Claiming suicide can get you out of anything!

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Specializes in OB, ER.

I'm so ****** off. We got a guy last night that was violent, fighting with family, breaking windows, ect. The family called the police and he cried suicidal and ended up with us instead of in jail. That was my first problem with the whole thing. He should have gone directly to jail. He has a violent criminal history.

So in the ER he is in 4 point leathers and continues to yell and swear. He states that if he is admited to our behaviour unit he will assault staff, steal a badge, open the doors and escape......He has done this before. He escaped the leathers, he tipped the cart, he was verbally abusive. Ativan did nothing. As I tried to give him an IM of Haldol he looked directly at the security officer and spit in his face. 100% intentional.

The psych facility refused him because he is to violent for them to handle. We called the police because psych, the MD, and I are all feeling like that is where he belongs. Well the officer comes in and says right off the bat he will not take him to jail because he has a 24 hour psych hold. Long story short if you have claimed suicide, psych, ect you can not be arrested and sent to jail because he is not in his right mind. Security wanted to press charges and was told he couldn't. It seems to get more common lately that the police just do a 24 hour and dump them with us instead of dealing with it.

So now we have this viloent patient that I believe is 100% in his right mind and is just an *******. Psych won't take him and jail won't take him. We can't let him go. What is the solution???? When I left after having him for 6 hours. Lets just snow him with drugs and wait until morning for a pyschiatrist. I have NEVER in 10 years seen a psychiatrist come to the ER.

So frustrating, such a waste of time. We can get verbally and physically abused for hours and there is nothing we can do about it because he claimed suicidal at one point. Jail is a safe place! I guarntee they can do suicide watch and he can get a mental health eval there. All this while the kids and little old ladys are not getting the best care they can because we are so tied up with this ahole. Plus he was yelling and swearing loud enough for the whole ER to hear for hours!

What do you guys do in these situations? Can you press charges if you are assaulted? Do you get a lot of police dumps?

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Sorry, the police are in just as bad a situation as you. I have frequently seen articles, police kill violent mentally ill man.....why don't police get training in dealing with psychiatric patients. Or inmate hangs himself in jail, family sues police. No police department has fully funded, 24/7 ability to do mental health evaluations or suicide watches. Any more than your ER does.

I don't have any solution for you, the police, or society. But it isn't really fair to dump it all on the police.

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Specializes in Hospital Education Coordinator.

someone who acts like this is not in their "right mind". There is some reason for constant aggressive behavior. I hate that these people fall in the cracks. He definitely needs MORE drugs for restraint and if he does not have a medical reason for admission, he needs admit to a psych hospital. Sorry you had to endure this

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Specializes in SICU/CVICU.

I am assuming that the police have placed an ED on him. After psych sees him and he is medically cleared, he will probably be commited for 72 hours and once cleared he will then go to jail.

How was he physically abusing you if he was in leather restraints? If he spits just put a surgical mask on him. As far as verbal abuse goes, I just tune them out, to get upset just fuels the abuse. Think of him as an overgrown 2 year old having a temper tantrum, (sorry to be insulting to 2 year olds:))

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Specializes in Geriatrics, LTC.
Or inmate hangs himself in jail, family sues police. No police department has fully funded, 24/7 ability to do mental health evaluations or suicide watches. Any more than your ER does.

I don't have any solution for you, the police, or society. But it isn't really fair to dump it all on the police.

Any more than it's fair for this man, a threat to staff (not to mention patients), to be "dumped" in an ER. While people get killed in jail, there's even more of a risk of this man escalating to physical violence in an ER that does not have the personnel or security measures that a prison has.

Family sues the police for an inmate hanging himself? That's definitely possible. So is the patient's family suing a hospital for "malpractice" or "neglect." Or, what about ANOTHER patient's family suing the hospital for harm or damage done by the mentally-instable patient?

What's unfortunate is that both police and hospitals/ERs have to be "dumped" on.

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Specializes in Emergency.

I feel your pain. There is nothing that will suck the life right out of an ER nurse like the type of patient you describe. It never fails that truly sick people that need nursing care do not get the care they need because of the time it takes to deal with the actual situation and then the added charting required whenever a patient is in restraints. I have seen many patients, once realizing they were facing jail time, say the magic words 'I think I am going to harm myself". In real life, how many people use that particular phrase when truly contemplating suicide? The ones who know the system are the ones who use it.

I realize I didn't solve your problem... sorry, I just needed to rant with you! :uhoh3:

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I would personally endorse the idea of a gag, hog ties and throwing him in the back of thr ole pickup and yelling YEEEEEHAW! I mean if he's already got the 4point on the job is half done! See who can yell louder ;)

Joking aside, I think by the fact that you are listening to him means you are a great nurse because despite the situation you still at heart are caring but you cannot take what he is saying to heart. People can be cruel, hateful, vindictive and a whole assortment of other evils, but it comes down to if you want to let it roll off your back and keep moving or land on your feet and take care of the patients that need what you can offer: your caring heart :)

It sucks having to deal with that and I do see how that would be horrible but if I may ask also, will you be seeing him again? Probably not, so don't sweat it hun and take care in knowing you are a good person.

Good luck and keep your head up!

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Specializes in wound care.

wash your hands and go home to your family and friends and be glad that hes not a member of your family and this isnt a every day experience for you. The system sucks, it sucks you have to deal with this grown up child. but you get a paycheck and have your right mind, and get to move on with your life. now that doesn't change the ****** situation that happened but this guy might never have peace. at least you do... idk

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Specializes in LDRP.

the hospital i do clinicals at has a special section of the ER for people like that. it is a locked area with three rooms, unbreakable glass(plastic), the nurses station is separated with a big window to watch them. its like a mini psych unit. no windows in their rooms, locked garage door hiding the sink, all the psych fixings.

anyway, when i did my rotation there who was homeless and this was his 4th hospital in the area hed shown up at that month stating very calmly "i want to kill myself and hurt my family". so they automatically had to place him on a hold. he was there for 36 hours when i started the day, and hadnt left by the time i went home. no psych units would take him because he was on o2.. thank god he wasnt violent like this guy, but my point is, a sectioned off part of the er for cases like this would be useful in most hospitals me thinks.

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Specializes in OB, ER.
Sorry, the police are in just as bad a situation as you. I have frequently seen articles, police kill violent mentally ill man.....why don't police get training in dealing with psychiatric patients. Or inmate hangs himself in jail, family sues police. No police department has fully funded, 24/7 ability to do mental health evaluations or suicide watches. Any more than your ER does.

I don't have any solution for you, the police, or society. But it isn't really fair to dump it all on the police.

We live in a decent sized town and our officers are very trained. They have a special group of them to deal with this. Our jail does offer mental health care and eval. The problem was not that they couldn't care for him they just refused to press charges so they didn't have a "reason" to take him to jail. I think the security officer should have been allowed to press assault charges but the officer wouldn't let him.

We did our eval but he the psych facility refused him because he was unsafe and the jail refused him....he can't just hang out in the ER for days, he has to go somewhere. The question is where? I don't feel like we were dumping on the police. They picked him up at his house and brought him to us. He has a violent history, he is a drug abuser, he does not have a psych diagnosis, other then suicidal. If he were shizophrenic or something it's a different game but he is not.

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Specializes in OB, ER.
someone who acts like this is not in their "right mind". There is some reason for constant aggressive behavior. I hate that these people fall in the cracks. He definitely needs MORE drugs for restraint and if he does not have a medical reason for admission, he needs admit to a psych hospital. Sorry you had to endure this

He eventually got a lot of drugs and was sleeping peacefully when I left :) But that doesn't fix anything, just masks it. I agree he was not "right" but his actions were intentional. He was very manipulative and purposeful. A psych admit was refused and there was no reason for a medical admit. A rock and a hard place. He obviously cant' go home but no one will take him....

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Specializes in OB, ER.
I would personally endorse the idea of a gag, hog ties and throwing him in the back of thr ole pickup and yelling YEEEEEHAW! I mean if he's already got the 4point on the job is half done! See who can yell louder ;)

Joking aside, I think by the fact that you are listening to him means you are a great nurse because despite the situation you still at heart are caring but you cannot take what he is saying to heart. People can be cruel, hateful, vindictive and a whole assortment of other evils, but it comes down to if you want to let it roll off your back and keep moving or land on your feet and take care of the patients that need what you can offer: your caring heart :)

It sucks having to deal with that and I do see how that would be horrible but if I may ask also, will you be seeing him again? Probably not, so don't sweat it hun and take care in knowing you are a good person.

Good luck and keep your head up!

hehe that's exactly what I wanted to do!!!! I did try hard with him. I took him drinks of water, I tried to reason with him, ect. It would work for a short time then he would escalate again. I do need to just let it roll off and start fresh tomorrow. Thank you for your kind words!

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