Need advice...life threatened by pt's family today

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Hi all,

I'm a charge RN at a chronic hemodialysis unit for a major dialysis group. We have a pt who's 16 with not only a slew of health problems but also some major psycho-social issues that extend to her mother and grandfather (who was found to actually be her father through dna testing at their prior clinic). To paint a clear picture of this family would take a while, so I'll cut to the chase. The grandfather today stated to 2 of our patients in the lobby that I would not be at that clinic past September and that he was going to bring in a gun and shoot me. This was after appx 1 hour of time spent by myself and my administrator talking with the mother and grandfather...talkng is actually too nice a word...this was more a pointless rambling by both about everything from our request that the mother remain in the waiting room during the pt's put on and take off to their mistrust of the black nurses in the facility. Both the grandfather and mother are those types of people we as nurses dread dealing with b/c they are completely irrational and skip from topic to topic...they are definitely not operating with a full deck, not to mention the whole incest issue. They've been disruptive to other patients and have bad mouthed the care received at our clinic to the transportation drivers, other pts, anyone who will probably listen, which has no basis at all...all of our other pts love our clinic and look forward to spending time with our staff. We've gone out of our way to accomodate the special needs of the pt and the family since their family dynamic is such a complicated one, all with the best interest of the 16 yo pt in mind.

Anyway, after I was told of this threat by the pts who he told, I immediately told my FA, the MD medical director, and the FA who's over ours and 4 other clinics. She contacted risk mgmt...we were told this afternoon that the police dept was contacted and a complaint filed, the mother and grandfather were contacted separately & told that the g'father was banned from our clinic/parking lot/grounds, etc and that 911 would be called immediately if he came onto our property, an armed security guard will be in our clinic on Friday and all next week. Of course the g'father denied the threats. However, he is so off his rocker, he is just the type of loose cannon that you'd see on the news. These people are just plain crazy.

My question is, how do I deal with this?!? The g'father stated to our senior FA that he thought I was a 'jellyfish' b/c I was letting a newly hired FA 'run all over me' (who is black)...she's not running all over me, she's the boss! This is the same reason he gave to the other 2 pts for killing me. I am scared and hurt b/c I just do not understand his screwed up rationale...I know you can't try to understand the thought process of a crazy person, but I just don't get it. I have never done anything to this family and have bent over backwards to accomodate them and their screwed up situation, have listened when I was ready to pull my hair out, and still been nothing but kind. So I'm hurt as well, I suppose.

Also, what are my rights as a nurse? Do I have the right to refuse to interact with them or does that go out the window when you're the charge nurse? Should I take advantage of the ECP counseling thing or whatever it's called lest this come back to rear it's head with me 5 years down the road?

Any input is appreciated here...sorry for the length...:sniff:

Specializes in LTC, assisted living, med-surg, psych.

The laws governing the use of deadly force are different in each individual state. A few years back, I took a police firearms-safety course and obtained my own concealed-weapons permit, and the very first thing I learned was that a shooting is justified ONLY when there is an imminent threat to life. That means a) someone with a weapon is threatening to hurt you, or b) someone IS causing you bodily harm (hitting you, beating you, or otherwise trying to kill you).

This isn't the Wild West or "NYPD Blue"; advising someone to go out and buy a gun to 'protect' herself against 'some deranged slimeball' is not only reckless but foolish, IMO.

:stone

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Specializes in Psych, Informatics, Biostatistics.

[Any input is appreciated here...sorry for the length...:sniff:

LEAVE, do not pass go do not collect $200.00 LEAVE.

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Specializes in Hospice, Med/Surg, ICU, ER.
The laws governing the use of deadly force are different in each individual state. A few years back, I took a police firearms-safety course and obtained my own concealed-weapons permit, and the very first thing I learned was that a shooting is justified ONLY when there is an imminent threat to life. That means a) someone with a weapon is threatening to hurt you, or b) someone IS causing you bodily harm (hitting you, beating you, or otherwise trying to kill you).

This isn't the Wild West or "NYPD Blue"; advising someone to go out and buy a gun to 'protect' herself against 'some deranged slimeball' is not only reckless but foolish, IMO.

:stone

Mostly agreed - however, these laws also apply to harm to others as well; i.e., you can defend the life of another person as well as your own.

Also correct in that this isn't the wild west or NYPD Blue.... but if you'll read my posts again, you'll see that I a) advised the OP to "Get a firearm, a CCW permit, and training in how to use it." ; b) stated what was likely stated to you when you took your CCW training: "Irrational people do irrational things, the police cannot be everywhere, and average response time is 4-6 minutes from a 911 call."; and finally c) "Taking someone's life should always be a last resort, and you should not carry a deadly weapon unless you are prepared to take that step if absolutely necessary."

I fail to see how any of this advice is foolish or reckless. I have never had to use deadly force, and I pray that I never have to, but nonetheless am prepared to do so if necessary.

Might I ask what prompted you to get a CCW? Do you carry regularly?

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I agree with some of the other posters that it would be best if the pt was switched to another clinic. Just make sure that the next clinic is aware of the probs with the pt's family.

As for the gun thing, I fully support the idea of self defense. But this takes TIME. You have to learn to be proficient in the use of the firearm, and it is a skill that doesn't happen overnight. And it is a perishable skill so you have to practice frequently. Also, the decision to take a human life in self defense is a very serious one. It's a decision that you must make before purchasing the firearm. If you hesitate, the bad guy will get your gun from you.

Your concerns right now are for the near term. Get the pt and family moved away from you. Your employer should support you. You should not be the one who has to get away. Job safety is your right. There is a good possibility that you might not be able to get a restraining order because of hearsay in this situation, all the more reason to move the pt.

Once things are settled down, you may want to assess the idea of carrying a concealed firearm. It is a decision you need to make with a clear head, not while under this pressure.

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Specializes in LTC, assisted living, med-surg, psych.
Mostly agreed - however, these laws also apply to harm to others as well; i.e., you can defend the life of another person as well as your own.

Also correct in that this isn't the wild west or NYPD Blue.... but if you'll read my posts again, you'll see that I a) advised the OP to "Get a firearm, a CCW permit, and training in how to use it." ; b) stated what was likely stated to you when you took your CCW training: "Irrational people do irrational things, the police cannot be everywhere, and average response time is 4-6 minutes from a 911 call."; and finally c) "Taking someone's life should always be a last resort, and you should not carry a deadly weapon unless you are prepared to take that step if absolutely necessary."

I fail to see how any of this advice is foolish or reckless. I have never had to use deadly force, and I pray that I never have to, but nonetheless am prepared to do so if necessary.

Might I ask what prompted you to get a CCW? Do you carry regularly?

I did it for the experience at first, as well as because of the job I held at the time, which required me to drive long distances alone several days a week. I figured I'd be OK as a woman alone on the road as long as I had a credit card, a cell phone, good insurance, and a gun.........luckily I never had to use anything but the cell phone and the MasterCard once in a while.:specs:

Nowadays my snub-nosed .38 lives in my bedroom closet instead of the glove box, although I still take it along if I'm doing any long-distance driving by myself. I know how to clean it, and I know how to shoot it.......it's a skill, just like any other, and I also hope I never have to do so for any reason other than practice.

Now, to return to our regularly scheduled thread...........

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Specializes in Hospice, Med/Surg, ICU, ER.
Now, to return to our regularly scheduled thread...........

:) :cool:

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Has anyone considered a referral to child protective services?

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Thanks for the responses everyone...to answer a few questions, the clinic this family transferred to us from was not very forthcoming with the truth of the whole situation prior to our taking them. Our docs didn't want them b/c she's considered pediatrics which they don't generally do. The company however is the type who really doesn't refuse anyone care which is noble and all that happy horse dookey, but real life can leave the staff fixing some major problems! This was one of those cases. We had a prn nurse come to our clinic for a few weeks & her dau worked w/this family at the old one. She told us these things and a few others just to give us a 'heads up'. From what she said, dna testing was done b/c of the incest issue...obviously it never went farther than that. And the clinic she came from is actually a children's hospital which she was in for a while. They have a center within the hospital which she went to after dc. We've tried getting paperwork from the old clinic w/no success. Granted the incest issue is heresay from a nurse who heard from a nurse, but you know how word spreads among nurses...I'm fairly certain her story is correct.

In talking to my boss, my immediate supervisor wants them gone, but the one over her said we can't just terminate them as pts. The kidney council has to be notified, etc. and there are rights that dialysis pts have once they're in a clinic...our docs said we could get rid of them but we'd have to give them 30 days notice & find them another clinic...given their hx, it's hard to imagine a clinic that would be very willing to take them unless we didn't disclose the full situation as was done to us...while I'd love to do that just to get rid of them, I don't agree with not fully disclosing their hx. Considering the threat came from the g'father & he is now banned from our property, I would think that we can't turn it onto the pt & her mother...however, I will tell you that this mom is just as much a fruit loop as her father, you know the apple doesn't fall far from the tree.

I thought last night about this and changes that we could make within the clinic...starting with this girl's chair. They sit sort of diagonal/behind my med station where I spend a lot of time. The mom can't sit still for long and is constantly going in and out of the door to smoke. She ends up walking behind me a lot. I want her gone from that chair and in front of me, as far away as possible. This will no doubt upset the pt who freaks out at any break in the routine, but screw them...I'm in the mood to be a little selfish at this point. Also, if the mom wants to have access to sit with her daughter, then she needs to stay with her and not go in and out, in and out. We have a locked door from the lobby & people have to push the doorbell for us to let them in...she will sit there and push the button 20 times over and over until we open it. I've told her many times that if we don't answer right away, it's b/c we're busy with the OTHER pts but she just doesn't get it (she thinks we do this on purpose b/c we're keeping her from her dau...:banghead: ). We're also going to have a meeting with the mom on Monday about her behavior & give her a warning. I know that my bosses and the company are serious about this threat which is comforting, however, a crazy person is just that. I'm not the type to pack heat, never have been & never will be, but I will change up my routine. This man isn't a 20 year old fit one...he walks w/a limp & is weak to one side...and he's about as dumb as a box of rocks (I know clee...you'd say those are the words you'll put on my head stone...haha!). But I guess it makes me feel a little better that he's that way.

I think I've answered most of the questions...I'll keep you posted on Friday's events! So, why did I become a nurse again? Someone remind me, please! :smackingf

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Specializes in MICU.

I'm so sorry to hear about what happened. No one deserves to live in fear.

I think child protective services def needs to be contacted. I agree, I don't know how DNA testing came up in the last clinic, but even if the incest thing isn't true, this still sounds like a bad situation.

It's your choice if you want to remain @ your job. You need to see if she can be transfered to another site (w/o granddad coming) or if there is another site for you.

Even if you decide to get a gun, there are other evasive measures you can take. Always call the police if something doesn't feel right: Listen to your gut. Be aware of your surroundings. Take a different routes to/from work. Stay with groups. Carry a cellphone and have a codeword with friends/family, so if you're accosted say that you need to call someone you were supposed to meet or they'll report you missing. (As in, if the codeword is "Washington", you can say, "Hey, can you walk Washington for me? I'm going to be late, I'm stuck @ work." The person you called can then call the police.)

Although you may not have thought of it, most police departments have a domestic violence dept (sometimes a whole department, sometimes a couple of officers). While you case will not be assigned to them, you can call the dispatcher and ask to speak to them. At the very least, they can point you to the resources you will need: counseling, how to get a gun permit, how to get a restraining order, etc.

I wish you luck and while no one should have to live like this, some of us do, even if it's for a little while. Mobilize your resources (work, personal, and civic) and protect yourself.

Good luck.

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I certainly respect the right to bear arms and protect yourself issue (I just wish I knew how to use one). However , where I work there is a notice on the door that no firearms are allowed on the premisies and wouldn't you be fired if it were found that you had a concealed weapon on you?

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Specializes in Psych, Med/Surg, LTC.

I agree with getting a concealed carry permit. (Of course, get some training on how to use the thing and how to carry safe) I would not carry while on the job though. Your employer has a duty to protect you on the job, and I would assume it is illegal to carry in a hospital/clinic setting. YOU have a duty to protect yourself off the clock. I do have a permit, and do sometimes carry while not on the job. I would never hurt someone if I didn't have to. Only if I felt my life could be taken, or I could be seriously injured (or the same goes for my family). I do not want to leave my baby motherless and my husband a widow. I would rather be be in court over it than be dead or permanently disabled. If you really feel like this guy could go off, I would consider changing jobs. I would assume this kid will be under your facilities services for quite some time yet.

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To the OP.

Is it possible for you to get a personal restraining order against the grandfather? Not just one while you're at the facility.

I'm not an expert on firearms, but I do know how to use them. Instead of a gun, why not a taser? You don't have to be a great shot to hit someone.

To truly stop someone with a gun you've got a particular area of effectiveness: the torso or head. You hit them in an arm or leg, and they could end up just plain mad and can still get you.

A taser, you hit them anywhere and apply the juice they're out for a bit while help can get to you.

I do know that every facility I've ever worked in requires employees to sign an agreement to not bring weapons of any kind in to work. You'd have to keep the thing, whatever it is in your car, which is not the best place to keep any kind of weapon.

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