Violence and Suicide: Bringing Epidemiologic Research to Policy. Annals of epidemiology 25, no. 5 (2015): 366-376.CrossRefGoogle Scholar
NRA, available at <https://twitter.com/NRA/status/1060256567914909702> (last visited August 21, 2020; Twitter account required).+(last+visited+August+21,+2020;+Twitter+account+required).>Google Scholar
Haag, M., “Doctors Revolt After N.R.A. Tells Them to ‘Stay in Their Lane’ on Gun Policy,” New York Times, November 13, 2018; Ranney, M.L., Betz, M.E., Dark, C., “#ThisIsOurLane - Firearm Safety as Health Care's Highway,” New England Journal of Medicine 380, no. 5 (2019): 405-407.Google Scholar
Berger, W., Coutinho, E.S., Figueira, I., et al., “Rescuers at Risk: A Systematic Review and Meta-regression Analysis of the Worldwide Current Prevalence and Correlates of PTSD in Rescue Workers,” Social Psychiatry and Psychiatric Epidemiology 47, no. 6 (2012): 1001-1011; Fullerton, C.S., Ursano, R.J., Wang, L., “Acute Stress Disorder, Posttraumatic Stress Disorder, and Depression in Disaster or Rescue Workers,” American Journal of Psychiatry 161, no. 8 (2004): 1370-1376.CrossRefGoogle Scholar
Greenspan, A.I. and Kellermann, A.L., “Physical and Psychological Outcomes 8 Months after Serious Gunshot Injury,” Journal of Trauma 53, no. 4 (2002): 709-716; Vella, M.A. Warshauer, A., Tortorello, G., et al., “Long-Term Functional, Psychological, Emotional, and Social Outcomes in Survivors of Firearm Injuries,” JAMA Surgery 155, no. 1 (2019), available at <https://jamanetwork.com/journals/jamasurgery/fullarticle/2755361> (last visited August 21, 2020); Schwab-Stone, M.E., Ayers, T.S., Kasprow, W., et al., “No Safe Haven: A Study of Violence Exposure in an Urban Community,” Journal of the American Academy Child & Adolescent Psychiatry 34, no. 10 (1995): 1343-1352; Santilli, A., O'Connor Duffany, K., Carroll-Scott, A. et al., “Bridging the Response to Mass Shootings and Urban Violence: Exposure to Violence in New Haven, Connecticut,” American Journal of Public Health 107, no. 3 (2017): 374-379.CrossRefGoogle ScholarPubMed
Ranney, M., Karb, R., Ehrlich, P., Bromwich, K., Cunningham, R., and Beidas, R.S., “What Are the Long-Term Consequences of Youth Exposure to Firearm Injury, and How Do We Prevent Them? A Scoping Review,” Journal of Behavioral Medicine 42, no. 4 (2019): 724-740.CrossRefGoogle Scholar
See Bielopera et al., supra note 1.Google Scholar
Valerio, M.A., Rodriguez, N., Winkler, P., et al., “Comparing Two Sampling Methods to Engage Hard-to-Reach Communities in Research Priority Setting,” BMC Medical Research Methodology 16, no. 1 (2016):146.CrossRefGoogle Scholar
Hewitt-Taylor, J., “Use of Constant Comparative Analysis in Qualitative Research,” Nursing Standard 15, no. 42 (2001): 39-42.CrossRefGoogle Scholar
Dedoose Version 8.0.35, web application for managing, analyzing, and presenting qualitative and mixed method research data, available at <www.dedoose.com> (last visited August 21, 2020).+(last+visited+August+21,+2020).>Google Scholar
Havron, W.S. 3rd, Safcsak, K., Corsa, J., Loudon, A., and Cheatham, M.L., “Psychological Effect of a Mass Casualty Event on General Surgery Residents,” Journal of Surgical Education 74, no. 6 (2017): e74-e80.CrossRefGoogle Scholar
Glasofer, A. and Laskowski-Jones, L., “Mass Shootings: A Call for Nursing Awareness and Action,” Nursing 48, no. 12 (2018): 50-55; Willis, J. and Philp, L., “Orlando Health Nurse Leaders Reflect on the Pulse Tragedy,” Nurse Leader 15, no. 5 (2017): 319-322; Sofer, D., “Respohnding to Mass Shootings: Are Hospitals-and Nurses-Fully Prepared?” American Journal of Nursing 118, no. 9 (2018): 18-19; Turner, C.D., Lockey, D.J., and Rehn, M., “Pre-hospital Management of Mass Casualty Civilian Shootings: A Systematic Literature Review,” Critical Care 20, no. 1 (2016): 362.Google Scholar
See generally, Cohen, G., Crespo, A.M., and White, D.B., “Potential Legal Liability for Withdrawing or Withholding Ventilators During COVID-19,” JAMA 323, no. 19 (2020).CrossRefGoogle Scholar
See Institute of Medicine, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report (2009).Google Scholar
See Office of Civil Rights, Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency, DHHS (2020), available at <https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html> (last visited August 21, 2020)+(last+visited+August+21,+2020)>Google Scholar
Meindl, J.N. and Ivy, J.W., “Mass Shootings: The Role of the Media in Promoting Generalized Imitation,” American Journal of Public Health 107, no. 3 (2017): 368-370.CrossRefGoogle Scholar
M.L. Ranney et al., supra note 9; Mozaffarian, D., Hemenway, D., and Ludwig, D.S., “Curbing Gun Violence: Lessons from Public Health Successes,” JAMA 309, no. 6 (2013): 551-552.Google Scholar
Tourangeau, R. and Yan, T., “Sensitive Questions in Surveys,” Psychological Bulletin 133, no. 5 (2007): 859-883.CrossRefGoogle Scholar