Emily Mongan

Here at McKnight’s, stories about workplace violence and active shooter situations come across our radar from time to time. And when they do we try to approach them from somewhat of an educational angle, asking experts how such an event could happen and what providers could do to prevent them or — God forbid — handle them if they happen within their facility.

But attendees at the National Association of Directors of Nursing Administration in Long Term Care’s annual conference in Orlando last week experienced a different perspective on the active shooter education — one from someone who has survived such a situation.

Betty Brunner, BS, RN, NHA, CDONA, FACDONA, had an appointment at Azana Salon & Spa in Brookfield, WI, one Sunday morning in October 2012. Brunner’s appointment came during a trying time — her husband had recently been diagnosed with brain cancer, and he had made the appointment for her to recharge and take a brief break from the chaos in their lives.

Instead, shortly after sitting down in her stylist’s chair, Brunner found herself in the middle of a shooting rampage that would end with three people killed, four injured, and the gunman dead of a self-inflicted gunshot wound. The shooter, Radcliffe Haughton, was the estranged husband of Brunner’s stylist, Zina, who had recently been granted a restraining order against him but was shot dead.

Brunner dove to the floor of the salon and remained there during the ordeal, with Haughton at one point stopping to grab items out of a backpack he had dropped near her head. Haughton eventually went up to the second floor of the salon where other workers and patrons had barricaded themselves, leaving Brunner to wait for a SWAT team to arrive and give her the signal to run from the building to waiting authorities.

In her NADONA session “When Seconds Count,” Brunner stressed to audience members that situations like the Azana shooting can happen anywhere, at any time. But for those in the long-term care industry, Brunner especially emphasized the importance of keeping their guard up.

“Think about this in the work setting,” Brunner asked the audience. “I cannot tell you since this has happened to me how many people walk up to me and tell me about spouses, boyfriends, that have shown up at their nursing homes. The violence that has happened, the murders that have occurred in nursing homes. Why? Because we let our guard down.”

Haughton had visited Azana before and knew the layout of the salon before he entered on that Sunday. It’s a fact to keep in mind the next time a significant other is allowed to walk into a nursing home to deliver a forgotten lunch to a nurse, Brunner said. The warning we’ve seen in airports or on subways applies here, she said: If you see something, say something.

“We talk about, ‘Oh, there’s a disruptive family member.’ Start looking at employees too,” she advised. “Your life depends on it, your staff’s lives depend on it, your residents’ lives depend on it.”

But proactive policies and keeping a close eye on staff members’ relationships don’t always guarantee a violent situation will be prevented, like in the case of last month’s shooting at an Ohio nursing home that left two employees and a police officer dead.

For those who find themselves involved in an active shooter or similar situation, Brunner brought tips collected through her own experience and from her husband, who had worked as a police officer. First and foremost, get low.

“Shooters don’t look down, shooters look out because they’re trying to do their damage,” Brunner shared. “The first thing you always remember, you get down as quick as you can.”

She also advised taking everything in — what the shooter is saying, knowing what kinds of weapons or supplies they have on them, where they are — but “creating your own world” and not being a part of theirs by responding or trying to intervene. From there, “play dead,” Brunner said, and wait for the “new people in charge” — the first responders.

Other tactics, like knowing routes out of the building, always having a phone on hand to call 911 and barricading yourself in a room when escape isn’t possible, also can help in surviving such situations, Brunner said. And in the aftermath, having a strong support system and taking time to heal is crucial.

“Something that we all have to remember is that we don’t believe it can happen to us, because we’re all really good people,” Brunner told the audience. “What I found out was whether you’re good or bad doesn’t matter. Things happen and it’s how you handle it. If it can happen to me, it can happen to you.”

For more information on handling active shooter emergencies in healthcare facilities, click here.

Follow Emily Mongan @emmongan.