Dangerous Situation

  1. What would happen at your agency if a patient called the office and stated that he didn't think that it was a good idea for a nurse to come because had thoughts of killing himself and his family? And there was a nurse scheduled to see the patient that day??

    Is there a legal obligation to report this to the police?
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  2. 16 Comments

  3. by   majorwrigley
    I don't know the legal aspect, but I would think it would be better to contact the authorities and be wrong than to do nothing. What if something did happen?!!!
  4. by   caliotter3
    If it were my decision to make, unless there is a better answer that I'm unaware of, (after all I am not in a mgmt position), I would call the authorities and give the information necessary to get the pt taken in for a 5150 (72 hr hold d/t danger to self or others). At the very least, it warrants a call to the MD for his/her involvement. I would think twice about sending a nurse to the house unaccompanied or unwarned, b/c weapons might be avail and no telling if he does go over the edge, and manages to take someone with him. The police and paramedics are better prepared to deal with these eventualities of a suicidal person, that's why they have those 72 hr hold laws (at least in my state).
  5. by   DDRN4me
    anyone who is deemed a threat to himself or others should (and can ) be reported to the police without any repurcussion. Under no circumstances would i go or send another nurse to that kind of situation!!
  6. by   meagansmom
    This happened to me yesterday. I was called and told that this happened and not to go see the patient that he had agreed to go the ER. Well, he didn't go to the ER and I was called to go on and see this patient. My supervisor offered to go with me but I still refused....... Most guns hold more than 1 bullet. Another nurse volunteered to go and they LET HER without hesitation !!!!!! (2 went together) actually encouraged it because the situation needed to be assessed.

    I am just totally upset that my HH had no regard for my life or anyone else's. I am just as angry today as I was yesterday. They stated today that
    they overreacted. I think they failed to react. What will they do in the future, just not tell the nurse that is going on??
    Last edit by meagansmom on Jan 23, '07
  7. by   caliotter3
    My agency did this to me. They did not warn me or the other nurses involved, about the threats communicated by a client. Later, I was told that I could not get a restraining order. I no longer work for this agency. They did it to me. They would just as quickly do it to another. No regard whatsoever about the personal well-being of the nurses. As far as your agency stating that an assessment needed to be made, well, yes, of course. Let the psychiatric personnel at the hospital do this once the police and paramedics have brought the patient in. Do not jeopardize your nurses.
  8. by   Cattitude
    Quote from meagansmom
    this happened to me yesterday. i was called and told that this happened and not to go see the patient that he had agreed to go the er. well, he didn't go to the er and i was called to go on and see this patient. my supervisor offered to go with me but i still refused....... most guns hold more than 1 bullet. another nurse volunteered to go and they let her without hesitation !!!!!! (2 went together) actually encouraged it because the situation needed to be assessed.

    i am just totally upset that my hh had no regard for my life or anyone else's. i am just as angry today as i was yesterday. they stated today that
    they overreacted. i think they failed to react. what will they do in the future, just not tell the nurse that is going on??
    sounds like your supvr. and that nurse either have a death wish or seriously lack in assessment skills. we would call 911 and let them know of the situation. we have done this before with suicide threats, no hesitation, especially when there is an expressed intent to harm someone else. with psych. situations, you can;t just take the pt's word that they are going to go to the er. that's irresponsible. what if he had hurt his family and then told authorities, "well my agency knew about this". that could have held your hh agency liable. i don't blame you one bit for being angry. my boss may be a bit annoying at times, but she always has our back.
  9. by   henayneiCLNC
    the issue that fuels this situation is that patients tend to sue and win large amounts over small or imagined slights, plus the impact of the negative press is horrendous --- meanwhile nurses write on boards, complain to each other and change jobs --- but they don't sue and the media never hears their story.... so the agencies respond where *their* risk is greatest and ignore that which is no risk to *them*... simple actuarial risk analysis
  10. by   meagansmom
    I agree no one in our agency should have been subjected to this. We still have this patient and he was never psychologically assessed and he is in my area. So I assume I will be scheduled to see him Monday.

    Not sure what to do other than stick to my guns and refuse to see him.
  11. by   DutchgirlRN
    Quote from meagansmom
    What would happen at your agency if a patient called the office and stated that he didn't think that it was a good idea for a nurse to come because had thoughts of killing himself and his family? And there was a nurse scheduled to see the patient that day??

    Is there a legal obligation to report this to the police?
    I would not go to the pt's home. It would be dangerous and this pt needs help that is beyond my scope.

    I would definately call the police ASAP. YES there is a legal, if not ethical and moral obligation, to report it.

    Your agency is soooo in the wrong. I would refuse to see the patient. let the brave nurse who so
    inappropriately went on Friday, go back and take this pt over. Were the police ever notified?
    Last edit by DutchgirlRN on Jan 28, '07 : Reason: Spelling
  12. by   AnnieOaklyRN
    I beleive it is legal to tell aurthorities since he is homicidal and not just suicidal.

    swtooth
  13. by   Ophelia78
    I worked Mental Health outreach for a couple years- we dealt with this all the time. If ever a client expressed the urge to harm themselves or another we called 911. Never, under any circumstances, would anyone be sent to visit someone expressing these thoughts. In fact, the agency has a legal obligation to inform anyone he threatened what he had said, as well as report it to authorities. You can report an agency's negligence to OSHA, who can cite them under the Workplace Violence Regulation. I had to do this myself at a group home where we were not informed of the violent sexual offender who resided there. They received 13 citations. All reports can be anonymous.
  14. by   angelslpn
    yes you have one nurse contact m.d. ,another call authorities, another contact a crisis hotline, and talk with pt and ask why are you having these thoughts? anytime with suicidal idealations you take them seriously; just like when an pt tells you they're dying! as for the other who sent out to an suicidal idealation situation. they should have followed the same protocol. that could have put yall in grave danger. also when talking to an suicidal pt try to give them something positive to focus on such as family,teaching such as former career. hha's should try to get the police to do an safety awareness in service; they can also be teaching tips with pts.

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