Forensic Nursing in the ER: Gang Violence

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Working in a busy emergency department in a city with one of the highest crime rates in Southern California definitely brings in some interesting clientele.

It was a busy Friday night and I received word as the assigned trauma nurse that I would be receiving a critical trauma victim with a gun shot wound to his chest. The patient arrived with paramedics performing CPR as they entered the trauma room. We worked the patient for about 20 minutes until the trauma surgeon pronounced the patient and our efforts were stopped.

The patient had several very distinctive tattoos as well as the clothing we had cut off of him being characteristic of a local gang.

Gang and drug activity was certainly not a new concept to this emergency room. We prepared the patient for the coroner and I was informed that “his family” was in the lobby. I called them into an area that provided privacy for discussing issues with family members that were sure to be emotional.

There were several Hispanic men with the same type of clothing and tattoos in the room when I entered and I proceeded to inform them that I was very sorry, but that their friend had not survived the shooting incident. The gang members proceeded to become very angry and several of them began punching the walls. One of the members had me up against a cabinet wall and was yelling at me.

They were obviously very distraught and were not handling their emotions well. Several of them were threatening retaliation against the opposing gang members responsible for the death of their friend.

I looked the man directly in the eyes and told him very calmly but quite directly to let me go. I was prepared to come up with my knee into his groin if necessary. I was scared but thankfully able to think rationally. Such a necessary trait of an ER nurse I believe!

I obviously put myself into a very bad situation and should of thought about the potential for violence in this situation.

My first clue should have been with the obvious indications of the patient being a gang member and that his injuries were the result of gang activity that I would be potentially dealing with violent individuals.

The police were apparently still on the scene of the shooting and had not yet arrived to the ER. Before taking the family members into the private room I should have waited for a police escort or in the very least had hospital security with me.

I also did not provide myself “an out” in the small, enclosed room. I think the lesson learned here is that my own safety needed to be a priority and that it is important to look for indications that there is a potential for danger. There were many indications that that was the case. I certainly learned a great deal this night about “looking for clues” that there is a potential for violence.

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