No one in the emergency department (ED) expected it to be a busy night. In the days prior, Baltimore (Maryland USA) residents protested the death of Freddie Gray while he was in police custody.
This day, a Monday, the day of his funeral, we were not expecting violent protests or riots. Unfortunately, this was not the case. The events of the evening left a permanent impression on most of us that would not soon dissipate.
My charge nurse and I had each traveled to disaster zones before, such as Hurricane Katrina (Gulf Coast, USA; 2005) and Gaza (Palestine) during the Intifada. In each of these cases, our safety was far from guaranteed.
However, that night was different. When the riots and violence encroached upon our hospital without warning, we had to ensure the safety of our entire department, staff, and patients from an unknown and unpredictable threat.
Our hospital, a large academic medical center, was situated on the opposite side of town from where the protests began. In between treating patients for the usual Monday night emergency medical conditions, we began to hear reports of fires and looting that were moving closer and closer to our facility.
Emergency pages sent to all hospital staff reported that armed, masked men were on the streets close to the hospital. Shortly thereafter, an officer came into the ED to be treated for eye injuries sustained when the windshield of his patrol car was smashed.
At that moment, when injured officers appeared in riot gear and pages about armed, masked men were received, the situation suddenly became real for us.
“We Need to Protect Our Staff and Our Patients”
A team huddle was called in the ED. We worked together to divide tasks, made decisions regarding patient and staff safety, increased security measures, and created staffing and staff care plans for food and rest.
We locked all doors, including the ambulance and ED entrance. Patients were allowed entrance, but no one came in unannounced. Our hospital security stepped up patrols with extra cars surrounding the hospital, and extra security personnel on foot patrols were started directly outside the doors. That night, these security personnel put their own safety at risk for ours and the patients, and no amount of gratitude is too much for them.
Patients in the waiting room were moved away from the front door and any glass. Registration personnel, normally also at the front door, were moved to a safer location.
“No One Leaves or Goes”
Soon, a partial shift change was about to occur. While the violence grew closer, we knew our staff would be getting in their cars and driving to the hospital shortly. We had to make a decision at that moment regarding travel for staff. We knew that some events were close to the hospital and heard some reports of people being taken out of their cars and assaulted. Given this information, we requested that no staff attempt to travel to or from the hospital overnight and made plans to keep all current staff in the ED for their safety.
“We Need to Stay Open”
We made a decision early in the evening to remain open unless the rioters were at the front door. As the night went on, we heard news reports of two buildings engulfed in flames and more looting in our surrounding neighborhood. We also heard of a possible hostage situation not far from the hospital. Our department is a crucial neighborhood resource, and we needed to be open to treat injuries as well as acute medical emergencies.
“The Sun Always Rises”
During the night, we saw patients with every imaginable complaint. Some with injuries came in angry. Some came in laughing after being tased by the police. One lady openly admitted to looting and came in with an injury she sustained during her activities. Another woman came in to be treated for injuries she sustained while trying to discipline her own daughter after she had looted.
One thing that kept us going was an old saying from residency, “the sun always rises.” Thankfully, that morning was no different. As the sun rose, most of us believed we had experienced something that we would never forget, and the immediate threat had subsided.
That morning, the National Guard (Baltimore, Maryland USA) troops arrived to support the hospital. Troops stood in a show of force in the same spot where just previously our own hospital security risked their safety to protect us.
In the light of day, we saw the city we love start to come back to life. Neighborhood families gathered in the streets to clean, and citizens urged that this violence needs to stop. While the final repercussions of the Baltimore riots are yet to be determined, for our department and staff, it brought us closer together and made us stronger than ever before.
