Need some advise...Please!!

[1godlynurse]

I had a pt in the ER who refused to have a nurse put in a foley so the resident ordered a urology consult. The doctor had a really hard time persuading the pt to let him put the foley catheter in. The pt was verbally abusive to the urologist, ER physician and I the nurse. Tell us we were stupid, didnt know what we were doing.. so on. 30 minutes and 4 mg iv versed later, the patient had the foley in. The doctor said try not to let him pull this foley out. The pt proceeded to say he had to pee. I and other nurses tried to pursuade this pt that he had the foley in draining his bladder. Pt stated it wasnt draining fast enough and that he had to go pee. Pt stated that he wanted the foley out. Numerous times did I have to tell the pt to relax and lay down but he was very agitated and annoyed. Pt locked himself in the bathroom and came out with the foley in two pieces. He went into his belongings and had a box cutter he used to cut the foley tubing and pulled the foley out. I inspected the foley initially and it looked intact so I threw it away. Went to the orders to notify the resident and the urologist wrote orders for sedation 1:1 sitter or restraint to keep pt from pulling out foley. I think about the situation 24 hours later and I cant say for sure what i saw. What if the foley was not intact when I threw it away? Am I guilty of neglect or negligence?

[58flyer]

Lostdruid, with all due respects I disagree. When a police officer makes an arrest it is based upon probable cause. Showing intent has nothing to do with it. Probable cause means that there is a reasonable belief that an offender has completed the elements of a crime as defined by state statute. There are 3 tests for criminal prosecution and conviction. First the police are concerned with probable cause, second, the prosecution is concerned with reasonable expectation of successful prosecution, and third, the courts are concerned with guilt beyond a reasonable doubt. The subject of intent comes in somewhere between the prosecution and courts. As far as being able to charge someone with sexual battery in the circumstances provided at the start of this thread, it would depend upon how the state statute was worded in the state in which it occurred. In Florida, penetration of the urethra is not specifically covered in the sexual battery statute. In other state laws that I have reviewed, it is covered. I know of a case in Florida where a child molester penetrated a male child's urethra with an object and was charged and convicted under the sexual battery statute. I'm no prosecutor, but I think it had something to do with case law. There is a provision in the statute for bona fide medical purposes. But bona fide goes out the window when the patient refuses or withdraws consent. As to the matter of using a sedative to make the patient more compliant, there is a provision in the Fla statute that makes the use of this a higher degree of felony if it renders the victim helpless. The use of a sedative could result in a charge of false imprisonment if the sexual battery charge could not be applied. During my career I have had several advanced classes on the subject of sex crimes investigation. The issue of medical personnel going over the limit has come up. You really have to be careful when it comes to consent. The police are charged with the responsibility to protect the rights of an individual with regards to equal protection of the law. Failure to do so may result in criminal and civil liabilities. It is preferable to make an arrest if it meets the elements of a crime even if you don't agree with it.

[uk_nurse]

Neglect, no. Negligence, no. Battery, yes. Sexual Battery, probably. That's what I would be worried about, this pt coming back with a lawyer. A pt has the right to be in control of their own healthcare. Period. Any competent person has the unmitigated right to refuse care. Whether they are verbally abusive or polite and respectful is irrelevant, they have the right to say NO. Or is there something that I don't understand about patients rights???

This is more or less what i said earlier on in this post. Pt not consenting to a procedure and it still being carried out = battery!!