A man who took hostages in a Pennsylvania hospital during a shooting that killed a police officer and wounded five other people highlights the rising violence against U.S. healthcare workers and the challenge of protecting them.

Diogenes Archangel-Ortiz, 49, carried a pistol and zip ties into the intensive care unit at UPMC Memorial Hospital in southern Pennsylvania’s York County and took staff members hostage Saturday before he was killed in a shootout with police, officials said. The attack also left a doctor, nurse, custodian and two other officers wounded.

Officers opened fire as Archangel-Ortiz held at gunpoint a female staff member whose hands had been zip-tied, police said.

The man apparently intentionally targeted the hospital after he was in contact with the intensive care unit earlier in the week for medical care involving someone else, according to the York County district attorney.

Such violence at hospitals is on the rise, often in emergency departments but also maternity wards and intensive care units, hospital security consultant Dick Sem said.

“Many people are more confrontational, quicker to become angry, quicker to become threatening,” Sem said. “I interview thousands of nurses and hear all the time about how they’re being abused every day.”

Archangel-Ortiz’s motives remained unclear but nurses report increasing harassment from the public, especially following the coronavirus pandemic, said Sem, former director of security and crisis management for Waste Management and vice president at Pinkerton/Securitas.

In hospital attacks, unlike random mass shootings elsewhere, the shooter is often targeting somebody, sometimes resentful about the care given a relative who died, Sem noted.

“It tends to be someone who’s mad at somebody,” Sem said. “It might be a domestic violence situation or employees, ex-employees. There’s all kinds of variables.”

At WellSpan Health, a nearby hospital where some of the victims were taken, Megan Foltz said she has been worried about violence since she began working as a nurse nearly 20 years ago.

“In the critical care environment, of course there’s going to be heightened emotions. People are losing loved ones. There can be gang violence, domestic violence. Inebriated individuals,” Foltz said.

Besides the fear of being hurt themselves, nurses fear leaving their patients unguarded.

“If you step away from a bedside to run, to hide, to keep safe, you’re leaving your patient vulnerable,” she said.

Healthcare and social assistance employees suffered almost three-quarters of nonfatal attacks on workers in the private sector in 2021 and 2022 for a rate more than five times the national average, according to the U.S. Bureau of Labor Statistics.

Other recent attacks on U.S. healthcare workers include:

The shooting is part of a wave of gun violence in recent years that has swept through U.S. hospitals and medical centers, which have struggled to adapt to the growing threats.

With rising violence, more hospitals are using metal detectors and screening visitors for threats at hospital entrances including emergency departments.

Many hospital workers say after an attack that they never expected to be targeted.

Sem said training can be critical in helping medical staff identify those who might become violent.

“More than half of these incidents I’m aware of showed some early warning signs from early indicators that this person is problematic. They’re threatening, they’re angry. And so that needs to be reported. That needs to be managed,” he said.

“If nobody reports it, then you don’t know until the gun appears.”

—Associated Press writer Chris Weber contributed to this report from Los Angeles.