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Uniforms, firearms, and the image of a hospital security officer


First impressions are important in any industry, but for hospital security officers, those initial interactions can have particular implications for deterring crime.

Uniforms, firearms, and the image of a hospital security officer

First impressions are important in any industry, but for hospital security officers, those initial interactions can have particular implications for deterring crime.

An officer projects a certain image to visitors?and prospective criminals?based on the type of uniform he or she is wearing, as well as the tools strapped to his or her waist. Hospital security departments should be aware of how that image is received.

In November 2014, officials at Erlanger Health System, a level one trauma center in Chattanooga, Tennessee, announced that they would disarm security officers who previously carried handguns and replace tactical uniforms with blazers, according to the Chattanooga Times Free Press. In 2011, Erlanger signed a $2.3 million deal with Walden Security for armed guards, but hospital officials said they would choose a new contractor in December.

The decision was met with resistance from hospital staff. A petition claimed that unarmed guards would directly place "employees, patients, and visitors in danger." In the last several months, police have responded to a crowd of more than 40 people outside of the emergency department where a shooting victim was being treated. In a separate incident, a woman reported she was assaulted in the system's parking deck.

In a memo to employees, Erlanger President and CEO Kevin Spiegel indicated that the health system's security force "will continue to be composed of armed, off-duty law enforcement officers and security guards." Hospital guards, he added, will be "wearing blazers and be readily identifiable as security guards, reflecting an approachable, customer-friendly look."

The discussion in Chattanooga has raised an interesting debate about how hospital security officers should present themselves and what tools they should have at their disposal. Hospitals that want to mix safety and security with a friendly, welcoming environment often face these same issues.

"The main consideration is most people confuse security officers with police officers," says Dick Sem, CPP, CSC, president and security consultant for Sem Security Management in Lake Geneva, Wisconsin. "The function of security officers?the industry standard? is they are there to observe, report, and be a deterrent by their presence. They are not there to take on an active shooter."


The benefit of disarming officers

A report published by the International Healthcare Security and Safety Foundation in July 2014 indicates that 50% of security personnel in the hospital setting are equipped with handguns. However, a breakdown of that statistic reveals that the majority of officers equipped with guns are police or sworn hospital employees. Approximately 30% of contracted sworn officers are equipped with a handgun, while both non-sworn hospital and contract officers fall under the 20% mark.

The majority of hospital security officers are non-sworn, says Tony York, CHPA, CPP, chief operating officer of HSS, Inc., in Denver. Typically, hospital security officers are equipped with Tasers, pepper spray, or other non-lethal equipment.

"I think we are starting to see armed security hit its floor and seeing a little bit of a tick upwards," York says. "Most of that is related to the concern with active shooters."

The decision to arm officers depends on the risk factors surrounding an organization, Sem says, but in general he favors non-lethal options like Tasers. Firearms, he says, bring significant liability concerns, which is one of the primary reasons hospital administrations make the decision to disarm officers.

"In my experience, when a security officer fires a gun, more often than not it's for the wrong reasons," he says.

Instead, many hospitals opt for a blended approach to security, with armed off-duty police officers strategically stationed in places like the ED, or specifically designating one armed security officer on each shift.

"That's becoming a more and more common model inside of healthcare," York says.

 A uniform speaks volumes

A crucial element of hospital security is the image that officers project to potentially disruptive visitors and patients. An officer's attire is a major part of that perception.

York says he is not typically a proponent of the "soft-look" uniform (e.g., suit, blazer, polo shirt, etc.) because it offers less visibility. "The [traditional] uniform is a visible presence and it has the psychological deterrent, but it also helps people identify someone they can turn to when they have a need, and I think that's often times lost," he says.

York admits he only knows the details of Erlanger's decision from what has been reported in the media, but he suspects the administration's transition likely reflects its unhappiness with the current security program.

"This is bigger than the security uniform and the equipment they are carrying around on their belt," he says. "I'm quite convinced they are trying to show their organization that they are taking security with a higher level of seriousness then they historically have."

What the soft-look uniforms lack in visibility, they make up for in approachability, and more hospitals are trending toward such uniforms to provide a more welcoming image, Sem says. In many cases, hospitals will use a mix of attires, often placing traditionally uniformed officers in places like the ED, while utilizing officers adorned in blazers in other areas of the hospital to greet patients and maintain a proactive approach to security.

"I've seen security officers in blazers or suits or polo shirts, who, when they have to be assertive and when they have to step into a firmer response role, can do it just as well and they can make just a good impression," he says.

Ultimately, Sem adds, that's a reflection of effective training. Although uniforms certainly factor into the overall perception of a hospital security officer, appropriate de-escalation training usually trumps physical appearance. For example, officers who simply initiate eye contact and acknowledge visitors and patients, regardless of their attire, project a stronger safety and security presence.

"Underneath this mask of customer service there is a psychological deterrent that says, 'I've observed you, I've noticed you, and you didn't just come into this environment and blend in without anyone seeing you,' *" York says. "That's been proven to be very effective, and I think that's what we want to see security officers in today's healthcare environment being focused on instead of just being quiet and shuffling their feet and looking down while waiting on something to happen and they respond. It's more of a proactive patrol."


Communicating security changes to clinicians

When hospital administrators decide to make changes to their security department?particularly when those changes involve disarming officers?it can raise concerns from clinicians. At Erlanger, clinicians signed a petition opposing the security changes. One OB-GYN physician told the Chattanooga Times Free Press that delivery rooms are plagued with outbursts. As a result, communicating and instituting security changes can be a tricky endeavor.

"If you make a change like that, you really have to communicate it to the people in a real positive way, and oftentimes it's not; the administration just seeks changes, and this is the kind of kickback they get," Sem says, referencing the reported pushback at Erlanger.

Switching from armed officers to unarmed officers can be particularly problematic from a public relations perspective, he adds. If a violent event occurs following the change, many will point to the lack of firearms as the reason for the event.

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