When active shooter drills become the threat: Organizational trauma and nursing implications

Healthcare organizations increasingly implement active shooter drills for emergency preparedness, yet research rarely examines how poorly coordinated drills may cause workplace trauma.

This study examined healthcare staff experiences following an inappropriately conducted active shooter drill at a healthcare facility providing inpatient behavioral health care for children and adolescents.

A qualitative descriptive design analyzed deidentified statements from 88 healthcare workers collected 8 months post incident. Inductive thematic analysis identified patterns across experiences.

Five themes emerged: organizational chaos and communication breakdown, immediate physical and emotional responses, pressure to resume normal duties, development of trauma symptoms, and long-term professional disruption. Many participants reported clinically significant symptoms, career instability, and loss of institutional trust.

Poorly coordinated preparedness drills without trauma-informed planning can cause lasting harm to staff well-being, patient care, and organizational trust. Healthcare systems must integrate trauma-informed principles into emergency preparedness to protect psychological safety.