Duty to inform?

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Specializes in Addictions, psych, corrections, transfers.

I have a question and I have researched all over the internet to find the answer but I could find no definitive answer. I'm hoping that some of you may have some insight into the legality and/or ethical issue. I work at a chemical addiction detox facility and we have a separate residential dependency unit in which patients share a room with 4-5 other individuals, and the nurses in detox also oversee this unit when needed. We are unable to treat registered sex offenders due to our location to a school and public park or at least that was the original plan. In detox we still don't take sex offenders but the residential program just signed a contract with corrections in order to take those on probation for their court mandated treatment. Many are coming right from prison.

Anyway, it came about that the staff found out that they were treating a registered sex offender in the residential program and everyone was angry that they weren't told of his status, especially since the house has both females and males all sharing the same areas and they have limited staff to watch the clients. This became a big issue with employees threatening to quit. They had a meeting and management stated that they didn't need to disclose his status because staff didn't need to know. Although, I beg to differ because it would make employees more vigilante for our clients and increase safety. I have no problem treating sex offenders because I did it frequently working in prison, but I think in this case with the patients all living in a house together without a lot of supervision is not a best case scenario and could lead to someone getting hurt and a lawsuit waiting to happen.

All I kept thinking about was when my friend worked in a child psych unit, the staff was not told about a young sex offender's history and he was given a roommate in which he raped at night and it wasn't until after the incident that they found out his status, which management knew about. Management still said it was need to know and they did it to prevent discrimination. Ethically, I think the harm of a client is more important than worry of discrimination.

Does anyone have any information on the legality of duty to inform staff of sex offender status to prevent harm to other clients and staff? Does the management have the obligation to divulge this information to staff?

I know this may be a complicated issue.

I would really appreciate your thoughts. Thank you.

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I'm not a lawyer and the laws probably differ from state to state but I'm not aware of any statute that requires disclosure.

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Specializes in Psych (25 years), Medical (15 years).
it came about that the staff found out that they were treating a registered sex offender in the residential program and everyone was angry that they weren't told of his status, especially since the house has both females and males all sharing the same areas and they have limited staff to watch the clients. This became a big issue with employees threatening to quit. They had a meeting and management stated that they didn't need to disclose his status because staff didn't need to know. Although, I beg to differ because it would make employees more vigilante for our clients and increase safety. I have no problem treating sex offenders because I did it frequently working in prison, but I think in this case with the patients all living in a house together without a lot of supervision is not a best case scenario and could lead to someone getting hurt and a lawsuit waiting to happen.

I know virtually nothing about the laws pertaining to sex offenders and the duty to inform. However, angeloublue, your post has identified some major areas of concern.

The staff where I work typically identify sex offenders for the reasons you identified, angeloublue. Although the sex offender is not mandated to discuss their history with staff, they may do so upon their own accord.

In most cases, recovery is a comprehensive process, in that all aspects of our lives are examined and are applied to the recovery process. Now, I'm not saying that every sex offender has to confess in an open group to everyone, but the individual's past behavior does need to be a part of the treatment process.

For example, in Chemical Dependency Treatment back in the 80's, every Patient saw a Psychiatrist once out of detox, to identify other problem areas requiring attention that could be stumbling blocks to a successful program of recovery.

Staff need to be informed of a Patient's pertinent history, both for the reasons you identified and in order for successful treatment to take place. Of course confidentiality needs to be strictly adhered to and is of the utmost importance.

The best to you in your endeavor, angeloublue, and please- keep us informed.

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Specializes in Addictions, psych, corrections, transfers.

Thank you for your help. When I worked at a psych hospital we were told of a patients sex offender status and they were always a no roommate situation so that is why I was confused.

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Specializes in Pedi.

The only "duty to warn" law I am aware of is a result of Tarasoff v Regents of the University of California and applies to mental health providers who have a duty to warn a potential victim if their client discloses an intent to harm the victim.

So I don't think management necessarily has a legal obligation to inform staff they are just caring for registered sex offenders but if one of these clients expressed intent to attack a nurse or another client to a staff member, there would be a duty to warn.

In most states, the sex offender registry is public record.

I am a pediatric nurse and, in my 10 years of nursing, I have only ever encountered 1 sex offender. It was a teenage patient who had abused his sister. EVERYONE was well aware of his status before he was admitted and he had security planted at his door. He may have had a sitter in the room too. But, again, this was a children's hospital. He was an older teenager- maybe 17- and many staff had feelings that he should have been admitted to the adult hospital next door.

If we ever had a patient whose parent was a convicted sex offender, I imagine that parent may not have been allowed on the premises of the hospital, if the hospital were aware of his/her status.

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Specializes in Emergency Nursing.
I'm not a lawyer and the laws probably differ from state to state but I'm not aware of any statute that requires disclosure.

Ohio Has a law that sex offenders must register with the county sheriff and then deputies verify that address and a mailing goes out to any residence within a 1000' radius along with their location going into a public database.

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Specializes in NICU.

Doesn't the sex offender have restrictions on proximity to school and park? or because he is in a locked facility that the requirement not apply?

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.

Since registered sex offender status is a matter of public record I really don't understand management needing to keep this information from staff. Especially since you have vulnerable people in your facility, why wouldn't you do the utmost to keep them safe? You are right. This is a lawsuit waiting to happen.

I didn't read anything in your original post that any of your patients were there involuntarily. That would add another element to the situation. People who don't have the choice to leave the facility should have the expectation of safety.

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Specializes in Critical Care.

My understanding is that registered sex offenders are legally required to notify a facility they are admitted to of their status, and then depending on the level of sex offender the facility is required to notify all residents of the facility or their designated proxy.

Registered Offenders in a Health Care Facility - JUX Law Firm

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Not sure about the legal implications but the locked psych floor I used to work on did not accept patients with sexually inappropriate behaviors because we could not provide the proper monitoring for safety... or at least, we didn't want to. Another facility in the area had a sexual assurance happen and a lawsuit pending, so I'm sure that had something to do with it as well.

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Specializes in Addictions, psych, corrections, transfers.
Doesn't the sex offender have restrictions on proximity to school and park? or because he is in a locked facility that the requirement not apply?

Yes, there is that law and I'm not sure how we are getting away treating these individuals when we have a school 2 blocks away and our clients frequent the community park across the street which is why we have always turned away sex offenders but apparently some magical law has changed to make this okay. I'm not sure.

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Specializes in Addictions, psych, corrections, transfers.
My understanding is that registered sex offenders are legally required to notify a facility they are admitted to of their status, and then depending on the level of sex offender the facility is required to notify all residents of the facility or their designated proxy.

Registered Offenders in a Health Care Facility - JUX Law Firm

Thank you so much, that is what I was looking for.

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