Business of Medicine


Should Hospital Security Officers Be Armed?

Executive Summary 

As the number of violent incidents in healthcare settings rises, it is important that healthcare organizations understand their obligations when it comes to keeping their employees and patients safe. One possible solution is arming hospital security officers. However, organizations should understand the implications of such a decision before arming security officers.  

Recommended Actions 

 Consider implementing conflict de-escalation training for all employees, including any armed hospital security officers hired. 

Before bringing any armed hospital security guards onboard, consider whether or not your healthcare practice wants officers to conceal their weapons. 

Ensure that your healthcare organization has a workplace safety policy and hospital security policy in place that take into account patient safety as well. 

In light of continued reports of violent incidents in healthcare facilities, healthcare professionals are debating whether arming their hospital security officers will improve safety for patients. 

According to the National Institute for Occupational Safety and Health (NIOSH), healthcare and social service workers face significant risks of job-related violence. Although less than 20% of all workplace injuries happen to healthcare workers, they suffer 50% of all assaults. The actual rates may be even higher as research has shown that many incidents may go unreported. 

Security experts emphasize that using weapons in a healthcare setting has a different impact than when used on the street. Visible weapons in a healthcare facility are likely to send a negative message and security uniforms may agitate certain individuals. The purpose of using weapons is to enable trained security officers to prevent or stop violence directed towards hospital personnel, visitors and patients. 

 Most hospital security officers complete at least basic safety programs that cover subjects such as weapon safety and the laws related to arrest. Security officer basic training courses may be tailored to an individual hospital’s needs. Any type of weapon used by security officers in any setting must be licensed, and the officer must be certified to carry those weapons. 

 How common is armed hospital security? 

Funded by the International Healthcare Security and Safety Foundation (IHSSF) and investigated by Duke University Medical Center, a recent survey revealed the following regarding weapon use among hospital security personnel: 

  • Handcuffs are the most common weapon available to hospital security officers and used in 96% of the hospitals surveyed 
  • Batons are carried and used by hospital security officers at 56% of the hospitals 
  • The UDAP brand of pepper spray is carried by security officers in 52% of the hospitals 
  • Tasers are used in 47% of the hospitals surveyed, with a 41% lower risk of physical assault when hospital security personnel are armed with them 
  • Handguns are used by hospital security officers in 52% of the hospitals surveyed 


How does a hospital decide whether it needs a security policy that includes arming guards? 

Many factors are involved in the decision to arm hospital security guards and, if so, which weapon should be selected. Considerations include local, state and federal laws that apply to the possession of weapons. For example, an acute care hospital in a high-crime area is more likely to need armed guards than a specialty facility in a low-crime area. Hospitals must balance the need for a better overall hospital security policies and creating a comfortable, safe environment for patients and staff. 

Consider the following strategies before determining if, when and how to arm your hospital security guards: 

  • Conduct a comprehensive security risk assessment with a reputable company. 
  • Hire your healthcare security guards or agency carefully, ensuring that officers have the necessary training and certifications required both by your facility and state and federal laws. Officers experienced in healthcare security operations are preferable. 
  • Talk to peers at local hospitals about their experiences and policies. 
  • Contact your state hospital association for healthcare security data in your state and for other security-related resources. 
  • Conduct multiple security training sessions for employees about the warning signs of violence, taking these signs seriously and reporting them in a timely manner to the appropriate hospital managers. 
  • Develop strong ties with local law enforcement. 
  • Utilize strict access control in certain areas of the hospital, such as the newborn nurseries and operating room areas. 

The decision to arm hospital security guards is an individual one. It may be safer, less expensive and more effective to hire security officers who do not carry firearms but who are well-trained to defuse potentially violent situations. In addition, consider the use of tasers and mace, which do not carry the serious risks associated with firearms but have been proven successful in overtaking violent individuals. 


Lessons Learned 
  • Maintain a copy of any weapon’s licenses and certifications held by your healthcare organization’s security guards. 
  • Before hiring a security officer, vet the organization by consulting with at least two similar healthcare practices that use the security organization’s services. 
  • Ask for background checks of any security officers before hiring them. 


Potential Damages 

Healthcare organizations that fail to adequately protect their employees or patients could be liable for any injuries that occur on their premises, especially if the organization has a pattern or history of violent incidents. Although relatively infrequent, these costs add up since healthcare organizations must defend a costly lawsuit and end up having to pay for any damages. 


1. If a security officer employed by a healthcare organization carries a weapon on duty, the officer must be certified to carry that weapon.
2. Before hiring any security officer, a healthcare organization must ensure that the officer is trained under any required state laws.
3. A healthcare organization should ensure that any security officer hired has completed at least a basic safety program prior to starting.


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The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.