The burning issue of gun control has plagued our society and negated the lives of many, both as victims of gun violence and as families left to bear the pain of losing a loved one to the senseless act of another person.
America is a free society, however, where the respect of an individual’s right to confidentiality has presented its advantages, and sometimes costly disadvantages, such as the defeat of national gun reform legislation that might have prevented the senseless shootings across the country the past few decades from being repeated.
Others will disagree, but the freedom to own firearms protected by the Second Amendment to the U.S. Constitution has arguably become a deadly epidemic that is fast eating into the fabric of our society.
So what then do tougher gun laws passed in states like New York and Connecticut since the tragic shooting at Sandy Hook Elementary in Newtown, Conn., portend for our communities, and more specifically, the role of nurses and other healthcare professionals in curbing this menace to society known as gun violence?
Individual vs. Community
Since the Sandy Hook tragedy, healthcare providers are being encouraged more than ever before to understand the issue of mental health and its relationship with violent behavior, in addition to realizing that a closer look needs to be taken at existing nursing assessments to include specific questions about firearms.1
The adoption of the new gun control legislation passed by the State of New York and signed into law by Gov. Andrew Cuomo also provides some guidance. It states in part that a mental health professional who determines a gun owner is likely to hurt himself or others that risk must be reported and the gun removed by law enforcement.
This new gun law, which includes the nation’s toughest ban on assault weapons, also creates an opportunity for nurses and mental health professionals to brace up and fight to reclaim a safer community for ourselves and our children.
Nurses have long been known as the glue of the healthcare system due to their ability to not only assess a patient’s current overall health, but also prognosticate their future through cues and data collected from spending more time at the bedside than any other caregiver.
As a result, progressing the issue of gun control will not be completely possible without having the input of and collaboration between nurses and other caregivers.
Notifying authorities about cases of a possible or confirmed patient with mental illness who may present a risk to themselves or society becomes a duty for all healthcare providers. This is the paradigm for making ethical decisions as identified by Kidder (2009), i.e., weighing the right of a person to own a gun versus the safety of the community, who are the potential victims of gun violence.3
An ethical dilemma for nurses is making the patient with mental illness feel he is being stripped of his right to own a gun, for the greater good of society.
But consider that the Second Amendment states in part that it is the need for a “well-regulated militia necessary to the security of the State,” which grants the right of the people to keep and bear arms. The term “well regulated” is one the government and healthcare providers alike can argue carries the criteria for oversight and intervention, such as seen in the regulation of alcohol and other controlled substances that put individuals and others at risk.
Still, one fact that is clear in the gun control discussion is that we all realize and accept that something critical needs to be done to curb gun violence.
However, restricting the bond of trust between the patient and provider will, in fact, make it harder for the mentally ill to seek medical care.
This conundrum also makes it paramount for lawmakers to address the evident lack of resources for mental health services, treatment and follow-up, especially as it pertains to youth.
Better Mental Health Access
In order to craft a proper balance, I believe there is the need to come up with a sensible program that avoids creating circumstances that will ultimately prevent those who need and want mental health services from seeking them. This is where healthcare professionals should be seriously involved.
At the same time, there needs to be legislation passed that protects nurses from being fired or demoted when they report problems or threats to patient safety, or threats to society, as a result of the mentally ill patient who has access to firearms.
Nurses have a duty to their patients and must be empathetic in administering care. Yet, they owe a higher duty to protect the society as a whole ultimately.
By collecting data, identifying patients with mental illness who pose a risk to themselves and others, and passing on that information to the appropriate authorities, nurses can help curb the plague of gun violence.
References for this article can be accessed here.
Judith Egwuogu is a staff nurse at Montefiore Medical Center in New York, NY.