Death threats at work?

Davey Do · Jan 23, 2019

11 minutes ago, UKRNBSN said:
"I could kill you & get away with it".

My response: "I take that as a threat and if you don't apologize and commit to safety- say that you will not harm yourself or anyone else- you will have to deal with the ramifications of your actions".

If the patient apologizes and commits to safety, I merely objectively document the situation.

If not, I inform those in charge and pursue the matter, up to and including filing a police report.

RNNPICU, BSN, RN · Jan 23, 2019

I would have absolutely reported this. This was directed at YOU. We as health care providers should not take any abuse or potential for harm. What if things are festering in his mind and now he decides to act on these thoughts. By letting it go, you are allowing him to "get away with things" such as potential for further verbal or even physical violence.

UKRNBSN, BSN, RN · Jan 23, 2019

For clarification immediately afterward I of course told him that it wasn't acceptable and mentioned that security will get involved if he continued, which is when he stopped.

But I've definitely realized since then that I should've escalated it immediately.

JKL33 · Jan 23, 2019

Depending on the situation I will either reply according to the fact that statements like that are never okay, or according to my natural urge to let these people know I'm completely nonplussed and they will not be manipulating me.

[Edited on second thought ?]

I would say (not in an offended 'I-can't-believe-you-just-said-that' voice): "I'm here to help you and I'm on your side. Trying to threaten or scare me is not appropriate. It would be better for us to work together."

What all do I put up with? Not a whole lot, actually. But there are better and worse ways of not putting up with stuff.

RNperdiem, RN · Jan 23, 2019

I would have to restrain myself from mentioning that the most prolific serial killers worked in healthcare, and he is the one who should be worried.

Would never say this, of course.

ruby_jane, BSN, RN · Jan 23, 2019

As a new nurse, you are literally learning something new every day. Heck, I've been a nurse for a decade and I still learn something new most days. Next time you'll know to document. I don't know that the comment about boundaries was helpful. Document the refusal, run that up the chain.

I also have a 8 1/2 by 11 legal pad and I document things there that I won't document in a chart. If it was me I'd put date and some non-identifying info (so that it would trigger your memory) about what happened. Don't put chart #. Move on, knowing that you learned a new thing and you'll be better equipped next time this happens.

ruby_jane, BSN, RN · Jan 23, 2019

3 minutes ago, RNperdiem said:
I would have to restrain myself from mentioning that the most prolific serial killers worked in healthcare, and he is the one who should be worried.
Would never say this, of course.

This actually made me choke on my coffee. Good job, Perdiem!!! It's a good thing that there aren't really thought bubbles over our heads at any given moment.

Spadeforce · Jan 23, 2019

change the channel to blues clues

NightNerd, MSN, RN · Jan 24, 2019

Yeah, something like this needs to be taken seriously. I've had a few patients threaten to send someone else to the hospital if they don't plan to deliver on their promise themselves. Most of the time it turns out to be nothing, sure, but it's definitely important to document, notify management (and security if needed), and set some hard limits with the patient. People are capable of some crazy things.

I'm not sure I completely understand the tone of your reaction to your manager. Do you feel like this really wasn't that big of a deal or was blown out of proportion? Just curious what your thoughts are now that you've had time to process the situation.

I've had a handful of similar situations. It's sometimes still a little scary, but every time I just get more and more burnt out of bedside nursing. I'm in a position where I don't have the luxury of judging anyone, and I don't really want to; I just want to help my patients get well, and I want to go home after work and be reasonably sure that I'm safe. I told a patient the other day, "I literally have NO REASON to try to slip you medications. That has NO benefit to me; I only offer it because it's to help YOU. You can take it or not, but don't yell at me, curse at me, or threaten me over it." People get so rageful over the most ridiculous stuff!

Ruby Vee, BSN · Jan 24, 2019

Always document things like this. I quote exactly what the patient said -- as close as I can remember, and put it in quotation marks so no one auditing the chart thinks *I* am the one who chose to use that language. And notify the charge nurse. If I'm the charge nurse, I notify the provider, the nurse manager or nursing supervisor and usually the AOD. (Administrator in charge.)

When I was a brand new nurse, one of the older nurses I worked with told me a story I will never forget. She was working in the CCU, and a patient told her that he was going to "jump out of the damned window" rather than live as a cardiac cripple. She brushed it off, didn't document anywhere. Late that night, he tossed the visitor's chair through the window and jumped out after it.

Years ago, a newer nurse was caring for a transplant patient who was septic. She (the patient, not the nurse) was agitated, combative and seemed to be disoriented. The NP was trying to draw blood cultures, but the patient had been stuck so many times it wasn't going well. The patient said she was going to "call my brother and have him come here and put you in the ground." It would have been nice to have known that before 8:30 the next morning when I was at the bedside and the patient's brother and a companion showed up, armed, looking for the NP.

evastone, BSN, RN · Jan 24, 2019

There was an old demented patient that said she would kill me. This was not a patient I was caring for or interacted with. She kept trying to get out of bed and could have used a 1:1 but the supervisor wouldn't provide one.

We kept her in the hallway in front of the nurses' station where she would continuously state loudly to anyone who could hear how she was going to kill me because I apparently burned down her house and elementary school. None of my coworkers took her seriously since she was old and clearly not in her right mind. I was a bit nervous about her but said nothing because I didn't want to look weak. I put my ego before my safety.

I was asked to reposition this patient one day. When I got close enough to her, the woman proceeded to strangle me. Because she was in front of the nurses' station the attack was witnessed and she was pulled off me before any damage was done.

Always take threats seriously. If the woman had been slightly younger and stronger I don't know if I would be here today.