Patient is a sex offender with a tracker on his ankle

  1. 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?
    Last edit by Alex_RN on Jul 24
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  2. 98 Comments

  3. by   EllaBella1
    Absolutely not. It's not relevant to the care that you are providing, and you shouldn't be searching for info on patients online in the first place.
  4. by   macawake
    Quote from 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?
    No.

    Was the RN who did the internet search expecting to find information that would improve the quality of medical care that you all provide?

    Considering that you've described your patient as very ill and bed-bound, I assume he isn't a threat to anyone. I also assume that none of the physicians, nurses or CNAs are thirteen years or younger so even if his health improves, you should be okay.

    Ask yourself, what possible benefit to the patient do you see from adding the information in his chart?

    As a side note, pedophilia is sexual attraction to prepubescent children. Plenty of twelve and thirteen-year old girls do not fit into that category so even if you were to include the result of that ill-advised internet search (which you aren't), you wouldn't be able to stick a diagnosis on him without knowing all the facts. (Of course I'm not saying that being attracted to a twelve-year-old is normal or acceptable, but it's not necessarily pedophilia).
  5. by   Not_A_Hat_Person
    Presence of an ankle bracelet, and why, should definitely be passed on in report. The charge nurse and security should be made aware that a registered sex offender is on the floor, if they aren't already. If it's a small community hospital where patients of all ages end up on the same floor, or he ends up with a roomate who has minor visitors, there could be problems. You may also need to worry about vigilantees.
    Last edit by Not_A_Hat_Person on Jul 24
  6. by   juan de la cruz
    I would agree that adding "pedophilia" to the problem list is diagnosing without a formal psychological assessment which is outside of your RN scope in the first place. Not all sex offenders who were involved with minors are pedophiles.

    As the RN, the information behind this patient's sex offender status is of no consequence in how you should deliver care but I think the information can still be pertinent in making sure Social Work or Case Management is aware. For instance, you mentioned that this patient is bed bound and very ill, what is his current living situation and what is the projected discharge disposition? This becomes important because he has limitations in placement options if he were to require placement in a nursing facility for instance (i.e., must be a certain mile radius from elementary schools, etc. which the law dictates even if he is bedbound).
  7. by   RotorRunner
    That would be totally inappropriate.

    I'd advise your coworkers against "googling" patients in the future.
  8. by   llg
    Personally, I would discuss this situation with my manager and ask what the facility's position is. In such a sensitive situation, I would never make that decision by myself and take full responsibility for it. I would use my resources (manager, risk manager, etc.) and comply with my facility's policy -- which is hopefully, based on a consensus of expert opinion.
  9. by   Jonsushi
    Similar situation at my work. We did pass it on in report, but the thing is we are a smaller hospital and it was important to know since we have a peds unit right below the unit the patient was in. We did not include it in his Electronic medical chart, but it was something we kept in mind in case the patient wandered off. We had a ankle brace on the patient also.
  10. by   EllaBella1
    Quote from Not_A_Hat_Person
    Presence of an ankle bracelet, and why, should definitely be passed on in report. The charge nurse and security should be made aware that a registered sex offender is on the floor, if they aren't already. If it's a small community hospital where patients of all ages end up on the same floor, or he ends up with a roomate who has minor visitors, there could be problems. You may also need to worry about vigilantees.
    I completely disagree with you. 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.
  11. by   Pepper The Cat
    I'd be more concern about what to do with the tracker. Can it around the CT scanner? MRI? Will it effect the ECG? What if the pt codes?
    As for why he was wearing it, not my business. He has/is been punished for his crimes. Maybe he was an 18 year old dating a 13 year old.
  12. by   macawake
    Quote from llg
    Personally, I would discuss this situation with my manager and ask what the facility's position is. In such a sensitive situation, I would never make that decision by myself and take full responsibility for it. I would use my resources (manager, risk manager, etc.) and comply with my facility's policy -- which is hopefully, based on a consensus of expert opinion.
    I understand the point you're making but in my opinion that responsibility falls squarely on Nurse Snooping Susan, OP's coworker. Since she chose to do something (likely for the purpose of satisfying her curiosity) which might even be against facility policy for all we know. If anyone should do anything, I think she's the one who needs to assume ownership of the ensuing mess.

    I noticed that some posters seem concerned about various possible scenarios that may or may not happen in the future, involving this currently very ill and bedridden patient. As former law enforcement I always operate under the assumption that the only difference between a convicted criminal and a person who's not convicted of any crimes, is that the convicted criminal got caught. My point isn't that I think that all of humankind are criminal or will commit crimes as soon as the opportunity presents itself, but rather that you never know in advance which person it is who will do something wildly inappropriate or even criminal. For everyone's safety, you simply keep a watchful eye on everything that goes on, and any patient wandering off to a different floor than their own, should be noticed.

    The only reason Curious Candace started looking for information on this patient was because he has an ankle bracelet. That's what led to her internet search, right? Most people convicted of crimes don't have one of those after having served their sentence, and no staff member would have been any the wiser.
    Last edit by macawake on Jul 24
  13. by   ItsThatJenGirl
    Maybe it's because I'm not a nurse yet, but the thought of googling a patient seems really inappropriate to me.
  14. by   JKL33
    I agree with the others; snooping into the patient's background online is inappropriate. I would neither chart on this information nor pass it on in report. All of these are unprofessional acts that are not undertaken in the patient's best interest. Anyone so concerned about the ankle monitor should be more concerned with checking the area for pressure points, circulatory compromise and skin breakdown in a very ill bed-bound patient than why the patient is wearing it!

    That said, there are situations (different than the OP, obviously) in which the patient verbalizes concerns about legal restrictions or concerns about complying with probation conditions while hospitalized - or some other issue directly related to his/her legal situation. A social work consult is often appropriate if available. Legitimate nursing actions undertaken at the patient's request should be factually documented without going into unnecessary detail and passed on for follow-up.

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Patient is a sex offender with a tracker on his ankle