Lessons Learned

While we believe the residents and the program were well-prepared for the patient-care aspects of this tragedy, we were not adequately prepared for the emotional toll this event would take on them. Immediately after the shooting, the hospital began extensive counseling efforts for all employees. As a program, we held a two-hour group debriefing and counseling session led by our physician coach, who is a PhD. Psychologist.


Shortly after the mass casualty, we surveyed our residents and looked at their emotional response to this event. While our sample size was too small to reach statistical significance, we found a high rate of major depression and post-traumatic stress disorder in our residents. This finding was not isolated to those residents who worked the night of the shooting. In addition, we found a high level of guilt in those residents who did not work the night of the shooting. Several of our residents sought additional counseling to help them deal with the emotional toll. The support we as a program received from the hospital and the hospital system was incredible. They continue to devote resources towards the well-being of our residents.   


As a program, we have recognized that we were not well-prepared for the media/social media response. Social media has become an outlet for decompression in recent times. Times of joy and times of peril are often posted in various social-media platforms. Social media is an excellent outlet for some individuals. After an event such as the Pulse shooting, social media posts ranged from tempered and appropriate to those that likely crossed the line of what would be viewed as acceptable. While we have a social-media policy in place, many of those individuals who posted felt they stayed within the lines of the policy. It was necessary to curtail some of the posts as they were viewed as being inappropriate. In those situations, we found the residents involved felt stifled or censored. It was essential to explain to them that this event was bigger than any one person’s involvement and that consideration on all fronts, social media included, needed to respect the victims, the community, the hospital system and the providers.


While social media presented various issues, the mainstream media posed others. At the initial onset of the media response, residents and their families were contacted directly by the national news media. This was in direct response to some of the social media posts that had been picked up by the mainstream news. The media policy for employees states that all requests for news interviews must be processed by the hospital’s media relations department. We found that early on numerous interviews were conducted outside of the hospital policy, and had to discuss its specifics with our residents. When we surveyed our residents, they tended to feel that the media response was overwhelming.