Use of restraint on out of control pt....look out ! - page 2

i was so frustrated the other night i couldn't see straight. a pt, who is an illegal immagrant, went off in our triage are because they didn't like the triage process. when our nurse tech went over... Read More

  1. by   Cattitude
    Quote from earle58
    the ethnicity isn't relevant, except in that both atty and pt/client are the same ethnicity....then i need to take off my rose-tinted glasses and acknowledge that there probably would be more of a bias- or more of a chance, in the atty/pt's eyes.
    as for immigration status, it's not a direct correlation.
    but seriously, it doesn't sound like a strong case at all.
    this pt sounds totally out of control.
    and if he is an illegal, i don't see how bringing attn to that would help him in any way.
    i'd be curious to see charges he could bring, that would hold in court.
    it sounds like he was the immediate threat...

    leslie
    i'd be curious to see if ins lets him stay in the country long enough to see his "case" even brought to court. it's just ridiculous. next time i suppose the tech should let him hurt someone? and then get sued for that.
    i'm sorry but even a detective looking at a tape can get it wrong. i'm quite sure that tech did the right thing. when you are staring at someone agitated face to face, sometimes, you just know.
  2. by   Freedom42
    I'd still like to know how the OP knows that the patient was an illegal immigrant. Is a patient required to disclose that status when receiving treatment? It was clearly significant to the OP.

    I agree with Tweety: The patient's immigration status and ethnicity are not relevant. The OP has made them relevant, however, because they suggest a potential bias on the part of the OP, not the patient. We also don't know how the OP knows that the patient has consulted attorneys. Has the hospital been served with a notice of claim?
  3. by   lauralassie
    Quote from gitterbug
    once again this is another reason why er's are closing or limiting their scope of practice. i would not want to work in an er in many areas today.
    instead of being thankful for getting care and treatment, these illegal individuals are clogging the system and demanding to call all of the shots. i am sorry your coworker was injured, i hope there are no legal complications from this altercation. if the detective says police should be present before treatment can be started, then a meeting with administration should take place and a plan of action should be established for the care and treatment of these individuals and for the protection of staff. sure, and i am selling the london bridge tomorrow at auction. lol!



    you said it! yep, i'm looking for a diffetent job, the management has no idea what goes on in the er, infarct ,(whoops, wait, that's what my brain does every night i work, i ment infact ) they can't do our job. when we are short staffed and busy, they try to help but they end up like fish out of water, gasping for air, (can you start this iv for me , don't know where the braslow cart is, or any crash cart for that matter i could go on and on about this but..oh well , frankly don't care any more !)
  4. by   lauralassie
    Quote from freedom42
    no one should be assaulted on the job. i'm curious, though: how do you know the patient is an illegal immigrant? why is that relevant, and what is the significance of "latino lawyers?"



    don't want to give out too much info on this pt. lets just say we knew from various ways. let me make it clear that i in no way discriminate angaint immagrants. but, i would like to see a better system to make them citizens. that way we know what costs are being absorbed, we would be able to track communicable diseases better and criminal back grounds could be checked. as far as the latino lawer, i suppose it was because many times the services are free or minimal cost and they speak spanish. the fact that the pt was latino makes no difference to me. don't even go there, my mom and dad are immagrants too. . besides, the topic is assualt against a medical worker, not immiagration issues. if your not a nurse that has to deal with these type issues on a daily bases then you wouldn't have a clue. find a another thread.
    Last edit by lauralassie on Jan 23, '07
  5. by   lauralassie
    Quote from tweety
    that's not the topic of this thread. the topic is the a nurse was assaulted and responded, and the aftermath of that. the ethnicity of the attacker is doesn't seem necessary to mention, nor the fact that they are getting latino layers.

    it really has distracted from the main point and has the potential to go off on a tagent that really isn't necessary.

    the main question of the op is can health care providers respond to a violent patient, or do we have to wait for the police?

    if you'd like to discuss how illegal immigrants are impacting emergency rooms and the bottom line of health care, please post another topic.



    yes , the topic isn't immigration, the topic is assaulted health care workers. it's dangerous in many er's, er's are on the front line so to speak.
  6. by   rjflyn
    Im in Florida as well as Tweety. Unfortunately the patients most likely to assault healthcare workers are psychiatiric pts. SO even if the states attorney charges the person often times the get off due to said psych problems.

    Rj
  7. by   santhony44
    I'm puzzled by the detective saying that the ER worker approached the patient so it wasn't assault.

    Now, I'm assuming that the ER person didn't "hit the first lick" so to speak.

    If the individual in question had been a police officer rather than a health care worker, would the patient have been charged with assaulting a police officer?? If so, then why isn't it assault?
  8. by   ICU_floater
    one, with any assult, a form is filed with risk management ie. harm to worker claim form, what ever your facility calls it.

    two, in every ER, the management of security and the sheriff on guard, is tenuous, not all partake in take downs.... fill out the form

    three, a worker injury occurred, a comp. claim for the worker to be seen and evaluated in the ER form is now generated.

    four, regardless of a potential lawsuit, the patients behavior needed to be adequately documented as well as offers to a non biased hospital interperter offered to ensure the pt. had adequate understanding of the process.

    five-for what ever you legit reasons, social work needed to be consulted for the lack of access to a continium of care.

    six- INS needs to be notified of such a suspected illegeal immigrant.

    seven- a formal sheriff dept. complaint needs to be filled out for the assult of the patient upon the staff member and formal charges filed.


    from here- the hoe-down on risk management- the sheriff office and the offended and injured employee occurs - he MUST lodge a formal complaint, follow up with employee health, go downtown and file a complaint and insure INS has been called.

    If you want to stand up for yourself, follow your LEGAL rights, do NOT count on administration to make it so., experience shows me you'll be appologising in spanish before the day is through.... use the LAW to protect you, It will still become quite the battle. make sure your chart has demonstrated attempts at communication to clarify your position as a health care provider.

    it's a long process and much beating your head against the wall, but protects you in the end. Unfortunately, this is common from the ER's I've come from.... stay the course and do the process. don't forget the INS
  9. by   Tweety
    Quote from rjflyn
    Im in Florida as well as Tweety. Unfortunately the patients most likely to assault healthcare workers are psychiatiric pts. SO even if the states attorney charges the person often times the get off due to said psych problems.

    Rj
    You're right about that. Our patients that attack are usually drunk, high on something, or going through DT's and are rarely proscecuted.

    However, we nurses in return are rarely procescuted or sued for our taking down of them. At least not where I work. The local police are particularly supportive of our ER staff and have no tolerance for that sort of stuff and I can't imagine a detective around here saying we should have waited for police help. Usually it's "good job, thanks, we'll take them to jail if you want." But usually they are in the hospital for reason.
  10. by   lindarn
    Quote from ICU_floater
    one, with any assult, a form is filed with risk management ie. harm to worker claim form, what ever your facility calls it.

    two, in every ER, the management of security and the sheriff on guard, is tenuous, not all partake in take downs.... fill out the form

    three, a worker injury occurred, a comp. claim for the worker to be seen and evaluated in the ER form is now generated.

    four, regardless of a potential lawsuit, the patients behavior needed to be adequately documented as well as offers to a non biased hospital interperter offered to ensure the pt. had adequate understanding of the process.

    five-for what ever you legit reasons, social work needed to be consulted for the lack of access to a continium of care.

    six- INS needs to be notified of such a suspected illegeal immigrant.

    seven- a formal sheriff dept. complaint needs to be filled out for the assult of the patient upon the staff member and formal charges filed.


    from here- the hoe-down on risk management- the sheriff office and the offended and injured employee occurs - he MUST lodge a formal complaint, follow up with employee health, go downtown and file a complaint and insure INS has been called.

    If you want to stand up for yourself, follow your LEGAL rights, do NOT count on administration to make it so., experience shows me you'll be appologising in spanish before the day is through.... use the LAW to protect you, It will still become quite the battle. make sure your chart has demonstrated attempts at communication to clarify your position as a health care provider.

    it's a long process and much beating your head against the wall, but protects you in the end. Unfortunately, this is common from the ER's I've come from.... stay the course and do the process. don't forget the INS
    And make sure that you make a copy of everything for yourself. I would also
    find out the law firm that represents your hospital. Talk to an employment attorney. Make an appointment with the senior, or at least, the managing partner, and bring an extra copy of these writeups. Make sure that they understand that you have spoken to an attorney, and will take legal action against the hospital for lack of support, injuries you received, and any retaliation that may occurr.

    Why do I say that? Believe it or not, many hospitals do not involve their legal counsel in the poor decisions that they make. This law firm will have to defend the hospital if you file a law suit. When they realize that the hospital is making bad decisions, and doing things illegally, or dicriminating, they will take the hospital aside and tell them the facts of life. I tell you this from personal experience. CYA!!!

    Lindarn, RN, BSN, CCRN
    Spokane, Washington
  11. by   Antikigirl
    I have had to take down two patients in my career, and nothing was ever said about it except "good job NURSE!!!".

    The first one was from a fight in a crowded space and innocent people were getting injured and starting to fight themselves. There were children in the mix...so I grabbed the main offender and used my weight to pull him down to the ground as others grabbed the other offender. Of course I wasn't strong enough to really hold him, and he was tweeking on some meth...so I was helped to get him back up in a compliance hold by security (who arrived just in time to help me thank goodness). Police showed up and off both went in handcuffs!

    The second was much more ill! A demented older male pt in a room near the nurses desk for fall risk who kept getting oob. He was a very tall strong fellow let me tell you...just getting him back in bed was a challenge! He hit me once, and it HURT! We got an order for mits so if he did hit, it wouldn't be so bad. Well...a CNA went in to get his VS, and he attacked her full on...pulled up his gown and pinned her on the ground trying to remove her pants (didn't work well with the mits thank goodness)! He was trying to rape her!!!!! No time for security in my book let alone police! I ran in, basically used the same technique for the other guy by using my weight to roll him off...she got free and I told her to run and get help. OH wow...good move...LOL, now he was trying to rape me!

    So basically I yelled to him "Mr. ------, you are in the hospital and trying to have sex with me, my husband will not tolerate that nor will I~! I am NOT your wife...she is at home...do you want to call her, I will dial the number!" Thank GOD it worked...he had a flash of reality and was stunned! I was getting him back into bed as security arrived.

    I was not injured in either case, and I was seen as protecting pts and staff for both happenings. I documented the heck out of both (I know CYA~!).

    If I had been charged for either case..I would so be getting my own lawyer and broadcasting this unfairness on every local news channel I could! No way would someone that is a risk to patients or staff going to go off and me sit there and wait for police if the situation can't wait!

    What ever happened to the days when the victims of crimes and injustice had more rights than the assailant????
  12. by   cardiacRN2006
    Quote from Freedom42
    I'd still like to know how the OP knows that the patient was an illegal immigrant. Is a patient required to disclose that status when receiving treatment? It was clearly significant to the OP.
    Uhh, they don't try to hide their illegal status. I've been told by each pt when they were illegal.


    This poor tech that just went out to calm the pt down, what has happened to him? Is the hospital supporting him??
  13. by   nurse4theplanet
    Quote from ICU_floater
    one, with any assult, a form is filed with risk management ie. harm to worker claim form, what ever your facility calls it.

    two, in every ER, the management of security and the sheriff on guard, is tenuous, not all partake in take downs.... fill out the form

    three, a worker injury occurred, a comp. claim for the worker to be seen and evaluated in the ER form is now generated.

    four, regardless of a potential lawsuit, the patients behavior needed to be adequately documented as well as offers to a non biased hospital interperter offered to ensure the pt. had adequate understanding of the process.

    five-for what ever you legit reasons, social work needed to be consulted for the lack of access to a continium of care.

    six- INS needs to be notified of such a suspected illegeal immigrant.

    seven- a formal sheriff dept. complaint needs to be filled out for the assult of the patient upon the staff member and formal charges filed.


    from here- the hoe-down on risk management- the sheriff office and the offended and injured employee occurs - he MUST lodge a formal complaint, follow up with employee health, go downtown and file a complaint and insure INS has been called.

    If you want to stand up for yourself, follow your LEGAL rights, do NOT count on administration to make it so., experience shows me you'll be appologising in spanish before the day is through.... use the LAW to protect you, It will still become quite the battle. make sure your chart has demonstrated attempts at communication to clarify your position as a health care provider.

    it's a long process and much beating your head against the wall, but protects you in the end. Unfortunately, this is common from the ER's I've come from.... stay the course and do the process. don't forget the INS
    Fantastic points! yes, yes, yes...

    After the assault, was everything properly documented? This tech's case can be rock solid if the appropriate actions as listed above were followed!

    As for this detective, he's right! It's not assault...it's battery, which is even worse! What a moron! During his 'investigation' did he take statements from other eyewitnesses, both employees and non-employees? If he did not follow the correct procedures of an investigation that could also strengthen your co-worker's case.

    A word of caution...(hubby works in law enforcement) corrupt detectives usually come from corrupt departments...sad but true...they have been in the game for awhile and know what they can get away with. However, I don't understand what motivation he would have for siding with an illegal immigrant. Usually, law enforcement officers are more than happy to detain these guys, especially if they are causing trouble, and hold them for INS. Sounds a little fishy...

    Worst case scenario, if this detective is not on the up and up, proper documentation and follow through as described in the referenced post will fall heavily on your co-workers side.

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