Treating children wounded by gun violence: ‘They always scar’

Huntsville Hospital sees victims of gun violence virtually every day, Nathan White says.

Alabama doesn’t have many trauma programs, so the hospital takes all of the patients injured by gunfire in the Huntsville area, he says.

“Everything comes to us, as far as for our region,” White said.

White has spent more than a decade in emergency nursing and he’s also a clinical education specialist. He said it’s necessary to put on some emotional armor to handle treating patients of gun violence.

But he said emergency nurses are human, and it’s only natural that they are affected by the patients they see.

• Read more: The toll of gun violence, seen through the eyes of nurses | Special Report

White said it’s especially difficult to treat children who have been injured and killed by firearms. He hasn’t seen many children with gunshot wounds, but they are impossible to forget.

“Those are tough, those are hard pills to swallow,” White said. “You remember those cases, you remember those situations, especially when you know they were very preventable.”

It’s difficult to see those wounded because guns weren’t locked away securely, out of the reach of children.

“Those are definitely ones that you take with you, you carry with you, for sure,” White said.

“Those are always going to hit home,” White said. “I think some people can cope with that better than others. I know for me, it's just one of the things that … you always remember those cases. They always scar. You always remember.”

• Read more: Emergency nurses treating gun violence can’t ignore the pain

Huntsville Hospital offers a good process for helping nurses cope with violences, and White says debriefing after caring for patients injured in gun violence can be valuable.

He said the debriefing process goes beyond the delivery of care and includes asking if nurses are able to properly decompress from treating patients injured by gun violence and other traumatic events.

After seeing children injured by gun violence, White said he’d like to see more education on firearms, storing guns safely and understanding how they can be dangerous if they aren’t handled properly.

“I grew up in a very rural area,” White said. “And I remember going through middle school, you had to go through hunter’s education, you had to know weapons safety. And I know that doesn't get taught everywhere. I know, it's kind of decreasing … But I think it's important.”

“If you don't know what something is, you need to be introduced to what works and what makes it dangerous, so that way you can appreciate it,” he added. “No different than when you drive a car. You go through driver's education to understand why it's dangerous … I think that a big piece of it, is prevention.”

• Read more: For an emergency nurse, dealing with gun violence doesn’t get easier

Some hospitals and health systems have been talking more about education efforts related to gun violence.

At a 2023 forum on gun violence sponsored by Northwell Health, U.S. Surgeon General Vivek Murthy, pointed to the alarming disparities in gun violence deaths among children in the U.S. and other countries. He noted there were 4,357 gun deaths involving children in the U.S. in 2020, far more than other countries such as the United Kingdom (15) and Germany (13).

More hospital leaders have also been speaking out about gun violence as a public health threat. Michael Dowling, CEO of Northwell Health, has urged more healthcare leaders to take a more vocal stance.

“There are more people recognizing the fact that this is a society that should never be able to use the statistic that guns are the leading cause of death for kids,” Dowling said at a Northwell forum on gun violence in February.

White said he sees a place for hospital and healthcare leaders to talk about gun violence, but he also cautions against getting mired in politics and debates about the Second Amendment. He sees value in having conversations about storing firearms safely, and getting people to view gun violence as a serious threat to public health.

“It's not a political statement,” White said. “We’ve got to focus on taking care of a problem. Because end of the day, people get hurt by these weapons, they come here, and then that's everything. And that's just not even from a healthcare worker’s perspective, all the trauma that comes with that, but then the patient's trauma, and then the family's trauma with that.”