The Pennsylvania Capitol building on Tuesday, May 24, 2022. (Photo by Amanda Berg for the Capital-Star).
It’s the smell of blood and the stench of charred flesh that stays with medical professionals as they go from one trauma patient to another – often with a smile on their lips, “as if our subconscious wasn’t in the midst of its battle,” fighting what we just saw, and with a painful reality for us,” Dr. Merle Carter told Democratic lawmakers on Wednesday.
That’s why working in health care feels like a “war zone,” Carter, vice chairman of the emergency department at the Albert Einstein Health Network in Philadelphia, told a hearing before the Senate Democratic Policy Committee on secondary effects of gun violence.
“No matter how hard we try, we can’t save everyone,” she said.
Democrats in the Republican-controlled General Assembly passed legislation to reduce gun violence in Pennsylvania, including suggestions establish universal background checks, safe storage requirements, mandatory training for those who want to purchase firearms, reporting of lost or stolen guns, and repeal Uphold the law.
Although their bills have stalled in committees, where Republican chairmen have the power to determine which legislation comes up for a vote, and have failed as amendments in the House and Senate, Democrats are continuing efforts to combat rising gun violence and advance legislative reform.
Legislative Republicans have targeted Philadelphia District Attorney Larry Krasner when it comes to gun violence in Philadelphia, launching an impeachment effort, introducing legislation to limit his tenure to two terms and forming a committee to investigate the rise in crime during Krasner’s tenure. ownership.
“The psychological effects of gun violence can further damage the mental health of our already burned-out professionals on the front lines,” said Sen. Amanda Cappelletti, D-Delaware. “And our younger generations bear the brunt of our inaction.”
After two hours of testimony, Sen. Tim Kearney, D-Delaware, described the speakers’ remarks as “sobering” as they outlined how the epidemic of gun violence has affected society, the physical and emotional toll of gun violence and ways to combat it. crisis.
“When someone is shot, their whole life changes. They face physical, mental and emotional effects that can last the rest of their lives. But the impact doesn’t stop there,” said Alexia Clark, executive director of the Chester Community Coalition, a group that addresses the emotional impact of homicides.
The impact of gun violence extends to family and friends, often changing their lives forever, Clark revealed. The ripple effect continues in the health care system, in communities where the shooting occurs or where the victim lives, among first responders and law enforcement agencies tasked with responding to the scene, Clark added.
Trauma centers have a “well-planned response” to trauma patients, and as much as Carter wants staff to be immune to the emotional toll of their work, that’s not the case.
“Yes, there is a certain degree of numbness in our work. Otherwise, we would not be effective in the work we do,” she said. “We have no choice but to run. You can’t panic and freeze. We can’t leave if it’s too much. Any hesitation on our part can mean certain death for another person. And violence is the antithesis of who we are as doctors, and being exposed to all of that on a daily basis takes a toll.”
In addition to patients and their families — the initial victims of gun violence — Carter said health care workers are the second victims of the epidemic, describing the toll that declaring someone dead takes on personnel who have the means to save lives. but “sometimes, it’s not enough.”
Doctors and support staff face violence and threats, Carter testified. Medical professionals are acutely aware of the epidemic of gun violence. When there is a shooting in their communities, they sometimes know the victims. Although health professionals are not allowed in the room, if the patient is a friend or relative, they know what is going on behind the door.
“You know what the result is when you see the team calmly leaving the trauma room and the heart monitors are now silent,” Carter said, adding that increased stress causes high rates of depression, anxiety, substance abuse and insomnia.
Medical professionals were burning out and some had left the profession. Between 20 and 30 percent of doctors meet the diagnostic criteria for PTSD, Carter said, “and many others meet some but not all of the criteria.”
Albert Davey, executive director and paramedic of Norbert Ambulance in Montgomery County, told lawmakers that over the past five years, he’s seen more people seek help than ever, handing out more employee assistance programs than ever.
The COVID-19 pandemic has taken its toll on emergency medical workers. But in discussions with psychologists, Davey said the main problem arose in situations where people were in dangerous places, often arriving before fire and police could respond. With help from the county, they have deployed bulletproof vests for first responders, but they are adjustable, not fitted.
“If you’re trying to dodge projectiles, the fit has to be pretty good,” Davey said, adding that EMS providers are also limited in training and simulation budgets.
His team managed “this growing challenge only with additional outside training and funding.”
“Every ambulance is being asked to go on their own,” he said. “If you look at what Pennsylvania is, that’s 1,200 additional EMS agencies. Some of them perform together. Some of them are fighting to stay. We’ve lost about a quarter of our ambulance companies across the state.”
Davey urged lawmakers to push for red flag laws that allow police, family members or doctors to petition state courts to temporarily remove firearms from those at risk to combat the rising suicide rate. He also advocated centralized resources, suggesting that county and state aid should be the starting point.
Leah Brogan, a licensed clinical psychologist, outlined how increased gun violence has affected children across Pennsylvania, citing poor youth mental health outcomes such as anxiety, depression, post-traumatic stress disorder, social withdrawal, irritability and disruptive behavior.
School shooting drills and training are not the answer, she told lawmakers.
She cited an approach used by the Center for Violence Prevention to combat violence, which includes interventions and prevention measures such as addressing behaviors that lead to gun violence. These include efforts to reduce injuries from assaults, bullying and aggression in schools, prevent suicides and reduce levels of family violence.
Delaware County State’s Attorney Jack Stollsteimer, a Democrat, told lawmakers that cooperation at the local level should be the first step in fighting gun violence. He cited the Chester County Partnership for Safe Neighborhoods in Delaware County, which has implemented a deterrence strategy to mitigate violence by fearing certain sanctions and offering benefits to those most at risk.
“We offer vocational training, education and mental health support,” he said. “But when these individuals break the law, the police take prompt action.”
In the first year, CPSN reported 42 fewer shooting incidents than in 2020 and 88 fewer in 2017, Stohlsteimer testified. He’s also supported fun law reform, promoting legislation that would ban ghost guns and mandate reporting of lost and stolen firearms.
“We can and must reduce the supply of illegal guns without violating our Second Amendment rights,” he added.