Nurses' Questions About Guns Could Save Lives

Alexandra Wilson Pecci, for HealthLeaders Media , April 9, 2013

The national debate over gun violence, firearms legislation, or gun control, (take your pick) is as fraught as the debate over what to call it in t he public square.

While headline–grabbing mass shootings provide recurring triggers for public conversation, there's much less talk about handguns, pistols, shotguns, and rifles in the emergency department, where the devastating effect of guns on human flesh and bone is front and center.

Even the simple question, "Do you have access to firearms?" is one that few nurses and physicians routinely ask suicidal patients. You've got to wonder why not since six in 10 firearm injury deaths in 2009 were suicides, according to the Centers for Disease Control. What's more, 40% of suicide victims "visited an emergency department at least once and often many times" in the year before they died University of Colorado research shows.

Here's what we do know: Researchers from the University of Colorado School of Medicine surveyed 631 emergency department doctors and nurses in eight American hospitals as part of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) trial. They found that the circumstances under which a nurse or doctor would 'almost always' ask suicidal patients about their access to firearms varies widely.

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3 comments on "Nurses' Questions About Guns Could Save Lives"

Gus Geraci, MD (4/19/2013 at 2:19 PM)
Part of the "standard" evaluation of a suicidal patient is, "If you were going to do it, how would you do it?" The rating of suicidality goes WAY up, if the patient says, "Well, I have access to guns and ammunition." That's not the issue. The issue is what to do with that information. Warning friends and family and removing the guns does not remove the risk, because a determined person will find a way. We can not force a person to accept care. Now imagine the person has said they want to kill others...

LJH (4/10/2013 at 10:02 AM)
In my area of rural America, I would guess well over 75% of the population has access to a firearm of some sort - a hunting rifle, shotgun, etc. As an ED nurse for more than seven years, (and a nurse for more than 25) I never asked the question because I assumed the answer would always be yes. And what would I do with the information? Am I allowed to tell the family members of a competent patient that he may have suicidal thoughts, but no specific plan? Do I come out of the room and tell the parents of the 19 year old to lock up their guns with no explanation? How about the woman who lives alone and says she accidently overdosed on her pain meds, then tells me she has a handgun for protection? I'm really unclear what action the study authors believe could be done.

Kent (4/9/2013 at 9:15 PM)
I understand the logic here, and we must do what we can, but a gun is still an inanimate object. We council against smoking (bad for you) and about wearing sun screen (recommended), but do healthcare professionals ask if cigarettes or sun screen are present in the home? Perhaps... But in my experience (and unfortunately both my parents committed suicide); those committed to doing so rarely talk about it (mine did not) and it is easy enough to do without a firearm (sad I know). Remove one inanimate object (gun) from the equation and they will find another means of doing it (knife). Guns are not a public health issue; no more than cars or cheeseburgers or motorcycles (all of which likely kill or injure more people). The improper use of each is at the core of the discussion. Maybe we should consider obtaining licenses for cheeseburgers??




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