Planning for the Unthinkable

Acts of violence at veterinary clinics remain relatively rare, but owners and staff should be prepared.
Don Vaughan
Published: January 09, 2019
This article was originally posted on AmericanVeterinarian.com

Charles Anthony Smith did not take well the news of his cat’s demise. On October 9, 2014, Smith, 57, showed up at the Maplewood Animal Hospital in Bellingham, Washington, where his cat had died the day before, and stabbed with a kitchen knife the veterinarian who greeted him in the lobby. The veterinarian suffered a puncture wound to the upper chest but was able to free herself from Smith and run to the back of the office. Smith pulled out a second knife and threatened the front-desk staff before fleeing.1

Minutes later, Smith walked into the nearby Fountain Veterinary Hospital, where he had been a client earlier in the year, and stabbed a female employee in the throat. The incident prompted police to urge other regional veterinary clinics to lock their doors until Smith could be caught. Authorities located Smith a few miles from Fountain Veterinary Hospital and apprehended him without incident.1

Smith’s horrific deeds were an isolated incident perpetrated by an emotionally distraught individual, but they demonstrate the unfortunate trend of sudden violence in private and public spaces. Schools, entertainment venues, churches, and businesses—once all considered havens—must now consider and plan for the unthinkable.

According to the US Bureau of Labor Statistics, 5190 fatal work injuries were recorded in the United States in 2016, a 7% increase over 2015.2 Transportation incidents (the largest category) accounted for 40% of fatal events. Violence and other injuries by persons or animals increased by 23% to become the second-most common cause of workplace fatalities in 2016.2

About 500 people are killed at work annually, mostly during robberies, according to workplace violence expert Steve Albrecht, an Association of Threat Assessment Professionals certified threat manager. “Cab drivers, retail employees, police officers, and hospital employees are most at risk from workplace violence,” he said.

TYPES OF WORKPLACE VIOLENCE
The Federal Bureau of Investigation divides work- place violence into 4 categories, each of which poses a potential risk to veterinary practices:3,4
• Type 1 involves offenders who have no relationship with either the victims or the establishments.
• Type 2 involves offenders who are receiving services from the targeted facilities when they commit an act of violence against them.
• Type 3 involves current or former employees acting out toward their present or past places of employment.
• Type 4 involves disputes between an employee and the offender that spill over into the workplace.

Criminals might perpetrate violence while stealing drugs. Clients, distraught over an issue with their pet, might become violent against practice staff, as demonstrated by the incident with Charles Anthony Smith. (In another incident in December 2014, a man shot himself in the parking lot of a veterinary clinic in Tuscaloosa, Alabama, after having his pet euthanized. The bullet passed through the man’s abdomen and struck his son in the forearm.5) Disgruntled employees might return, armed, to settle perceived slights. And former spouses or significant others of staff might show up to settle a domestic dispute. Such an incident occurred in 2011 when a female employee of Carolina Crossing Veterinary Clinic in Benson, North Carolina, was shot in the abdomen by a former boyfriend, who subsequently took his own life.6

In the past, law enforcement attempted to create profiles of individuals likely to commit acts of violence in an effort to stop them before they could act again. This is no longer the case, Albrecht reported. “We have moved away from the idea of profiles and back to behaviors,” he explained. “Workplace violence can be committed by people of all races, ages, and genders. The most common characteristics of those who engage in workplace acts of violence are desire for revenge, depression, no father figure, untreated mental illness, psychopathy, rage-filled narcissism, entitlement, and religious zealotry.”

THE COST OF VIOLENCE
The cost of workplace violence can be high for all involved, the Occupational Safety and Health Administration stressed in a December 2015 report.7 “First and foremost, it harms workers—often both physically and emotionally—and makes it more difficult for them to do their jobs,” the report stated. “Employers also bear several costs. A single serious injury can lead to workers’ compensation losses of thousands of dollars, along with thousands of dollars in additional costs for overtime, temporary staffing, or recruiting and training a replacement. Even if a worker does not have to miss work, violence can still lead to ‘hidden costs’ such as higher turnover and deterioration of productivity and morale.”

Although more violent episodes typically receive greater attention, worker-on-worker bullying or intimidation is by far the most common form of workplace violence and something that all practices should work diligently to prevent. The first step is fostering an environment of trust and respect among workers and between staff and management, noted Workplace Answers, an online compliance training company, in a report on strategies for preventing workplace violence.3 The company also suggested taking steps to reduce negativity and stress in the workplace, establishing procedures for employees to report threats and bullying, and instituting a mediation program to resolve employee disputes in a timely fashion. Employees who bully or intimidate other staff or clients should be terminated immediately.3

There are also steps that practices can take to address threats from individuals associated with employees, such as former spouses and significant others. Foremost, employees should notify administrators when a restraining order has been issued and give a photo of the individual noted in the order to front-desk staff so they will be aware. All telephone and in-office threats should be reported immediately to the police.

Should a distraught individual confront practice staff, there are behaviors that can help diffuse anger, notes the Centers for Disease Control and Prevention. Most important, present a calm, caring attitude, and acknowledge the person’s feelings, the agency advises. Additionally, don’t match threats or give orders, and avoid any behavior that may be interpreted as aggressive, such as moving rapidly, getting too close, or talking loudly.8

PLANNING AND PREVENTION
Although the likelihood of a violent incident at a veterinary practice is statistically low, owners and staff should still have a prevention/action plan in place. Acts of violence tend to escalate very quickly, often with little to no warning, so developing a plan is vital. Ensuring staff and client safety is the primary goal of a workplace violence policy.

Among the most important protocols9:
• Establish a zero-tolerance policy toward workplace violence that includes all workers as well as clients and contractors.
• Establish a zero-tolerance policy regarding weapons in the clinic and on clinic grounds.
• Designate a windowless safe room to which staff and clients can flee if threatened by an individual with a weapon. The door should be sturdy, preferably bullet-proof, and lockable from the inside.
• Train front office staff to recognize—and report— potential preattack behaviors and events, such as threats, multiple office visits by an angry individual, vandalism, confrontations with staff, and arguments over treatment or billing. “Veterinary offices should use access control to keep clients on one side of the counter,” Albrecht advised. “Clients should not be able to go into any part of the practice without an escort.”
• Make sure staff are aware of all office policies specific to workplace violence and understand what to do in each type of emergency. Hold regular practice drills after hours so staff maintain a heightened awareness of potential threats.

SURVIVAL MINDSET
“Realizing that the incident may end prior to the arrival of law enforcement demonstrates the need for workers to take responsibility for their own lives, in part, by developing a survival mindset, which involves being ready (both mentally and physically) for the worst-case scenario,” Federal Bureau of Investigation experts reported in Workplace Violence Prevention: Readiness and Response.4 “While no foolproof strategy exists for surviving an active shooting incident, this type of mindset has the three components of aware- ness, preparation, and rehearsal that can provide a foundation for survival” (Box).3,4

Some practice owners may consider having a gun on premises for defense. However, most law enforcement experts believe that’s a bad idea. Most active shooter events occur very quickly and without warning, leaving staff members no time to get the gun from its lockbox. And even if a staffer is able to retrieve the gun in time, attempting to engage a shooter in the chaos and horror of the moment would likely endanger more lives than it would save.

Workplace violence will always be a possibility; that’s just the world we live in now. But by planning, training staff, rehearsing scenarios, and remaining vigilant, veterinary clinics can effectively prevent violence before it happens and know exactly how to react should the unthinkable occur.










References
1. Hutton C. Police: Bellingham man goes on stabbing spree at vet clinics after his cat dies. Bellingham Herald website. bellinghamherald.com/news/article22251186.html. Published October 9, 2014. Accessed September 24, 2018.
2. Census of fatal occupational injuries summary, 2016. US Department of Labor, Bureau of Labor Statistics website. bls.gov/news.release/cfoi.nr0.htm. Published December 19, 2017. Accessed September 24, 2018.
3. 13 effective strategies for preventing workplace violence. Workplace Answers website. workplaceanswers.com/resources/blog/strategies-preventing-workplace-violence/. Published January 21, 2016. Accessed September 24, 2018.
4. Romano SJ, Levi-Minzi ME, Rugala EA, Van Hasselt VB. Workplace violence prevention: readiness and response. Federal Bureau of Investigation, Law Enforcement Bulletin website. leb.fbi.gov/articles/featured-articles/workplace-violence-prevention-readiness-and-response. Published January 1, 2011. Accessed September 24, 2018.
5. Brown M. Man shoots self, injures son in Tuscaloosa vet clinic parking lot after family pet euthanized. AL.com website. al.com/news/tuscaloosa/index.ssf/2014/12/man_shoots_self_injures_son_in.html. Updated December 2, 2014. Accessed September 24, 2018.
6. Woman shot at Benson vet. WRAL.com website. wral.com/news/local/story/9235691/. Published March 9, 2011. Accessed September 24, 2018.
7. US Department of Labor, Occupational Safety and Health Administration. Preventing workplace violence: a road map for healthcare facilities. osha.gov/Publications/OSHA3827.pdf. Published December 2015. Accessed September 24, 2018.
8. National Institute for Occupational Safety and Health. Workplace violence prevention strategies and research needs. cdc.gov/niosh/docs/2006-144/pdfs/2006-144.pdf. Updated June 6, 2014. Accessed September 24, 2018.
9. Workplace violence. US Department of Labor, Occupational Safety and Health Administration website. osha.gov/SLTC/workplaceviolence/index.html. Accessed September 24, 2018.
10. US Department of Homeland Security. Active shooter: how to respond. dhs.gov/xlibrary/assets/active_shooter_booklet.pdf. Published October 2008. Accessed September 24, 2018.

Don Vaughan is a freelance writer based in Raleigh, North Carolina. His work has appeared in Military Officer, Boys’ Life, Writer’s Digest, MAD, and other publications.

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