Nurses and Mass Shootings | The Nurse Keith Show, EPS 129

In the aftermath of the October 2017 Las Vegas mass shooting, I feel a need to respond to what happened in relation to the nurses and healthcare professionals who are impacted by such events. With more than 250 mass shootings in the U.S. in the first nine months of 2017, the healthcare community is at the center of response efforts when large numbers of people are violently injured en masse.


I need to give some shout outs here in terms of the Las Vegas shooting:

  • First responders
  • Law enforcement and fire fighters
  • Courageous civilians who helped each other
  • Hospital staff who went above and beyond (University Medical Center, Dignity Health St. Rose Dominican, Mountainview Hospital, Sunrise Hospital & Medical Center, and other facilities)
  • Private ambulance companies

Gun-related deaths are the third major cause of injury-related fatalities in the United States, and there were more than 36,000 deaths related to firearms in the U.S. in 2015. The CDC says that gun-related injuries cost more than $25 billion between 2006 and 2014.

As nurses and healthcare professionals, there are many things to consider:

  • How prepared am I for the horrific?
  • What skills am I prepared to put into action if I’m on the scene when a mass casualty event occurs?
  • What related skills do I need to improve and refresh — or learn for the first time?
  • If I wouldn’t or couldn’t help out with immediate hands-on trauma response, do I have other skills that might be helpful? (eg: crisis debriefing, logistical support, etc)
  • What organizations doing this type of work would I like to support?
  • Is there more I can do in preparation for these types of situations, either as a citizen or as a healthcare professional?

And when it comes to your workplace, here are some more questions to ponder:

  • Is my workplace prepared for mass casualties and other disaster scenarios?
  • Does my place of employment carefully prepare and run drills in anticipation of these types of circumstances?
  • If myself and my colleagues were called on to respond to such an event, would our employer provide aftercare and crisis debriefing for us?

Vicarious Traumatization

In a recent blog post about mass shootings and nurses, I wrote the following:

When a nurse, doctor, fire fighter, police officer, or other responder interfaces with some aspect of a mass casualty event, those individuals’ lives can be inextricably altered. Vicarious traumatization involves the empathic response and countertransference experienced by rescue workers, first responders, ER staff, or anyone who has witnessed, or attempted to mitigate, the suffering of others.

Being faced with two hundred incoming patients with acute bullet wounds from an active shooter can be overwhelming on multiple levels for a nurse in the ED. For those with experience in combat, this may not seem so far-fetched, but to a nurse who has only seen normal emergency department scenarios, a mass casualty can be an entirely different experience.

When I was living in Western Massachusetts, my wife and I were trained in a crisis debriefing model developed by the military and subsequently adapted for civilian use. We provided emergency debriefings following a rape, a murder, and even a bank robbery, This type of intervention following a trauma can be very helpful for victims, for responders, as well as others experiencing a more peripheral impact of these types of events.

Vicarious traumatization feels as real as any other trauma, and healthcare workers and first responders need trained professionals to walk them through a debriefing process that moves them in the direction of healing. After all, healed healthcare workers are healthy and productive healthcare workers.

Volunteering as a Nurse

Consider your options as a nurse volunteer. Sure, volunteering is a great resume-builder, but it’s really about giving back and contributing to society. Do you want to volunteer? Do you want to learn skills that can be utilized in times of mass trauma or disasters? A recent episode of RNFM Radio digs deep into this idea, and check out episode 124 of The Nurse Keith Show for more about nurse volunteerism.

It’s Not All About Careers

This whole issue of mass shootings isn’t really a career issue per se, but when it comes to nurses’ careers, we need to look at all of the permutations of what it means to be a healthcare professional in the 21st century.

Some people make a career out of disaster response and emergency preparedness, and that’s certainly a route to take. Others have a side volunteer career where they do local, regional, national, or international work as a means of giving back to society and making a contribution.

Your career decisions about these areas of being a nursing professional has to do with what skills you’d like to develop in order to be useful in emergencies, and whether or not you’d like to volunteer either on an ongoing basis (like being a member of the Medical Reserve Corps), or being at the ready when the going gets rough and you’re needed in response to specific events.

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Be well, dig deep, and keep in touch!

Keith Carlson, RN, BSN, NC-BCKeith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind and the well-known blog, Digital Doorway.

Keith is co-host of, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses. Keith was previously the resident nursing career expert at

A widely published nurse writer, Keith is the author of “Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century” and “Aspire to be Inspired: Creating a Nursing Career That Matters.”

He has also contributed chapters to a number of books related to the nursing profession, and has written for,, MultiViews News Service, LPNtoBSNOnline, StaffGarden, American Sentinel University, American Nurse Today, Working Nurse Magazine, and other online platforms.

Mr. Carlson brings a plethora of experience as a nurse thought leader, online nurse personality, holistic career coach, writer, and well-known successful nurse entrepreneur.

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