A Hennepin County Medical Center employee looked for escape routes as the man bearing a gun stood above him. He considered spraying the fire extinguisher as a distraction, so co-workers could flee. Maybe he could race to the door before the gunman fired.
Tuesday's episode was only an exercise, and the gunman was only firing balls of paint. But the "active-shooter" drill was just the latest example of the way hospitals and clinics are preparing themselves to prevent and respond to violence that is increasingly common for health care providers.
The latest example came this week, when authorities confirmed that obstetrician Stephen Larson was killed in his Orono home by a man who was said to be upset over his mother's medical care.
"All you have to do is turn on the news," said Mike Cole, a retired security chief for Hennepin County Medical Center (HCMC), who organized Tuesday's drill. "I don't think a day or two goes by that there isn't an incident."
While emergency room doctors and nurses have long been at risk when seeing patients who are inebriated or in psychiatric crisis, Minnesota safety officials say that the problem is spreading beyond the ER and mental health units and that assaults have been reported from the maternity ward to the pathology lab.
Federal workplace injury data show that doctors, nurses and mental health workers are more likely than other workers to be assaulted on the job. The share of health care employees who missed work due to injuries caused intentionally by others was 6.5 per 10,000 workers in 2011 — four times the overall U.S. rate.
"Hospitals used to be sacred places," said Joy Plamann, medical care center director at St. Cloud Hospital. "They aren't anymore."
Injuries and deaths outside the medical setting aren't counted as workplace incidents, but health care officials say they're concerned about the risks reflected in Larson's death.