Is there a Cure for Gun Violence?

gun-violence.pngThere’s no doubt that gun control is a hotly debated topic today. Supporters of tight gun control argue that access to guns is too easy. Those on the opposition believe it is unconstitutional and that despite a rise in gun ownership, gun homicide rates have dropped. Irrespective of this debate, the statistics are staggering. There have been over 200 mass killings (defined as four or more victims) in the United States since 20061. The rate of people killed by guns in the U.S., is almost 20 times higher compared to similar socio-economic countries in the world. It is clear that Americans experience too many senseless deaths associated with firearm violence and that we need to work harder to find a solution to this devastating problem.

According to the Centers for Disease Control and Prevention (CDC), in 2013 there were 33,636 deaths attributed to firearms or 10.6 deaths per 100,000 Americans2. That same year, there were 33,804 motor vehicle traffic deaths or 10.7 deaths per 100,0002.  Auto accidents have declined over the last several decades largely due to mandatory education and government regulations. You cannot drive without first taking a driver’s test, acquiring a license and paying for car insurance. In addition, your car must pass emissions and inspection testing on a regular basis. Guns manufactured in the U.S. do not need to pass federal safety standards.

Last week President Obama proposed “executive actions” on gun violence, a set of recommendations to close loopholes in gun control legislation in an effort to prevent future mass shootings. A few of the initiatives include increasing mental health treatment, improving universal background checks, requiring gun dealers to be licensed and keep formal sales records, and advancing technology on safety locks and “smart guns” that can only be fired by the registered owner. The presidential proposal will likely meet resistance and possible reversal should Americans elect a Republican in the upcoming election.

Regardless of the outcome of the new gun control initiatives, what role can healthcare providers play?  Nurses, who often treat victims of violent crimes and their family members, are uniquely trained to promote safety, public health and education. Several nursing organizations have issued position statements on gun control, including the American Nurses Association (ANA) and the National League for Nursing. In addition, over 30 nursing organizations signed a call-to-action letter to national, state, and local governments requesting better access to mental health services, a ban on assault weapons, and other gun control reforms.

The following recommendations could help us come closer to finding a cure for gun violence.

 

  1. Increase access to mental health programs for individuals, families, and students from elementary school through college:

    a. While the majority of people with mental illness are not violent, serious psychosis and schizophrenia combined with substance abuse could lead to erratic behavior. Funding should be increased to train nurses and health professionals to recognize signs of violent tendencies, as well as community and hospital based psychiatric care, housing, and access to medications.3

  2. Include a gun safety assessment as part of routine health screenings for all patients:4

    a. Several states continue to propose legislation to ban practitioners from documenting gun ownership in the patient’s record. However, the American Academy of Pediatrics endorses counseling parents on gun safety measures.This philosophy is also supported in adult dementia and elderly patient populations.

  3. Develop and implement Evidence-based Hospital Violence Intervention Programs focusing on:

    a. Intimate partner violence

    b. Behavioral health including anti-bullying

    c. Substance use

  4. Improve Community engagement/outreach and education programs with initiatives targeting:

    a. Life skills

    b. Anger management

    c. Conflict resolution

    d. Suicide prevention

    e. Violence prevention programs: successful research-based community programs that have proven to decrease homicide rates include Cure Violence, Aim4Peace and Wraparound Project.6

  5. Gather more data, conduct research and educate families on how to best protect themselves and their families from gun injuries:4

    a. Keep guns away from household members who would not safely use them such as children or people with dementia.

One measure alone is not the answer. Rather multiple strategies implemented in our local communities, within the mental health system, and ultimately at the federal level are needed to make an impact on the number of gun-related fatalities. We as a society need to strike a balance between maintaining individual constitutional rights and protecting the lives of each and every American. Perhaps by focusing on empathy, public health, and education we can change our culture, protect our freedoms, and save lives.

 


References:
  1. Overberg, P., Hoyer, M., Hannan, M., Upton, J., Hansen, B., & Durkin, E. (2013) Behind the Bloodshed: The Untold Story of America’s Mass Killings. USA Today. Retrieved from http://www.gannett-cdn.com/GDContent/mass-killings/index.html#title
  2. Centers for Disease Control and Prevention (2016) FastStats; All Injuries; Motor vehicle traffic deaths; All firearm deaths. Retrieved from http://www.cdc.gov/nchs/fastats/injury.htm
  3. The American Nurses Association. (2016) Call to end violence. The American Nurse. Retrieved from http://www.theamericannurse.org/index.php/2013/03/01/call-to-end-violence/
  4. Domrose, C. (2013) Nurses debate their role in firearm safety education. Nurse.com. Retrieved from https://news.nurse.com/2013/04/08/nurses-debate-their-role-in-firearm-safety-education-2/
  5. Graziano, M. & Pulcini, J. (2013) Policy & Politics: Gun violence and the role of healthcare: A confusing state of affairs (2013). The American Journal of Nursing. 113(9). Retrieved from http://www.nursingcenter.com/JournalArticle?Article_ID=1590663&Journal_ID=54030&Issue_ID=1590611
  6. Jacobson, J. (2015) A cure for gun violence. The American Journal of Nursing. 115(4). Retrieved from http://www.nursingcenter.com/JournalArticle?Article_ID=2794833&Journal_ID=54030&Issue_ID=2794782

 Myrna B. Schnur, RN, MSN


 

Posted: 1/12/2016 10:08:21 AM by Lisa Bonsall, MSN, RN, CRNP | with 3 comments


Comments
Gun Transfer
The best thing to do is to have gun awareness. Knowing your responsibility upon buying a gun is very important.
11/12/2016 6:53:51 PM

Myrna B. Schnur, MSN, RN
Thank you for your comments. The last sentence has been revised. I was in error in stating that guns manufactured in the US do not need to pass safety standards or testing. There are safety standards set forth by industry organizations (non-government) such as The Sporting Arms and Ammunition Manufacturer’s Institute (SAAMI). The federal government however does not have jurisdiction over the regulation of gun manufacturing as a consumer product and therefore safety standards and testing. The Consumer Product Safety Commission (CPSC) is the arm of the federal government charged with protecting the public from unreasonable risks of injury or death associated with the use of thousands of types of consumer products under the agency’s jurisdiction.1 Section § 3(a)(1)(ii)(E) of the CPSA excludes from the definition of “consumer product” “… any article, which, if sold by the manufacturer, producer, or importer, would be subject to the tax imposed by section 4181 of the Internal Revenue Code of 1986 [26 U.S.C. article 4181] (determined without regard to any exemptions from such tax provided by section 4182 or 4221, or any other provision of such Code), or any component of any such article {firearms and ammunition}1. The CPSC cannot make a ruling or order that restricts the manufacture or sale of firearms, fire-arms ammunition, or components of firearms ammunition.1 https://www.cpsc.gov/PageFiles/105435/cpsa.pdf
According to the 2000 report issued by the US Department of the Treasury, Bureau of Alcohol, Tobacco & Firearms, on Commerce in Firearms in the United States; Working for a Sound and Safer America Through Innovation and Partnership2: “Federal law does not require all sellers of guns to obtain a Federal firearms license. The Gun Control Act of 1968 (GCA) specifically provides that a person who makes “occasional sales, exchanges, or purchases of firearms for the enhancement of a personal collection or for a hobby, or who sells all or part of his personal collection of firearms” is not required to obtain a firearms license2. Non-licensed sellers are prohibited from knowingly selling a firearm to a person prohibited by law from possessing a firearm. However, they are not required to conduct Brady background checks, or maintain records that permit the firearm to be traced if it is recovered by law enforcement officials in connection with a crime.2 (page 11). In modifying the Federal firearms licensing system in 1993 and 1994, Congress added more safeguards to ensure that only legitimate gun dealers obtained Federal licenses.2 Unlicensed sellers do not have the same obligations as licensed firearms dealers to perform Brady checks and maintain records available for examination by ATF and other law enforcement agencies.”2 (page 19) “Federal law does not require unlicensed sellers to preserve transfer records, nor are gun owners required to keep a record of the serial number of their firearms or to report lost or stolen firearms.”2 (page 26)
1. Consumer Product Safety Commission (2011). Consumer Product Safety Act (Codified at 15 U.S.C §§ 2051−2089). Retrieved from https://www.cpsc.gov/PageFiles/105435/cpsa.pdf
2. Department of the Treasury, Bureau of Alcohol, Tobacco & Firearms. (2000) Commerce in Firearms in the United States: Working for a Sound and Safer America through Innovation and Partnership. Retrieved from http://www.joebrower.com/RKBA/RKBA_FILES/GOV_DOCS/BATF_report_020400.pdf
1/20/2016 1:16:24 PM

Tim Brooks
Your article is factually incorrect and reinforces an untrue theory that has been perpetuated for far too long. The last line in your first paragraph says; "Guns manufactured in the U.S. do not need to pass safety standards or testing and gun dealers are not required to hold a license, conduct background checks or track sales." U.S. gun manufactures are one of the most closely regulated industries in this country. Additionally any person or organization that sells firearms as a business is required to be licensed and must conduct a federal background check on all transactions including those conducted over the internet or at gun shows. They must also keep accurate records on all sales for as long as they are in business and for 15 years after. Your lack of research is either appalling or intentional, either way perpetuating these myths is a grave disservice to your readers and calls into question the reliability of Lippincott's editorial staff.
1/19/2016 11:48:22 AM

Subscribe