For those old enough to remember, April 20,1999 is a day in history that many wish to forget. Or better yet, long to turn back the hands of time and prevent the unimaginable heartache to follow. Now, 20 years later, we need only say one word to evoke the weight of the tragedy and its impact across the nation – and that word is Columbine.

A Columbine High School memorial brick in a sidewalk in Denver. Courtesy: Shutterstock

HCA Healthcare-affiliate nurse Sandra O’Connor says it’s a day she’ll never forget. O’Connor was the charge nurse on the day shift in the emergency room at affiliate Swedish Medical Center in Englewood, Colorado, when she received her first phone call just before 11:30 a.m.

“Our director of admissions, who was at lunch, called and said she’d seen on TV that there had been a shooting at Columbine High School,” O’Connor recalled. “I didn’t know what that meant, to be honest. You have to remember – at that time, many people didn’t have cell phones. So our phones weren’t blowing up; there was no Facebook, no Twitter, and no Instagram.”

“The only resource we had in order to know what was going on was the local news,” O’Connor explained. And it really did unfold on the air.”

On April 20, 1999, two students opened fire at Columbine High School in Littleton, Colorado, gunning down 12 of their fellow classmates and a teacher before killing themselves. Columbine became the first school shooting to become a nationwide media spectacle with wall-to-wall television coverage.

Emergency notification during Columbine

Swedish Medical Center was the closest Level 1 trauma center to Columbine. O’Connor remembers the medical control person calling to give updates and explaining that the HealthONE hospital could potentially receive hundreds of victims.

“Our ER physicians happened to be having their monthly meeting in house that morning, and it ended at 11 o’clock,” she said. “So, I still had extra physicians on-hand immediately, if needed.”

The protocol 20 years ago would have been to start a call or phone tree for an emergency notification. One person would call another who would call another to deliver the message to report to the ER.

Nurse Sandra O’Connor working triage in the early 1990s.

“That’s what we did for the nursing staff,” O’Connor said. “I had an administration secretary sit down with the staff phone list and start calling people to bring in a second wave of people to the ER.”

Approximately 13 nurses headed to the ER – some on their own after seeing the events live on TV – within the hour.

‘It was like textbook.’

Four Columbine students were rushed to Swedish Medical Center following the shooting. The healthcare team that was assembled to treat each patient included a trauma surgeon, an ER physician, two to three nurses and a patient tech, according to O’Connor.

“We received three patients fairly close together – one right after the other – and then about an hour later, the fourth patient arrived,” said the now house supervisor at Swedish. “We probably received the most critically injured, including two victims who sustained spinal cord injuries due to gunshot wounds.”

Local news footage of Swedish Medical Center physician briefing the public on the students’ conditions. Courtesy: Newsy.

The ER team had one goal that day – to save their lives. While there were no lasting relationships made with the four survivors, their names and faces will forever be seared into O’Connor’s mind.

“There have been interviews with different survivors leading up to the 20th anniversary of Columbine,” she said. “Just this week, I saw a segment with one of our patients. I was like, ‘Oh my gosh, there he is!”

“In the emergency room, we didn’t have time to build relationships with them or their families, so to see what he looked like 20 years later, it was overwhelming.”

As tragic as that day was, O’Connor is proud of how her team responded.

“It was like textbook. Everybody did what they needed to do. There weren’t any glitches and I couldn’t have been more proud of how we handled it.”

Lessons learned at Columbine

Two decades later, first responder and emergency preparedness plans continue to evolve from the lessons learned at Columbine.

“Twenty years ago, we didn’t have a command center or real incident command system set up at that time,” said the 34-year veteran nurse. “Everyone just came to the emergency room. Our hospital PR team, our administrative personnel…the ER was the command center.”

Today, Swedish Medical Center has a new command center, radio system, and have conducted countless trainings to make sure communication is streamlined and everyone is as prepared as possible for a tragedy.

A recent mass casualty training held at Swedish Medical Center.

O’Connor also believes the scale and resources available as a member of the HCA Healthcare family is unmatched. In the event of a disaster, the enterprise emergency operations center in Nashville will stand ready to assist its colleagues, patients, and communities we serve.

“I have such confidence that we’re so much better prepared today than we were 20 years ago,” she said. “We did phenomenally. We got four critical patients; those patients all made it to surgery in a short amount of time, and they all survived.”

Watch O’Connor share her story on Newsy here.

Sandra O’Connor joined the HCA Healthcare family in 1990 as an emergency room nurse at affiliate Swedish Medical Center in Englewood, Colo. She now serves as the house supervisor for the HCA Healthcare-HealthONE hospital. Swedish Medical Center’s emergency department was a recipient of the 2018 Emergency Nurses Association (ENA) Lantern Award – one of only 19 hospitals in the nation to earn the prestigious award. 

Sandra O’Connor served as ER charge nurse on the day of the Columbine shooting. She is now house supervisor at Swedish Medical Center.