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...
any chance of getting him a psych eval? someone who threatens you like that should be seriously evaluated. I understand it's the patient's family but still. dont they have protocol for that at your facility?>
i do not believe that a person loose's his/her citizen's rights just because they are in the nursing profession and have clocked in.
i get so tired of hearing about the "patients bill of right's"....and there are other groups out there with their own individual bill of rights... but what about me as a person who happens to be a nurse and my human and citizen's rights?
why are we suppossed to just "take it", let patients, visitors, doctors, all talk down to us, abuse us, or throw things at us. let alone being yelled at and put down in front of patients. i have been in a simular situation where a family member, a few french fries short of a happy meal , actually did attack me, twisted my arm behind my back and dragged me off into a room while verbally threatening to kill me.
i was terrified and crying so hard after i finally got away and called for help (((and this started in the hallway with that man dragging me down into the patients room.))))
i had to go home that day and i stay terrified for months, specially after he was seen several times in the back of the parking lot when i got off at night.
i didn't know i could press changes and was younger and a new nurse and vulnerable. the hospital didn't ever once talk to the law about it and only had our facilities security escort me to my car at night if i couldn't leave with a few other nurses at the same time. it was horrid.
i'm sorry fire wolf in regards to your experience. as nurses, we should not have to put up with abusive behavior, we did not forgo our basic human rights simply by virtue of choosing this profession. your facility really let you down in this situation. they should have encouraged you to press charges and offerred some sort of counselling to deal with what happened. they should have done a lot more than just provide security escort, especially since this person was seen on the premises after threatening you. unfortunately, they gave this clown the message that under similar circumstances in a hospital he can get away with abusing the staff.
we have all dealt with patients & families under extreme duress and interestingly enough the vast majority do not abuse the staff nor do they use the situation to justify doing so. we have all dealt with paitents & families that have a justifiable reason for being upset and again, in the majority of these situations they are not being abusive. so why is abusive behavior tolerated towards nurses?
there does seem to be an attitude where nurse's are concerned that putting up with abuse is part of our job, whether it is verbal, physical, sexual, etc. the justification for this seem to be that patients and families are going through a "rough time," and as nurses we should make allowances for that. we are also taught to make allowances for behavior because of the lack of "control" people may feel when they are hospitalized and that their behavior is a result of this lack of "control." we also know that we may be dealing with patients that are confused and may not be aware of their actions, however that does not mean that because the patient is confused that their family is. our institutions make rules that are not enforced, it's often common to have staff overrided by a supervisor when they have basically been enforcing hospital policy. we are also given little to no voice when it comes to decisions that affect how we do our job. than we have the fact that most facilities anymore have gone overboard with the "customer satisfaction" nonsense, in fact health care facilities tolerate more crap than would be tolerated by any other service industry towards their staff. in fact all the onus for customer satisfaction is basically placed on the nurses' shoulders.
when nurses do complain and seek recourse, we are often made to feel like we are at fault. we become the focal point of what "went wrong" in the situation. it turns into what "we did" or "didn't do" that instigated the situation. in fact, often the perpetrator is placated in these situations, thus reinforcing the misconception that it is all right to be abusive towards staff, in fact, you may actually be rewarded for it. bad behavior being rewarded in the health care setting is becoming far too common.
health care facilities need to start establishing guidelines for behavior instead of tolerating bad behavior. there needs to be repercussions for abusers, not rewards. threats should be dealt with seriously, including pressing charges, filing restraining orders, etc. physical violence needs to be prosecuted, not swept under the rug.
Specializes in ER, NICU, NSY and some other stuff.
You should personally file for a restraining order. I also agree with the ccw permit and a handgun BUT only of you are sure you could actually carry through. Otherwise your own weapon could get used on you.
Specializes in Clinical Research, Outpt Women's Health.
I would pressure your facility to transfer her care elsewhere. Once a threat like that is made the nurse-patient relationship is compromised, and the best care cannot be provided. For everyone's sake, and I would think from a risk management perspective, this would be the best action. I am sorry you are having to go through this.
I belileve they gave up their rights when one of them threatened to kill you. NO??? Don't want to hear anything about dialyisis patients have rights. It is no one elses's job to "Find a clinic who will accept them". As far as I'm concerned, it is THEIR problem that they made, and only THEIR problem to find a clinic to accept them. Maybe part of the problem in todays society is the lack of consequences for unacceptable behaviour. I think your clinic is justified in telling them "You are not welcome here, and YOU will have to find care somewhere else". PERIOD. Also keeping the restraiing order but i think it is wise to have your private reatraiing order as well as someone else mentioned. Any action short of that and I would quit. Your safety is not worth a job, especially with this nursing shortage in which you could probably work anywhere you choose.
There are laws that prevent providers of all levels from dropping patients without making sure there is a continuation of care.
And in this case, it's not the patient making the threats, but a father/grandfather.
Specializes in Med Surg, ICU, Infection, Home Health, and LTC.
i'm sorry fire wolf in regards to your experience. as nurses, we should not have to put up with abusive behavior, we did not forgo our basic human rights simply by virtue of choosing this profession. your facility really let you down in this situation.
health care facilities need to start establishing guidelines for behavior instead of tolerating bad behavior. there needs to be repercussions for abusers, not rewards. threats should be dealt with seriously, including pressing charges, filing restraining orders, etc. physical violence needs to be prosecuted, not swept under the rug.
thank you dusttildawn. it was a terrifying experience and being a young nurse and new nurse, i didn't know how to stand up for myself.
you said a mouthful and it is true that patients are vulnerable, sick, "out of control," but i don't think that anyone faults the confused behaviors of any of those patients.
it is the one's who are fully alert and oriented x 3 or their families that attack and are not going through grief or pain, just hateful and with this unreal sense of entitlement that can be so hard to deal with.
you are also correct that often it is the nurse who is made to feel that she/he is at fault and that we must have failed somewhere along the line to precipitate such a violent reaction.
it is almost the same mentality that makes the rape victim a silent victim. many women do not press charges and remain silent when they are victims of rape or spousal abuse.
prosecutors and courts try to point out what the victim did to warrant the rape and where the victim was walking or what she was wearing that may have precipitated the violence.
the administrator and nurse managers should help any nurse who is victimized... but until they do, we have to learn how to stand up for ourselves. i think education and being able to vent and seek advice from older, seasoned, and experienced nurses, such as on this board, helps.
any chance of getting him a psych eval? someone who threatens you like that should be seriously evaluated. I understand it's the patient's family but still. dont they have protocol for that at your facility?>
Contact the County attorney, County Sheriff and/or local PD. Cite your concerns about mental health issues. INCLUDE THE BELIEF BASED ON YOUR EXPERIENCE AS AN RN THAT YOU BELIEVE THERE IS AN IMMINENT RISK OF PHYSICAL HARM TO YOURSELF OR OTHERS DUE TO MENTAL HEALTH. This should be enough of a red flag to get a hold order and evaluation done. I wouldn't take no for an answer from County Social Services. I wish you all the best as you work through this difficult time.
There ought to be laws that protect healthcare staff from threat of harm too.
Yes, there should be. I think most facility "security" is a huge joke. I worked in one place where the guard used a walker.
But my point was, the poster said that he didn't care about the patient, throw them out. It wasn't the patient, and it's against the law in most places to just drop a patient, especially one who needs life-saving treatment.
I do commend the OP's facility for taking the threats seriously and getting a restraining order against the grandfather. A lot of places would somehow turn it around and make it the nurse's fault.
Specializes in LTC, SCI/TBI Rehab,RX Research, Psych.
I read through many of the posts on this thread--WHAT A MESS.
You certainly can't totally discount this 'imbalanced' individual's threats. Like many remarked, 'he's the kind you read/hear about in the news'[EVIL][/EVIL]
Since the clinic you work for oversees/manages other sites, is it possible to negotiate transferring this patient's care to another clinic?
Physician's offices 'dismiss patients from their care' ALL the time (for reasons MUCH less than this incident, too!)
It seems in everyone's best interests that this patient receive their treatment elsewhere. The client/patient relationship is DEFINITELY 'caput'----not to mention, this psycho may decide to follow you home one day. [EVIL][/EVIL]
Personally, it seems reasonable to everyone involved to have someone in Admin. prepare a list of facilities offering the necesary services for this family, call them in for a meeting to address their concerns---and give them a deadline to establish care @ another facility...with the agreement that services will be provided @ the present location until an appointment can be made at another site.
No one (nurse/practitioner providing care, patient, visitor, transport service) should have to be subject to irrational--and quite honestly TERRORISTIC behavior.
"Not dealing with a full deck" appears to describe mental illness. "Slimeball" is a pejorative term that I am surprised a professional nurse would stoop to without being fully apprised of all details of the individual's behavior and possible reasons therefore. Judgmental attitude + firepower = danger.
Spritenurse1210, BSN, RN
777 Posts
any chance of getting him a psych eval? someone who threatens you like that should be seriously evaluated. I understand it's the patient's family but still. dont they have protocol for that at your facility?>