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When terrorists strike, the police advice 'run, hide, tell' applies to nurses too

In the wake of the terrorist attacks in the UK over recent months, nursing staff have been praised for their courage. But the official advice is clear: you should never put yourself in danger to help others.

In the wake of the terrorist attacks in the UK over recent months, nursing staff have been praised for their courage. But the official advice is clear: you should never put yourself in danger to help others. 


Amid the confusion of a major incident, it is important to ensure your own safety before helping others. Picture: Getty

Nursing student Rhiannon Owen was at a cash machine in a busy area of London on a Saturday night when a taxi swerved towards her and the driver screamed at her to run. Looking up, she saw a man three metres away holding a knife with a 12-inch blade.

He was one of three terrorists who targeted the London Bridge and Borough Market areas on 3 June, killing eight people and injuring dozens more. They ploughed into pedestrians in a white van before getting out and attacking people with knives.

‘I just started running,’ says Ms Owen, a first-year adult nursing student at King’s College London. ‘I ran into an open-fronted restaurant and I just screamed “There are people out there with knives, get upstairs” and we rushed upstairs into a storeroom.’

Social media criticism

Despite helping people as she hid upstairs with the restaurant customers, Ms Owen later found herself at the end of some barbed comments on social media, questioning why she hadn’t headed into the centre of the attack to help people who had been stabbed. But her behaviour pre-empted perfectly the advice for all nurses caught up in unexpected incidents that was published by the RCN shortly after the attack.

This advice underlines official government guidance and highlights the Nursing and Midwifery Council code of conduct, which makes it clear that nurses and midwives must take account of their own safety.  

The college said it had received a number of queries from members asking in what circumstances they should provide care and if they should head to the scene of an attack to provide assistance.

Its advice is unequivocal. ‘There is no expectation that a nurse or midwife will put their own safety at risk,’ says the guidance, published a few days after the London Bridge incident.

Series of attacks

The first incident in the UK this year came in March, when an attacker mowed down pedestrians on Westminster Bridge in London, before fatally stabbing a police officer. He killed five people in total before being shot dead by police.

On 22 May, a suicide bomber targeted crowds, including many children, streaming out of a concert at Manchester Arena. In total 22 people died, plus the bomber, and 116 were injured. This was followed by the London Bridge attack nearly two weeks later. Then on 19 June, worshippers leaving a mosque were targeted by a terrorist driving a van in Finsbury Park in north-east London. This incident left one person dead and nine injured.

Media coverage of these events, particularly the Westminster attack which took place right outside a large hospital, often focused on the heroism of emergency services and the NHS staff who rushed to help.

Safety first

But the RCN advice to nurses stresses that a nurse's first priority must always be to check they are safe before helping others, even if their instinctive reaction is to go to the aid of others. ‘If it is not [safe], you should move to a place of safety,’ the advice says. ‘You should then ensure that you or someone close to you has contacted the emergency services. Only then should you consider providing care if it is safe to do so.’

The risks of helping others were highlighted tragically in the London Bridge attack. Australian nurse Kirsty Boden, who worked at Guy’s and St Thomas’ NHS Foundation Trust, was killed while rushing to help others. ‘As she ran towards danger, in an effort to help people on the bridge, Kirsty sadly lost her life,’ her family said in a statement. ‘She was the most outgoing, kind and generous person, who loved to help people. Helping people was what she loved to do in her job as a nurse and in her daily life.’

Anna Crossley, RCN professional lead for acute, emergency and critical care, says that nurses and midwives should always follow the Code, whether they are at work or have been caught up in an event elsewhere. It states that nurses must take account of their own safety, the safety of others and the availability of other options for providing care, which may include paramedics, ambulance crews or military personnel at the scene.

‘There was some confusion that people felt that if they didn’t run into an emergency situation they would be in breach of the Code,’ Ms Crossley says. ‘We felt it was important to point out that in any situation you actively have to make sure that your environment is safe and if it isn’t you have to move to a place of safety. Your safety is paramount.

‘People go into nursing because they want to care for people and they have the knowledge and skills to do that. If you are in a situation and you can see people in distress you understandably want to go in. Sometimes, common sense goes out of the window in these situations and people are so desperate to help that they forget about their own safety.’

Counter-terrorism advice

The advice from the police in the event of an attack – ‘Run, hide, tell’ – applies to everyone including nurses, Ms Crossley says. This advice from national counter-terrorism policing tells people caught up in a firearms or weapon attack to run if possible, hide if not, and dial 999 when safe to do so. It says you should tell others to flee with you, but not be slowed down by their indecision.

In the London Bridge attack, Ms Owen and about 30 other people hid in the restaurant storeroom for 90 minutes. They heard the gunfire from outside, as armed police confronted and killed the attackers. Eventually the building was evacuated by police officers, who told them to leave the market with their hands on their heads.

While in the storeroom, and in the middle of the chaos around her, Ms Owen felt her nurse training kick in. ‘I was handing out water, checking everyone was okay, looking for signs of shock, introducing myself and trying to keep everyone calm,’ she says.

Just as advised in the RCN guidance, Ms Owen found a place of relative safety and then offered assistance to those around her. She welcomes its publication.

‘There were comments on social media saying that I should have gone and administered first aid,’ she says. ‘But if you get yourself into a dangerous situation, you can’t help people. Nurses should not do anything that places them in a situation that is unsafe, but use their skills and help people where appropriate.’

Run, hide, tell

Run
  • Escape if you can and consider the safest options.
  • Insist others leave with you.
  • Leave belongings behind.
Hide
  • If you cannot run, hide.
  • Find cover from gunfire, such as substantial brickwork.
  • If you can see the attacker, they may be able to see you.
  • Be aware of exits and try not to get trapped.
  • Be quiet. Put your phone on silent and turn off vibrate.
  • Lock or barricade yourself in.
  • Move away from the door.
Tell
  • Call 999 – if you cannot speak or make a noise, listen to the instructions given to you by the call taker.
  • Try to give information on the location, direction and description of suspects, casualties, type of injury, building information, entrances, exits, hostages and any other information that might be relevant.

Source: Adapted from Stay Safe Film

Erin Dean is freelance health writer

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