Violence in your ER - what do you do???

Specialties Emergency

Published

Okay, situation: Had ambulance roll in w/female involved in altercation - two lacs that needed suturing, ETOH on board (of course). Went in, assessed her, no bleeding, stable, etc.. Ten minutes later, two sons come in - began at the triage desk to demand (with all expletives) that their mother had to be first and had to be taken care of immediately!!! Security let them back into room where they began to threaten staff, security w/them. Verbal altercation between them and security to include threats of violence to us. Security totally ineffective. I called police (they responded w/in three minutes, arrest one and let the other one go. The one let go p4romptly went to gas station and began shooting people!!!!

Nursing staff very concerned that they had guns while here in ER and they will come back. (I have to add that they are two of our sickle cell pts and know the layout well!!!)

Anyone w/experience in this area? What has worked? We are inner city level I trauma center and I'm the night charge RN.

Specializes in ER, ICU, L&D, OR.

Howdy yall

from deep in the heart of texas

I duck a lot, I pray a lot. And I speak softly and carry a 4 iron,,,,,,FORE

Specializes in Nephrology, Cardiology, ER, ICU.

Very cute!!! Well, in Illinois, its a felony to assault a healthcare provider, so we press charges and go to court a lot!!!

Specializes in Trauma, Teaching.

At the nurse's instigation, our triage area is now behind bullet proof glass (which a new CEO thought looked bad for community relations and wanted to get rid of), the glass is still here! You have to swipe your badge to get in the back door, are be let in by the triage nurse in the front.

We also managed to get a security guard assigned 24/7 to the ER so there is no waiting for them when needed. Most of our guys are ex-police so are really good at what they do. Saved my bones a few times.

We dial 911, if needs be, for the violent/abusive/threatening patients and/or family members. We pray. We thank God every night that our hospital has not had to deal with that much in the way of guns. Knifes, swords and machettes, yes, guns - only the ones that come attached to a cop.

Specializes in Nephrology, Cardiology, ER, ICU.

We have thought about bullet-proof glass, body armor, guns, etc., some serious, others tongue-in-cheek. It's just rough somedays and I know all you guys know where I'm coming from...judi

Specializes in ER, ICU, L&D, OR.

Howdy yall

from deep in the heart of texas

We all have our stories, some scarier, some creepier, some grosser than others, may we all escape unscathed.

And to traumaRUs, uits a felony here in texas, but pnly what they call a class b or c, whatever that means, Never jail time only a fine. Sorry I no longer want to waste a day off in court or in depositions, when I could be therapeutic and go play golf

Our County hospital has quite a few "jail checks," the patient being accompanied by 2 police officers.

Just their presence seems to quell the agitation in the whole ER. I am so thankful for them.

The psych facilities offer courses (by various names), in self-defense. I haven't seen any offered in my ER as yet, but think that it's a great idea. These lessons include interpretation of body language and de-escalation of potentially hyped situations.

Any suggestions?

I also like one nurse's suggestion that all ER waiting rooms be equipped with a fountain dispensing liquid Xanax!

The metal detectors, wands, etc. aren't for law-abiding concealed pistol permit holders like myself. No concealed pistol permit holder wants to risk having their permit revoked because they violated the law. I would never willingly bring my pistol into a hospital, and you can bet if I was injured while carrying and could tell the EMT's about the gun, I would.

I agree with the registered letter to the CEO idea. If nothing else, it might cause the clue phone to ring for them. Also, know where your exits are at all times. This is a basic survival tactic wherever you are--always look around for the exits whenever you enter a room. Think about where you could go for cover, if necessary.

Specializes in Emergency Room/corrections.

Our hospital has a strict policy on visitors. Especially since 9-11. I have a personal policy concerning Drunk patients. No one visits my drunk patient unless they are sober, and until I say so.

This wont alleviate the altercation, but will move it out of the patient care area into the waiting room, where our security is posted at our locked doors. No one enters our ER unless security lets them in.

If they get too out of hand, we call the cops and they take them away.

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