We have a frequent flyer who comes to our hospital and as well as other neighborhood hospitals for treatment of wounds and infections. He is paralyzed waist down from a gunshot wound. He is verbally, physically abusive and several doctors at my hospital refuse to accept him as patient because of his thug behavior and they have figured out that all he wants is dilaudid. They know this because every they switch him to PO pain meds, he signs out AMA immediately. This happens EVERY TIME.
Last time he was on my floor was around Labor Day, I had to care for him. I was told never to be in a room alone with him because he cannot be trusted. So I was in the room with him and another nurse changing his dressing which upset him because I insisted the other nurse be present. When she had to leave, we had a CNA come in while I finished wound care and drew blood. Unfortunately, the CNA ran out of the room exclaiming "I have to get this to the lab!" And she left me alone with him while I was picking something up off the floor near his bed. Seconds later he reached over, grabbed my behind and began feeling me up. I reported it to the supervisor who said protocol was to file a workplace violence report. During the rest of his stay he behavior was so bad with other nurses and even patients a security guard was placed outside his room 24/7. And needless to say when they took him off his dilaudid, he signed out AMA. I was told the hospital was going to file charges against him for sexual assault against me and physically/verbally abusing other nurses (he throw an IV pole at my friend).
Well now he is back and on my floor. Do I have a right to refuse this patient? I'm also assuming the hospital never filed any charges. I am also wondering why this hospital keeps admitting him for minor things like, this time, fever.
I'm pretty sure she'd have to actually assume care of the pt to abandon him, e.g. by taking report.
OP, I would file charges yourself. He sexually assaulted you. (The other nurse should, too. This scumbag could have killed her!!) I don't know about having to provide your street address; the police can tell you if that's true or not. Perhaps you could take out a PO box for receiving official mail r/t the case?
An RN in my hospital has a restraining order against a pt. The hospital still treats him, but he can't be admitted to the RN's unit, since he would be closer in proximity to her than is allowed by the OP.
First off, I am having a hard time following where this patient's pain is. If he is paralyzed from the waist down, he still has feeling below his waist?
People w/ anterior cord injuries can still feel pain. Or else it could be back or neck pain north of the injury.
Specializes in Med-Surg, OB, ICU, Public Health Nursing.
In California there is a huge campaign to have Cal OSHA write regulatations to address workplace violence. Historically, nurses who have been assaulted, particularly by patients with a psyche diagnosis, were discouraged from reporting. Nurses who have the most unsafe workplaces in the nation, are beginning to stand up for ourselves. It is not easy to go against administration's, "there, there, we will take care of it BS." Nurses need to contact authorities and report the violence. Reporting unsafe patients may save you or another nurse down the road.
I can't give you any legal advice, but to me it sounds like you need legal advice. It does not sound right to me that a plaintiff's address would be made known to a defendant in a case of assault. You need to find out about your rights and your safety from an actual attorney - if it were me i'd do it now since he's admitted again.
It is absolutely true that a plaintiff's known residence will become part of the legal documents, available under Discovery.
I just don't get why this patient is allowed to continue with this same stuff different day and nothing changes, nothing is done....and he continues to assault nurses....and off he goes on his merry way.....
Until the hospital is sued for failure to act. Or neglect as obviously he is unable to care for himself.
I am not sure that I would outright decline to take this patient,(but this kind of patient is my thing) but I would be absolutely sure that I was never alone with this patient. And that I document and advocate for stronger measures for harm to self and others is addressed, and re-addressed, and documented to the nth degree.
It's all fun and games until the reimbursement stops due to leaving AMA or re-admissions....THEN they will take his issues and assaults a tad more seriously, no?
There is something wrong with this kid, and he needs to be in an alternate level of long term skilled care. He can not take care of himself. He is acting out, out of control in his behavior, a threat to himself, a threat to others. He needs to be sectioned.
The hospital keeps readmitting this patient because he needs medical care .... and they get PAID to do that (read money signs).
Cheers
Probably not. He's most likely on Medicare disability. If he's enough of a frequent flyer that he keeps coming back within 30 days with the same admitting diagnosis, Medicare will deny payment.
I was told I was not allowed to file charges because hospital administration was notified. I also was told that if I filed charges personally against him, he could find out where I live.
aSK whoever said charges would be filed what the status is. I think you got the royal run around and will need to self-file if any filing is to be done.
I'll bet there is a way to keep him from learning your address, like maybe use your work address when you file. I think you're being lied to, railroaded, and bamboozled.
Talk privately with a couple of lawyers, too. Probably get free consult.
Definitely take Security or a male nurse with you to care for him, if you are going to care for him at all.
Specializes in Oncology, Rehab, Public Health, Med Surg.
As a charge nurse, i would do everything in my power to make sure this person did not get Dilaudid--- ever on my shift. Id be glad to assist the dr with planning other pain relief methods if needed. Luckily on my floor it wouldnt be needed. Our docs are great about this. Not saying he wouldnt get pain management but it wouldnt be Dilaudid
And what we would tell pt? " dilaudid has an adverse effect on you. You became aggressive and assaulted a nurse. We know you would NEVER purposely do this so we are listing Dilaudid as a drug that does not work for your body. But we can talk about other pain med options...."
And watch how fast he goes AMA to seek his drug of choice elsewhere
I work in Psych intensive care unit (Sylvania, Ohio) and first of all your combative patient sounds like he needs a psych consult to learn how to control his anger and compulsive behaviors better, along with possible addiction issues (and maybe some quiet room therapy!!) LOL But on a serious note in regard to the assault and he did sexually assault you! We have a lot of assault cases and threats from criminals and at our hospital I had to file the charges myself along with a restraining order because I was told the corporation does not or cannot do that because it is personal and it happened to me. And another RN filed against the same patient and I was told that that since there are two staff members that have filed against the person they will be on a "not welcome back" list or at least would not ever be placed on my unit again or I would be floated out to the main psych unit while the patient is there. Most likely the patient won't be brought be back though. I hope that you also formally spoke with your HR department so it is on record in case there is another offense because our employers cannot just allow "EVEN" the patients to treat us so horribly!! Sometimes it seems like administration gets so concerned about their customer satisfaction surveys that they lose sight of the well being of staff.
He sounds like a patient that has frequented my hospital. And so I'm not surprised.
I'd call the police and ask them what your rights are. Regardless of whether this patient is under your care or not, it does not mean he has free reign to put his hands on you while you're doing your job.
Here.I.Stand, BSN, RN
5,047 Posts
I'm pretty sure she'd have to actually assume care of the pt to abandon him, e.g. by taking report.
OP, I would file charges yourself. He sexually assaulted you. (The other nurse should, too. This scumbag could have killed her!!) I don't know about having to provide your street address; the police can tell you if that's true or not. Perhaps you could take out a PO box for receiving official mail r/t the case?
An RN in my hospital has a restraining order against a pt. The hospital still treats him, but he can't be admitted to the RN's unit, since he would be closer in proximity to her than is allowed by the OP.