responsibility to report threats?

[nursecass]

I will try to make this as brief as possible. Last week I helped take care of a patient that we have had behavior problems with in the past. He and his wife both have numerous incidents within both our facility and a neighboring facility-in fact they have been banned from the other facility. So before caring for this patient it was decided to do team nursing-no one enters the room alone so that there would be a witness in case anything occurred (most of the previous problems came with pt/wife accusing staff of things/comments). Another nurse and I went in to the room to complete care when very detailed and thorough death threats against a physician in our hospital were verbalized to us. I immediately went to my manager who took me to the quality control person (we don't have security at our hospital). QC person told me to fill out a report and she would call corporate to "see how they want to handle this". I asked if the doc would be notified and she told me she would notify him. I went and wrote up the report and when I turned it in to her she reassured me that the doc knew and when I told her about how this particular couple worried me more than others she proceeded to dismiss me because I'm "just an ER nurse and probably haven't had to deal with death threats before." I told her this wasn't my first time but that I just had a bad feeling about this couple and asked if police would be notified. She told me she would take care of all of it.

Fast forward to today (my first day back) and I find out nothing has been done. No one has been talked to (myself, the other nurse, a CRNA that also felt threatened, the doc) and no one knows what's happening. The pt completed his stay and when the wife found out we had reported them they both started calling the other nurse and I **** and saying we would pay for that, etc to other nurses on the floor. I called the police department today and they have nothing on file about any of this-no report, no statement-nothing.

At this point I'm not sure how to proceed. Should I try to call our corporate number to find out what's being done about this? Do I file a report with the police? (The other piece of this is that myself and a few other staff members are now concerned about running into this couple around town and aren't sure how to handle them if we see them in public.) Besides writing up/reporting the incident to my supervisor is there anything else I should be doing? Sorry this is so long, but I've never worked in a facility that doesn't know how to handle threats like this so I'm pretty lost. Any advice/feedback would be greatly appreciated.

[skipaway]

Protect yourself, file a report with the police. Your place of employment obviously does not value you as much as you think. Good luck and stay safe.

[Trekfan]

I would bann them too ! I am guessing that this is LTC ? If you at a hospital I do not know if someone can be banned from a hospital ?

[noahsmama]

You should absolutely report this to the police. QC and corporate clearly don't care about your safety, if they did they would have taken some kind of action. Health care staff have been killed by patients -- these threats should be taken seriously!

[Simply Complicated]

I would probably make a police report, as well as attempt to go up a little higher up the corporate chain. Is it possible the QC person didn't take this seriously, or is this a breakdown with more than just her?

[Guest717236]

File the police report yourself. If the patient stated a specific death threat

against the Doctor and , give the exact quote. Since you have a witness, have the nurse also file a police report

.

Threats should be taken seriously. Your management has failed to take

appropriate steps to safe guard the Doctor and you by not reporting.

Additionally, they may be in violation of the law. In many states it is law

that if a threat has been made to an individual, that person must be

directly and immediately notified and it needs to be documented by the healthcare staff as such. Your medical director should have been notified and he or she inform the MD.

You may want to consult with an attorney to find out what the law is in

your state. Protect yourself you are right to be concerned about

running into this couple around town. If you filed an incident report

how did the couple find out?

[CT Pixie, BSN, RN]

I would bann them too ! I am guessing that this is LTC ? If you at a hospital I do not know if someone can be banned from a hospital ?

The OP said he/she was an ER nurse.

[Esme12, ASN, BSN, RN]

i would bann them too ! i am guessing that this is ltc ? if you at a hospital i do not know if someone can be banned from a hospital ?

they can be issue a "no tresspass order"

here's the statute for the state i live in. the reason for giving a written notice is that it's good evidence in court. it's not required but highly recommended.

chapter 266: section 120

entry upon private property after being forbidden as trespass; prima facie evidence; penalties; arrest; tenants or occupants excepted

section 120. whoever, without right enters or remains in or upon the dwelling house, buildings, boats or improved or enclosed land, wharf, or pier of another, or enters or remains in a school bus, as defined in section 1 of chapter 90, after having been forbidden so to do by the person who has lawful control of said premises, whether directly or by notice posted thereon, or in violation of a court order pursuant to section thirty-four b of chapter two hundred and eight or section three or four of chapter two hundred and nine a, shall be punished by a fine of not more than one hundred dollars or by imprisonment for not more than thirty days or both such fine and imprisonment. proof that a court has given notice of such a court order to the alleged offender shall be prima facie evidence that the notice requirement of this section has been met. a person who is found committing such trespass may be arrested by a sheriff, deputy sheriff, constable or police officer and kept in custody in a convenient place, not more than twenty-four hours, sunday excepted, until a complaint can be made against him for the offence, and he be taken upon a warrant issued upon such complaint.

so yes people can be forbidden from the hospital except for "emergent care"

http://www.winknews.com/local-florida/2011-07-06/hospital-visitors-describe-lockdown-after-shooting

hillcrest hospital shooting has visitors on the look out

read more: http://www.newsnet5.com/dpp/news/local_news/hillcrest-hospital-shooting-has-hospital-visitors-on-the-look-out#ixzz1dpibzmgn

the quick action of a nurse at mease-dunedin hospital defused what could have been a deadly situation in the hospital's critical care unit monday afternoon.

cindy shaw, the nurse, took a loaded gun from paul shein after he became "angry and belligerent," according to the pinellas county sheriff's office.

shein, 74, a patient in the hospital's critical care unit, pointed the gun at another nurse who was in the room, deputies said http://privateofficernews.wordpress.com/2009/01/01/nurse-takes-gun-away-from-angry-hospital-visitor-wwwprivateofficercom/

a 58-year-old city man was charged with second-degree breach of peace and second-degree threatening after police said he caused a disturbance in the lobby of milford hospital and later threatened to return with a gun.

read more: http://www.ctpost.com/policereports/article/cops-milford-man-charged-after-threatening-to-2200218.php#ixzz1dpjmtajk

http://www.newsnet5.com/dpp/news/local_news/hillcrest-hospital-shooting-has-hospital-visitors-on-the-look-out

the hospital has an obligation to provide a safe work environment. you can contact osha. you can also file the threats with the police department for yourself but if the hospital isn't cooperating be prepared for the administration to be unhappy with you. violence amongst ed nurses is statistically very high. i would cal hr at coporate and ask what they wish you to do. ask if there is a poilcy that discusses workplace violence (there better be) and saftey. i would let the edmd know about the threat as there is strength in numbers.

https://allnurses.com/nursing-news/violence-against-er-639479.html

http://www.ena.org/media/pressreleases/pages/workplaceviolence.aspx

https://www.google.com/search?sourceid=navclient&ie=utf-8&rlz=1t4ggll_enus413us413&q=violence+against+ed+nurses

[nursecass]

Thanks for all the responses-that was my initial thought but I wasn't sure I should proceed with the police report until I did something else. I'm going to go by work today and contact corporate to see what they told our QC person, but honestly I think she dropped the ball and did nothing with this. (Not the first problem we've had with her-she's pretty useless.) I think though no matter what corporate says I'll file a police report, just so that if something does happen it was well documented that there were problems.

On a similar note though, when the threatened doctor asked for my written statement he was told he couldn't have it because it was a violation of HIPPA. Does this sound right? I used the pt and wife's name specifically in my report, but I don't think I put any medically relevant info in there (I will check it today). If I take out any references to why he was in the hospital it's not a HIPPA violation right? (I ask because I think if my QC person did drop the ball like I think and I escalate it, she will try to "get me" on HIPPA stuff.)

[nursecass]

Oh, and this actually happened in a surgical area. The threat was against a hospitalist, and the way the family found out was the surgeon went and told them directly before the pt even went to surgery (because the threat delayed the surgery), which of course placed us in harms way as we recovered the patient. The whole thing was/is just a mess.

[nurseprnRN, BSN, RN]

"on a similar note though, when the threatened doctor asked for my written statement he was told he couldn't have it because it was a violation of hippa. does this sound right? i used the pt and wife's name specifically in my report, but i don't think i put any medically relevant info in there (i will check it today). if i take out any references to why he was in the hospital it's not a hippa violation right? (i ask because i think if my qc person did drop the ball like i think and i escalate it, she will try to "get me" on hippa stuff.)"

horsepucky. hipaa (note correct acronym) is not a valid excuse for impeding legal action, qa, or public safety, and it says so on their website (http://www.hhs.gov/ocr/hipaa), and see attachment, to which i commend your attention so you will be armed with the facts and citations if this occurs. you can redact information about his medical condition without weakening the reporting process.

privacysummary.pdf

[Rob72, ASN, RN]

On a similar note though, when the threatened doctor asked for my written statement he was told he couldn't have it because it was a violation of HIPPA. Does this sound right? I used the pt and wife's name specifically in my report, but I don't think I put any medically relevant info in there (I will check it today). If I take out any references to why he was in the hospital it's not a HIPPA violation right? (I ask because I think if my QC person did drop the ball like I think and I escalate it, she will try to "get me" on HIPPA stuff.)

No, this is not "PHI", this is a physical threat, and carries the duty to report(i.e., the doc could sue for wilful endangerment by the facility and management, the QC person as an individual). Matter of fact, if you and the doc went together and obtained VPOs, the facility would be charged, by the State, for endangerment, if these folks were allowed on-property while either of you was on-duty.

Generally, its blow-hard stuff, but this behavior is why I carried a weapon 24/7 for many years. Document the activity. If they verbalize threats again, get a VPO. Make a report of any and every contact violation they make. Personally, if I felt the threat was real, I would have no issue making them DRT. Just be sure you have the paperwork beforehand to validate the action.