Should You Ask About Firearms?

Lisa Wolf, the director of ENA’s Institute of Emergency Nursing Research, on Thursday, laid out the unvarnished results of a survey that suggests as much as two thirds of emergency nurses don’t routinely ask if patients have or carry firearms.

Some nurses in the survey and two follow-up focus groups said they felt the question was too confrontational, and they feared they would become victims of workplace violence.

“If patients would punch me, why wouldn’t they get a gun and shoot me,” Wolf relayed as a sentiment shared by many of the nurses surveyed. “We found that nurses were more afraid of patients than for their patients,” Wolf said.

The group of about 20 nurses who attended Wolf’s session “Emergency Nurses’ Perceptions of Risk from Access to In-home Firearms,” all said they’d experienced workplace violence.

Wolf identified a number of barriers related to asking patients about firearms, including a lack of clear direction with the information provided.

Nurses asked “What do I do with that information?” and “Will I be liable if my patient does something after leaving my ED?”

But Wolf didn’t just present the questions. She also offered some recommendations for emergency nurses dealing with the trepidation of asking about patients’ access to guns during an exam. Normalize or standardize the assessment of firearms access by asking all patients under the auspices of public health, she said.

She suggested emergency departments should design standard protocols for patients who screen positive for risk and access to firearms, provide additional staffing to help assess such risk and implement strategies to improve the safety for patients and nurses through firearms injury prevention education and preparedness training.