The recent spate of mass shootings, including an incident that claimed four lives at a Tulsa hospital, is driving efforts to enact new safeguards for health workers and enhanced penalties for individuals who use dangerous weapons on medical campuses.

Why it matters: Hospital trauma departments are on the front lines whenever there’s a mass shooting, but when those spaces are targeted, staff must mobilize to not only protect their patients but also themselves.

  • And yet, efforts to fortify health facilities could also conflict with their traditional roles as community resources and safe spaces.

Go deeper: From 2010 to 2020, shootings resulted in 39 deaths at health care facilities accredited by the Joint Commission. From 2000 to 2011, researchers found there were 154 hospital-related shootings in the U.S.

  • A survey from the American College of Emergency Physicians in 2018 concluded that nearly half of emergency room doctors have been assaulted at work.
  • COVID-19 and the fractious debate over masks and vaccines has only exacerbated tensions.
  • “The pandemic made the workplace more tense, particularly for emergency departments,” Jennifer Schmitz, president of the Emergency Nurses Association, told Axios.

Driving the news: Bipartisan legislation introduced in the House this week would give health workers the same kind of protections as flight crews and airport workers and impose new federal penalties for individuals who use a dangerous weapon to assault or intimidate hospital employees.

  • “Our workforce is enduring historic levels of stress and violence as they continue to provide compassionate, quality care,” said Rick Pollack, president of the American Hospital Association, which pushed for the effort.
  • The measure would make exceptions for individuals who may be mentally incapacitated due to illness or substance use.

The big picture: Violence against health care workers existed long before the pandemic.

  • In 2016, OSHA released guidelines for hospitals to prevent workplace violence, including ways hospitals can identify their risks and implement solutions.
  • The guidance called for steps like adding panic buttons, video surveillance and bulletproof glass, giving employees special emergency training and rethinking how workplaces are designed.
  • The Emergency Nurses Association and the American College of Emergency Physicians now want Congress to require OSHA to set a standard requiring hospitals to write and implement violence prevention plans.
  • The House passed a version of this bill last year and Sen. Tammy Baldwin (D-Wis.) introduced a similar measure in the Senate last month.

Between the lines: But there are still questions about how much security is too much — and over the merits of new mandates.

  • Many hospitals already employ guards at entrances and have systems that alert employees to armed intruders.
  • A 2018 shooting at Chicago’s Mercy Hospital & Medical Center touched off a debate over whether a one-size-fits-all approach to security is appropriate, the Chicago Tribune reported. Not all hospitals installed metal detectors despite a push by some state lawmakers to require it.
  • Efforts to limit the number of visitors on hospital grounds also can run counter to evidence that patients have better outcomes when they have family and friends close by.
  • COVID often forced health care workers to become middlemen, communicating by phone with family members separate from hospitalized loved ones.
  • This often created a stressful dynamic for health care staff, Schmitz said.

The bottom line: While hardening defenses against active shooters or increasing penalties for violent behavior may help, they don’t address the underlying cycle of gun violence.

Roy Guerrero, a pediatrician who was present at Uvalde Memorial Hospital on the day of the mass shooting at Robb Elementary School, asked the House Oversight and Government Reform Committee this week to reform the nation’s gun laws.

  • “My oath as a doctor means I signed up to save lives: I do my job, and I guess it turns out I am here to plead and beg you to please, please do yours,” Guerrero told lawmakers.

Following the Tulsa shooting, Pollack called on lawmakers to take action.

“Legislators are working on a bipartisan effort to address gun violence, and we urge them to act quickly,” Pollack said in a statement.

“It’s so much bigger than that, even that piece of legislation isn’t going to prevent all of it, but it’s a step towards having it happen less,” Schmitz said.