Published Jul 14, 2019
PMHNP2023, RN
176 Posts
I was working in the ER psych unit with an older psychotic patient. A couple of uniformed PD came to pick up a patient in another room to bring him to jail after he was medically cleared. As they started walking out with the patient, I was about 2 feet from my patient (I was outside of the doorway to his room, and the patient was standing in the doorway). My patient sees the police and grabs me in a bear hug yelling "I don't want to go!" I was able to pry free of him as our hospital security tackled him to the ground. The PD had walked by escorting their patient as this was going on. Later on one of the nurses said to me that she was yelling for the PD to do something to which they replied "sorry, we can't do anything".
Does this sound correct? Should the police intervened in this situation? It took me a couple of seconds to get out of the bear hug, and the security eventually tackled my patient to the ground. I wasn't harmed (I'm a somewhat athletic guy). I imagine if it was one of the more petite female nurses, they would have gotten hurt.
Do you think I should do anything? File a complaint, or let it go? Does it sound like the police were following protocol by not stepping in?
caliotter3
38,333 Posts
Yet they tell one they can do nothing unless they witness the act. Well, which is it?
Ponymom2
41 Posts
They may not have been able to. I have been one-on-one where another staff was being 'mildly' (relatively) assaulted by a resident. I instinctively rose from my chair to go assist the staff, but she firmly told me to remain with my resident (I was new to this type of care). She restrained him and took him to the ground while I was seated with my resident about 10-15 feet away from them. After all was said and done, she apologized for for being abrupt ( she was not, it was just heat-of-the-moment). I was in awe, had never seen anything like that before. The s*** got real....
But then, they are the police. Maybe they just kept going because Security was there...?
JKL33
6,953 Posts
There are likely particulars in play, such as the fact that they were handling another person they already had in custody, and the fact that you don't mention their jurisdiction nor the type of security officers you have in-house nor anything about any agreements your hospital has with local PD.
Why don't you start by talking to your manager about it. Hope you already filled out an incident report and followed other applicable procedures.
Crash_Cart
446 Posts
Why would the police be required to intervene if security had already tackled him down to the ground? The so called "threat" was already neutralized.
I worked with ER psych pt's before and quite frankly the police are not going to do anything unless intentional violence occurred, a punch was thrown, your blood is involved, or if you sustained signs of physical injury.
A psych pt, probably whacked out on meds who's begging you for them not to take him away, hardly qualifies as an threatening situation, or even as an intentional assault in my own experience for that matter.
Do all the reports you want, but this really isn't going anywhere.
16 minutes ago, Crash_Cart said:Why would the police be required to intervene if security had already tackled him down to the ground? The so called "threat" was already neutralized.
The security tackled the guy to the ground a couple of seconds after the police were walking by saying they couldn't do anything.
49 minutes ago, CSUSM10 said:The security tackled the guy to the ground a couple of seconds after the police were walking by saying they couldn't do anything.
Was the pt. throwing punches, pushing you up against the wall and/or otherwise acting violently toward you as the police walked by?
All we can do is document the inappropriate behaviour and utilize our crisis intervention methods and techniques to diffuse the situation. That's what we should do with any psych pt's. Another thing to remember is always try to physically distance yourself in a way it prevents anyone from ever coming into such close contact with you and doing these things in the first place. Treat everyone as unpredictable.
He's simply a sick person and you're the nurse taking care of him, and that's exactly what the police seen as they walked by.
You need to realize psych pt's. exhibiting any kind of weird, agitated or inappropriate behavioural problems are not exactly going to be considered a criminal matter by anyone.
I feel for you brother and yes I really do completely understand what you're dealing with, but you have to let a lot of stuff slide off your back when doing this kind of work. Remember, you're not exactly dealing with "normal" people here and they can't help what they're doing most of the time. They're just emotionally upset or extremely confused about the way things are going in their lives sometimes.
All any report is ever going to do is put yourself in the spotlight in terms of what YOU did wrong in the situation. The typical scenario is they review the report and treat it as an "employee safety matter." Then they recommend some kind of additional training or consultation for you to prevent the same situation from occurring again in the future.
I know you probably don't really want to hear any of that, but that's the real world reality of the situation.
Crojo1501, BSN, RN, EMT-B
23 Posts
Sorry, you had to go through this brother. I work in an ED where many code greys are paged per shift. Staff members and security officers are assaulted quite often including me. Your situation is a bit tricky due to medical/ psychotic side of the patients' condition.
Do you think I should do anything? You can try and press charges but its not going to go anywhere due to the medical aspect of this situation! trust me, my coworker got kicked in the face by a patient, he pressed charges, hasn't heard anything and it has been a year. lol File a complaint, or let it go? Definitely bring up to leadership because this tihs has to stop, nursing education tells us that chemical restraints and physical restraints are last resort but B52 and TATS can prevent staff injury. By the time were at last resort, an ED tech has been chocked and slammed and security has their face bit off! We need to advocate for ED staff. Does it sound like the police were following protocol by not stepping in? PD should have assisted if there was no other help around but otherwise security is the PD of the hospital and they have their policies and procedures to follow.
Kooky Korky, BSN, RN
5,216 Posts
On 7/17/2019 at 8:09 PM, Crash_Cart said:Why would the police be required to intervene if security had already tackled him down to the ground? The so called "threat" was already neutralized.I worked with ER psych pt's before and quite frankly the police are not going to do anything unless intentional violence occurred, a punch was thrown, your blood is involved, or if you sustained signs of physical injury.A psych pt, probably whacked out on meds who's begging you for them not to take him away, hardly qualifies as an threatening situation, or even as an intentional assault in my own experience for that matter.Do all the reports you want, but this really isn't going anywhere.
A psych pt, whacked out on or off legal meds, possibly on illegal drugs, who is begging to not be arrested is most definitely a threat.
TCASII, ADN
198 Posts
This is becoming the norm, unfortunately. In a psychiatric setting, if the patient has a psychiatric Dx, then the police will not take them to jail. This means that nearly 98% of the patients will not be arrested for an assault. Even the detox patients are admitted with co-existing psych Dx's, such as MDD (major depressive d/o). Those admitting Dx's are just for billing, they aren't a valid or accurate Dx. Just a preliminary ICD code.
We had a supervisor get punched in the face 4 times by a patient a while back. The patient had a psych Dx and flat out told the police that they weren't sorry and would hit her again. Yet, no arrest. Even more ridiculous is that so many psych patients are malingering or partial malingering (exaggerating for secondary gain). Healthcare has really devolved into an unsafe atmosphere and patients are not held responsible for anything.
ETA: What gets me, is that the police would taze, nightstick, or shoot a psychotic patient if they were being assaulted, but the rules only apply to some it appears.
MunoRN, RN
8,058 Posts
I wouldn't call that "assault", it was clearly unwanted and inappropriate physical contact due to an inappropriate sense of humor and failure to understand normal limits of personal space, not unusual issues in psych patients. From you description there was pretty clearly no physical aggression involved.
You said you it took you "a couple seconds" to get out of the bear hug, and then after that security tackled the patient to the ground? It's not unusual for hospitals to prohibit police officers from getting involved in managing psych patients since there is specialized training required to do that in a hospital environment. But it does appear like that helped in this situation if your security staff "tackled" a guy poses no imminent physical threat, that's not at all appropriate.