What You Don’t Know CAN Hurt You

Abstract

Think for a moment of the research accomplishments of the past 20 years. One has only to look at any sector of health care to be in awe of the changes that have resulted from discoveries made or confirmed through research. New medications abound, robotic surgery is common, treatments unheard of just a decade or two ago now improve the quality of life for hundreds of thousands. These changes extend to injury prevention as well. Consider the influence of research in making automobiles safer, warning us of the dangers of concussion, and the importance of seatbelt use and child restraints. In every issue of the Journal of Emergency Nursing (JEN) there are pages and pages of research findings to inform and improve emergency nursing practice. Yes indeed, research makes a difference in our lives! Now think about what our circumstances would be if there had been no research in the past 20 years. There would be no new techniques, no new diagnostics, and no new pharmacotherapy or treatments. An improved understanding of the world in which we live would be unavailable to us. Clearly, what we wouldn’t know could surely hurt us! Yet that has been the reality when it comes to firearms and actions regarding their sensible use for decades, ever since the United States Congress passed the Dickey Amendment in 1996. The Dickey Amendment stipulates that “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention (CDC) may be used to advocate or promote gun control.” As a result of this legislation, for the past 20 years research related to firearms has been virtually non-existent at the CDC, the Department of Health and Human Services (HHS), and the National Institutes of Health (NIH). The Dickey Amendment continues to be in effect to this day. So it is not a surprise that we as a nation do not have evidence we so desperately need to help us understand and prevent gun violence. What if during the past 20 years there had been research to explore the root causes of gun violence, to develop ways to improve gun safety, to identify foolproof ways by which to recognize risk factors for violence, to establish sensible guidelines for gun education and licensing, and to learn how to prevent mass killings? What if … It is we in the emergency departments of our country who see the tragic outcomes of this lack of research on ways to make our world safer while protecting individual rights. We see the victims. We see the devastated families. We see lives forever altered. It is with this in mind that the 2017 ENA General Assembly passed a resolution that included a call for the development and dissemination of educational resources to promote safe gun storage; training in safe handling and competent usage of firearms; screening tools to identify individuals at high risk for death or injury from firearms; lifting of restrictions and limitations on research into firearm-related morbidity and mortality and that funding be allocated for this research; and support for technology to make firearms safer. In keeping with this resolution, the 2017 ENA President Karen Wiley wrote to congress expressing ENA’s support of a bill titled the Gun Violence Research Act. In her letter, President Wiley referred to gun violence in the United States as an epidemic. Others have labeled it a public health emergency. Will an emergency department with our 24/7 access be the site of the next mass shooting? Will our “active shooter drills” help to save us and our patients? Will tomorrow find some of us caring for the victims of yet another shooting incident? As emergency nurses, gun violence and the needless loss of thousands of lives holds great significance for us. If the epidemic/public health emergency that is gun violence is a problem we want resolved, there are many organizations whose efforts we can join, or we can choose our own course as individuals. The point is, that as eye witnesses to the tragic outcomes of gun violence, we must act. If not us, who? If not now, when? Anne Manton is Editor-in-Chief of the Journal of Emergency Nursing.