Defend Systems

Defend Systems offers tourniquet instruction as part of its active violence mitigation training at Nashville Symphony. 

Brink Fidler is overwhelmed with requests for hands-on active violence mitigation training. The president of Nashville-based Defense Systems and former Metro Nashville Police Department officer recently got his first call from an area hospital.  

“It’s crazy I can even do this for a living, but here we are,” Fidler said. “People are beginning to realize that these things are so frequent, and so fast. They just unfold so quickly that waiting on the cops is just not an option.” 

The state appears to be taking notice as well. The Tennessee Department of Health late last month issued a request for information from potential outside vendors to provide training for workplace violence, domestic violence and active violence in health care settings for all counties and metro health department employees. The RFI noted that over the last year, there have been more than 50 workplace violence incidents reported by TDH staff. These incidents included patients assaulting staff, staff breaking up fights between patients, domestic violence and clinics going into lockdown due to suspicious activity in the area. 

The Bureau of Labor Statistics reports that for full-time employees in health care and social assistance, rates of violence have grown. In 2011, rates of violence were reported at 6.4 per 10,000 full-time employees. By 2018, rates of violence increased to 10.4 per 10,000.

“The health care and social service industries experience the highest rates of injuries caused by workplace violence and are five times as likely to suffer a workplace violence injury than workers overall,” the bureau reports.  

Prompted by requests from a member needs survey, the Tennessee Primary Care Association offered a training specifically focused on violence in the workplace for the first time in June of this year, and the organization plans to expand it, said CEO Libby Thurman. Previous training focused on natural disasters and emergencies. 

“There were reports of heightened tensions in health care settings throughout the pandemic due to a variety of reasons,” Thurman said. “A few of our members also experienced incidents of violence and outbursts, and we wanted to support them with tools to respond to a potential incident.” 

Defense Systems already gives training to the state, including the Tennessee Bureau of Investigation and Tennessee Higher Education Commission. Fidler said his training is adjusted slightly for the health care setting, just as his trainings are tailored for the school setting. He added that the hospital presents a unique challenge in that the patient rooms often don’t lock and equipment like oxygen machines or ventilators are also at risk, plus some patients may not be mobile. 

“You have more to worry about from a crossfire situation in a hospital than maybe in some other environments that don't have as much sensitive equipment,” he said. 

There are currently no specific federal Occupational Safety and Health Administration standards for workplace violence, though in 2016 the organization released some guidelines specifically for health care settings. The Tennessee Hospital Association released information about developing a workplace violence prevention program in 2020. National legislation was introduced in 2021 in an effort to introduce standards for workplace violence in health care, social service and other sectors. Fidler said he hopes to see training for active violence become mandatory for workplaces. 

“I hope we're gonna get there eventually, where this kind of training is mandatory, whether it's mine or not, just because this is where we've missed the boat,” Fidler said. “The people that find themselves in the event not knowing what to do is where we've really not done enough as a society.”