Patient is a sex offender with a tracker on his ankle

[Alex_RN]

When I received shift report for my very ill, bed-bound patient, the RN giving report pointed out the tracker affixed to his anklet. She had admitted him a few hours earlier and did not know the details and there was nothing noted in his chart. Before she left, she looked online and he is a convicted sex offender (lewd and lascivious with a minor under the age of 14).

Is it appropriate to add this new information (pedophilia) to your shift report? To his chart?

[Non Sequitir]

Good grief, all this talk about searching for people on google...convicts are all registered on city and/or state law enforcement websites, and yes the information may be pertinent if, as aforementioned, the floor also sees adolescents. If this or a similar situation is the case, then it would be prudent to make security aware of this fact. The person has an ankle bracelet on, are staff supposed to pretend it's not there? That's not wise. SW/case managers may very well want to be aware. Those posting that it should just be ignored are not considering how this information could affect care tertiary to medical treatment. If you are in a facility which is restricted to certain beneficiaries (VA, IHS) then you bet the federal police, at the least, will want to be aware of this.

However, there is no reason to chart this in medical documentation except to maybe note that the bracelet is present as it is basically part of his person at this point. Medical records are documents which could be subpoenaed in court - let that inform your decisions about matters like this.

[Little.Lizzy]

Your point is well-taken but your example is interesting in that I certainly would've done more with that then write it down and tell the next nurse. I do not accept direct threats. Something is going to be done in response. I would use every proper channel to put a stop to it and to make sure the threats did not progress to behavior. No employer gets a pass on that.

We had security posted outside her room and 2 of them had to be present in the room any time a staff member entered. But the verbal abuse was just unreal. We really tried to get management to do something but unfortunately night shift over the weekend doesn't get much help. Eventually she transferred to icu so her behavior could be managed by the RN 1:1. That poor nurse! And I can't believe she took up an icu bed for that.

[canoehead, BSN, RN]

If I had a patient with a monitor on I'd chart it and ask him directly what was going on. I'd consider a predisposition to violence or sex crimes important information for the safety of the team, and discharge planning. If he refused to tell me, I doubt I'd google it, but I would get a SW consult. He obviously has issues, and I'd want more than just me trying to address them. Maybe it turns out to be just a bad check, but you have to do due diligence.

[Penelope_Pitstop, BSN, RN]

Eventually she transferred to icu so her behavior could be managed by the RN 1:1. That poor nurse! And I can't believe she took up an icu bed for that.

I know my charge nurse in the ICU never would have accepted that patient. Such a waste of resources...couldn't she have had a tech for the 1:1?

[blackmamba123]

I'm not sure you can legally add it to a chart, but you can pass it on in shift report. I've heard worse things passed on in shift report. By worse, I mean judgmental comments that really don't have a place in shift report. This is a fact you're passing on, and is information available to the public. I am an extremely security and safety minded person though, and think it's always better to be in the know, as much as possible.

[blackmamba123]

Sure, you can pass on that he has an ankle bracelet on, but it's absolutely not appropriate to pass on what his crime was, especially when the nurse only found out about it by searching his name online. If he has an ankle bracelet on, I guarantee he will be in touch with his parole officer and will be letting them know that he is in the hospital. If his parole officer feels he is a threat, they will contact the hospital to make sure the public is safe. Its not up to us as nurses to search our patients and discover personal things about them and to have this impact the care we give, or to treat them differently from any other patient.

I have to respectfully disagree with you on one point. It seems like one of your concerns is that knowing the patient is a sex offender could impact care. That definitely is a possibility, and not ethically or morally acceptable. But as advocates, keeping people safe is our job too. Leaving it to a parole officer or others in the justice system who are not on the scene, puts others in the facility at risk, including other patients, guests of patients, and healthcare providers.

[EllaBella1, BSN]

I have to respectfully disagree with you on one point. It seems like one of your concerns is that knowing the patient is a sex offender could impact care. That definitely is a possibility, and not ethically or morally acceptable. But as advocates, keeping people safe is our job too. Leaving it to a parole officer or others in the justice system who are not on the scene, puts others in the facility at risk, including other patients, guests of patients, and healthcare providers.

I agree that keeping people safe is our job, but it's not our job to police the community. You best bet that if I witnessed this patient acting inappropriately (unlikely since OP stated he was critically ill and bed bound), I would be more inclined to call security and notify my charge nurse and let them handle it. Simply existing in the community in a public space is not criteria for intervention to me.

Last night I had a patient's family member show up to visit extremely intoxicated and acting inappropriately. You best believe I had them removed by security, put a note in the chart, and notified my charge nurse and manager about it. In my mind that's the type of situation to make a big deal out of, not someone convicted of a former offense.

I think we all encounter criminals, sex offenders, etc a lot more frequently than we think we do in our practice, and we are none the worse for it.

[Dafabb, LPN]

Actually no it would be most inappropriate whether you know now or not. First off if they look at the Nurse who looked this up she would under most circumstances be in some big trouble. That is going outside the realm of the hospital. Secondly there are no young children in the hospital that he would ever see. Even working in a prison most of us do not know what offenders are in here for. We are not there to judge their sentence but to take medical care of them. You should not use this in any note you write as it might come back to bite you in the butt as to how do you know. He has an officer with him at all times. Over all they are all usually very polite and accommodating. Your ignorance is your bliss!. They put an ankle monitor on them when they come out of prison just in case they escape. There could be other reasons he has it but it is no business of yours....You could be opening yourself up for some legal reprisal to comment on any of this. Leave it alone and do your nursing job to the best of your ability. Just an FYI on "sex offender(although this one was explicit) If a man has to urinate quickly and goes behind a tree and does it, looks up and a family of 4 is walking down the street and see him, he can be charge and stamped a sex offender even if he is no such thing. So beware of what you see is not always what you know......

[Dafabb, LPN]

The charge Nurse and especially security know this before they hit the floor! At least we always did....

[vbright]

I am not an RN & neither do I work in a hospital; simply going off my basic common knowledge.

First of all, the on-coming nurse simply received the news from the out-going nurse that the patient was a convicted sex offender based on a internet-name-search. She might have done a follow up internet-search or not, nevertheless the source is secondary not to based as clinical information.

Secondly, the on-coming nurse did the right thing by being curious about that "something around her patients ankle". However, her curiousity should have ended there. She should have immediately consulted with her case manager or supervisor to report that, since every hospital follows different policies regarding such matters.

End of story!

Thank you,

Victoria Bright

[vbright]

Why does it have to be only a family of four?

[NunNurseCat]

Ok so...patient identifying information obtained from hospital records was used to perform an internet search into that patient's personal life? Wowwww.