A nurse had just helped deliver a baby when a report of an active shooter was announced at Mercy Hospital Southwest.
She quickly assessed the situation — a helpless newborn, a mother who had received an epidural and couldn't move — and told the nurse tech with her that if there was in fact an active shooter the tech was to take the baby into the bathroom, lock the door and hide in there until it was safe.
The nurse would stay in the room with the mother and do her best to secure the room.
Many similar instances of bravery played out as nurses and other hospital staff continued to care for patients during the three hours the facility was on lockdown the evening of Aug. 1, Chief Nursing Officer Jen Culbertson said during a symposium organized by Adventist Health Bakersfield featuring administrators of several hospitals that have experienced crisis incidents in the past year.
The symposium brought together hospital leaders from across Kern County to learn not only from high-profile incidents, like the Route 91 Harvest Festival shooting, but also smaller, local scares, like when a gunman opened fire at Bakersfield Heart Hospital last year.
Although most staff acted according to the their training during the Mercy Hospital Southwest incident — which turned out to be a false alarm — some unintentionally placed others in harm's way.
A nurse left the emergency department and went to the radiology department to transport a patient back to emergency, Culbertson said. Two others left a secured room and, when questioned why, said they knew how to handle someone with a gun.
Culbertson said "some hard discussions" took place with those people, not only because of what could have happened to them if there'd been an actual shooter but because by opening locked doors they could have given a shooter access to other potential victims.
The investigation into the incident is ongoing, Culbertson said. It's still unknown who made the call reporting the shooter.
"We have no idea where this call came from," she said. "We just know it was in our hospital, unfortunately."
Michelle Oxford, chief executive officer for Bakersfield Heart Hospital, also experienced a lockdown after a report came in of an active shooter.
In that case, however, the gunman was real.
On Dec. 1, Brandon Clark fired six rounds into glass doors at the employee entrance of the hospital, according to court documents. He entered the facility, spent three minutes walking around, at times pointing a rifle at people, then left.
Police confronted Clark in the parking lot and shot and wounded him. No one else was injured.
Clark is charged with 17 felonies in connection with the incident.
Oxford said a "code silver" — used to indicate a situation involving a weapon — was sent out when staff noticed a man, later identified as Clark, acting "oddly" at the employee entrance at about 4:41 p.m. One staffer saw the barrel of a rifle sticking out of his coat.
Between that time and Clark's arrest, several important lessons were learned, Oxford said.
One, provide specific locations when calling in an alert. There was some confusion at first as to where exactly the incident was occurring, or if there were two shooters, Oxford said.
Secondly, update the code if it changes. The code was never updated once the incident turned into an active shooter situation, she said.
Communication is key, as Oxford discovered first-hand when she and another staffer, unsure of what was going on or if there had even been a shooting, left a locked room to check the hallway.
They came face to face with Clark, who pointed a rifle at them but did not fire. Oxford and the other person immediately fled back to the room.
Since the incident, the hospital has installed an additional 30 security cameras, covering all public entrances and hallways so all sections of the facility can be monitored.
Also, the doors through which Clark entered have been replaced with high-grade steel and protective glass.
While his hospital was not targeted by a gunman, Mason Van Houweling, CEO of University Medical Center of Southern Nevada, oversaw the handling of more than 100 patients from the Route 91 Harvest music festival massacre, the deadliest mass shooting in U.S. history.
Van Houweling said the hospital was first notified five to 10 patients would be arriving from the shooting that occurred Oct. 1 on the Las Vegas strip. The second notification indicated a massive jump: 50 to 100 patients.
All told, the hospital treated 104 people, performed more than 20 surgeries in the first 24 hours and admitted a total of 60 patients. A triage area was set up outside the hospital to handle the flow of people coming in by ambulance and private vehicles.
Key challenges the staff faced were identifying victims, managing the flow of information — at one point there was a report of 13 separate shooters spread across Las Vegas —reuniting families and handling the immense call volume. The hospital received more than 5,000 calls in 24 hours, Van Houweling said, and he even missed a call from Vice President Mike Pence.
As Nevada's only Level 1 trauma center, the hospital is always prepared for "mass casualty incidents," Van Houweling said. That training and preparedness paid off in this incident as they were well stocked and never ran out of blood or other materials necessary to treat the victims, he said.