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

[SotaRN]

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...

[clee1]

It is not illegal to carry revealed. Anywhere.

Also very true....

However, most healthcare facilities take a dim view of their staff openly packing.

[imenid37]

I feel so bad for you. I think your facility should release the patient to another facility's care. The guy could come shoot up the whole place. How gross that the "mother" (I use that term loosely) wants the molester involved in the child's care. I don't care if he is her father. Does he have sex w/ the girl too? What a sick bunch. Maybe children and youth need to be involved in the home situation if this guy is violent. Take care of yourself. Do you have a personal restraining order against this man? I think you should.

[acynicalnurse]

Hi this is only after reading the first page and living in Australia.....

Wow what a head case they all sound like and its just plain wrong you should be doing this without any kind of support?? except to cover there perverbial back end :angryfire

I fail to understand why your facility and dept aren't contacting socail services, mental health services and taking out a restraining order. In Australia we are mandated reporters so we are, plus anyone else who is mandated reporters are required to report suspicions or anything else that says that child has been abused---->under 18 and frankly with the history you presented there would be abuse that must be ongoing . And yes i know services are always over worked etc but doesn't it become a priority when things like you have said come out :chair: Don't blame you for being apprehensive and scared, but just a thought wouldn't arming yourself make you a victim/ target or more at risk of injury especially if at work with being distracted by pt's and their care.

Just my worth

Cheers acynicalnurse

[sanctuary, BSN, MSN, RN]

First, good for you for taking verbal threats seriously. If the GF is as you say, you have every right to be concerned. Now; The grandfather is not the patient, and can certainly be prevented from being on the premiss. Tell your employee that they have a legal obligation to provide a safe and secure work environment, (per OSHA) and hold their feet to the fire. When nurses all stand together and refuse to be belittled, harassed, and abused will there be some changes made. Work with your state nurses association to get a law passed that says that nurses who are assaulted in the line of duty will be supported in pressing charges, and that any institution attempting to prevent it will be fined. California has a bill that is several years old, AB508, that details all that hospitals and other job sites have to do to protect us. Lets get one passed in every state. And keep the old coot away from the place, even the parking lot. And if there is any reason, including DNA evidence, to suspect the he has been a child molester, and has access to a child under 18, you must report it to Child Protective Services. And since the mother's replies were so loose and tangential, or complety innappropriate, I might call CPS and wonder if the mom is on drugs. They can act to protect the girl, and might take the matter out of your hands. Best of luck.

[mlhfisher]

You have one life. Do whatever you can to protect yourself within the law which seems to be what you are doing. I did not read all of your story due to length but of course a restraining order is called for . I will tell you this. and it is not out of respect for the legal system but don't count on them to protect you fully. I have had a similar experience and I ended up having to relocate across the country because the" nut " could not be contained and her family was just as sick. Your employer owes it to you to do EVERYTHING possible to proctect you. You did not instigate this and they are required to keep the workplace safe. Needless to say, the mental health issues in this country are still not being addressed properly.

[Psychaprn]

Wow.

Personally, if I were in charge of your facility, I would make sure other dialysis accommodations were made for this family STAT. Nobody should have to put up with death threats, no matter how 'off their rocker' someone is; the whole fam-dam-ly sounds dangerously unstable, and your employer owes it to all of you to prevent this sort of thing from happening again.

Failing that, your facility should obtain a restraining order against the grandfather barring him from coming within a certain distance of either the property or anyone employed there; if he does, he can be arrested and jailed. I agree, there's no reasoning with someone as deranged as this man---the threat has to be neutralized somehow, and while you can't beat someone over the head with a restraining order, at least you can call the

police.

FWIW, I can relate to the fear and anger you must be feeling. Years ago, I was working on the OB floor when a new father who'd just been told he couldn't see his crack-addicted newborn---placed in state custody at birth---came to the desk and told me he was going home to get his gun, and if I or anyone else tried to stop him from going into the nursery, he'd shoot us.

He left; of course, the instant the elevator door closed I was on the phone with the nursing supervisor, hospital security, and the police, and when he came back there were no fewer than eight people (four of whom had guns of their own) who were ready and waiting for him. They pulled him into an unoccupied room and searched him---as it turned out, he was still unarmed---and eventually talked him down; still, none of us who were there that night will ever forget what it felt like to be threatened with death for doing our job.

I wish you the best of luck in dealing with all this; sure, the guy could just be blowing off steam, but who wants to take that chance? The news is filled with stories of folks just like him who get a wild hair up their keisters for any reason or no reason; I hope your employer takes the threat seriously and takes appropriate action to protect you and the rest of the staff and patients.

It's always scary to be threatened. This has been traumatic for you and may continue to be- I would take advantage of the EAP counseling. The best predictor of violence is a history of such-has grandpa hurt anyone before? The 2nd best predictor-a threat of violence-which he has made. His being banned from the facility may escalate things. I would try to get out of dealing with this pt. and family if you can. I really think the administration should transfer this kid and his family. I would also, in an ideal world have them all get some psychiatric treatment. A gun is no solutuion and can be used to shoot you by an unarmed assailant.

[J'sGirl82]

The same advice applies to nurses and non-nurses alike: Get a firearm, a CCW permit, and training in how to use it.

Irrational people do irrational things, the police cannot be everywhere, and average response time is 4-6 minutes from a 911 call.

You DO NOT have to live in fear, and just because you're a nurse doesn't mean you should be defenseless in case this nutcase hides out down the street and follows you home one evening after work! The armed guard for a week will do you no good next month or at the gas station on the way home.

Stay safe and remember: it is better to be tried by 12 than carried by 6.

My thoughts exactly. You just never know what or how people are going to react. I think he is way out of line for his threats, and I'd be hurt too. We have a gun in our house, and, truth be told, when DH leaves for the field or on a deployment, I feel much more secure. At minimum, though, if guns are an issue, please look into other forms of self protection (ie, pepper spray, self defense classes, tazers, something..) Protect yourself and your family.

[LoriAlabamaRN]

Protection is the key.

I have a gun. In fact, I have more than one. I also have extensive range safety officer training, a permit to carry a concealed weapon, and the peace of mind of knowing that if someone breaks into my house he will be leaving feet first.

I have been mugged.

There is so much crime in this country. I work nights. I work in a facility that has narcotics. We have no security guard.

In the world we live in, I consider it a safe and smart choice to carry a gun. It's sad, but true. I feel much, much safer walking to my car at night with a gun in my belt. If you do choose to get one, I cannot stress how importnat it is to get thorough training.

I'm so sorry you're having to go through this. How incredibly stressful. I'll be praying for you.

[memily2000]

I don't know if the grandfather lives with the mom and pt., but if he does I don't understand why they haven't already been turned in to child protective services. Sounds like the girl would be better off.

[rntraveler]

SotaRN,You seem to be most bothered by why? Don't forget that there are all sorts of people in the world and they don't change for the better when they are sick. That is the sort of person he is. The illness of his child has not changed him for the better. Your facility should consider not allowing family members in the treatment area at all. I have worked in a large city where there was a lock on the treatment rm door and it was controlled by a buzzer at the reception desk. Pt were not allowed in the treatment area until staff called for them and no family was allowed in,for everyone's safety. No extra persons should be in treatment area during put ons and takeoffs due to the possibility of being sprayed by blood. The way dialysis is run,there are usually put ons and takeoffs going on almost continually. The reason that you can't refuse to treat the girl is because she made no threats or scenes,it was her relatives. She should not die because of them,that's why an alternative treatment center must be found for her if you refuse to treat her. The same holds true for drs-they can't abandon their pt. It sounds like your facility is being supportive of you. Just remember,it's them not you.

[kidsccrn]

I can't believe I'm actually writing this but I'm hoping it may be therapeutic for me.

I am the victim of an assault by a pt. I have been out of work since the day after christmas due to a torn TFCC which I just received approval from comp. for surgery. My MD told me I have a permanent injury that he can only try to make it functional enough to work, the next step will be some kind of ligament transplant. Oh did I also mention this is my dominant hand!!!

Anyways this was a 17yo punk who swallowed a bag of cocaine while being arrested. He arrived in custody but was then given an appearance ticket because the police did not have the evidence and did not want to wait for it. After they left the fun began, mom arrived demanding to take him home. To make a long story short CPS got involved d/t his age and said we had to keep him. 6 security officers took him down put him in 4 pt leathers I went to give him sedation IV he broke out of the restraint grabbed my arm threatened to kill me I went to the floor hanging by my twisted arm! The mother threatened to come back with a gun to take me out, and told me to watch my back. Oh did I mention he is a gang member and has been shot 3 times.

I am scared to death to go back I did press charges and asked for a restraining order (which I still have not gotten). The hospital has not been at all supportive as a matter of fact they put me in the float pool!!! I have been a nurse for 30 years at this hospital and I have never been so scared to leave my home as I am now.

Until admin. wakes up and admits we are always in danger and take these threats seriously this is going to continue. I called EAP they talked to me on the phone and said I need to see a councilor at my expense- I know the drill what I need is a safe working environment! I know I have PTDS who wouldn't I thought he was going to kill me and would have if security had not pulled him off. I think we should be allowed to tazer (? sp.)!!!

So what I say to all nurses take every threat seriously and report it to have a record of it. It is a felony to assault a health care worker.

Please protect yourself from the crazy people out in the world.

Sorry this is so long

[RuralNP4KIDS]

Hello,

Being a Peds nurse I suggest one of 2 things. 1. Speak with your 16 year old patient and find out about her home life. I am sure this grandfather is not putting on a special show for you. Her home life can't be that great. 2. If you don't feel comfortable having that kind of conversation with your patient go directly to child protection services. They are obligated by law to investigate any report of child abuse/neglect. It is possible that they already have an open case and this incident may be the one thing that can provide that child with a safer more stable foster family.