Patient is a sex offender with a tracker on his ankle

[Alex_RN]

When I received shift report for my very ill, bed-bound patient, the RN giving report pointed out the tracker affixed to his anklet. She had admitted him a few hours earlier and did not know the details and there was nothing noted in his chart. Before she left, she looked online and he is a convicted sex offender (lewd and lascivious with a minor under the age of 14).

Is it appropriate to add this new information (pedophilia) to your shift report? To his chart?

[Wolf at the Door, BSN]

As horrible as the information you have found out, no one should've google him (HIPPA). People get fired for things like that. Just do your best to treat him, the law will handle the rest.

Too funny. Please look up what HIPPA is before throwing it into a thread.

[Bumex, DNP, NP]

A criminal is still a patient. End of story.

Edit: meaning that, unless they are in jail, it will not affect patient care.

[Julius Seizure]

Yes, that is relevant information. I am glad she looked the person up. Not all the times are we informed of exactly what type of person we are dealing with. You need the information to keep YOURSELF/STAFF safe and visitors. Some nurses talk about their children and show pictures to patients. You don't want to set this person off on a sexual fantasy. I would document the tracker for sure.

This seems a bit dramatic. It has already been covered that his sex offender status could be just as easily related to something like public urination than molestation of a young child. Even so, its a little dramatic to act like at the mere mention of the existence of a school-aged child, this guy is going to be thrown into an uncontrollable (and bed-bound) fury of lust.

[Ruby Vee, BSN]

But you knew you were dealing with convicts, inmates, prisoners, and the accused who were awaiting trial.

That way you knew to take precautions - be courteous and give proper care, but don't share your personal biz with them, no favors (like mailing letters for them, making calls for them, shopping for them, running errands for them).

Apparently, no one gave any information or instruction to OP and her coworkers, so they are freaked out about it. Shame on their managers.

The OP doesn't need information; she needs instruction. I was a nurse long before Google, but we were taught that we didn't need to know the patient's legal status or the crime he was accused of. The guards were forbidden to tell us given the privacy policies of their facility. Since we had no way of looking things up, we just didn't know. We knew he was in custody, that's all. That's all we needed to know.

Our shift to shift report included safety information such as "one of the guards has to be within three feet of him at all times and the other guard carries a gun," "he has ankle restraints -- if you're going to cardiovert on this shift, please get the guards to remove t hem first as they could cause burns," and "He is not allowed to have any visitors at all." There were other things, too, such as the patient wasn't allowed to consent for surgery, the incarcerating facility sent a representative to sign or not sign. In that sense, the patient had no right to privacy.

I don't see how knowing the crime the patient has been accused or convicted of changes the nursing care at all -- except for allowing the unconscious biases of the nursing staff caring for the patient to influence his care. That's not a positive thing.

[concerned citizzen]

Definitely you don't state such things on someone's chart! You are a care provider and that's what you job entails. You are not law enforcement! Please just do your job, which is to care for people and not judge them! For God's sake!

[concerned citizzen]

See! This is the problem with the public registry....people fear mongering and creating havoc where there should be none! Everyone deserves the same chances and care, and that includes every human being without judgement!

[kbrn2002, ADN, RN]

I am disturbed by the fact that this patient was admitted to a floor without a monitoring bracelet being at least mentioned. While I don't think that googling a patient while at work is an appropriate way to get information, the sex offender registry is a public record so there aren't privacy concerns there. My bigger question remains why wasn't management made aware of this before this patient was admitted? If they were, why didn't they inform the staff at least of any facts surrounding the monitoring that could affect care? For instance, legally the police/probation office needs to be aware of the patient's whereabouts for the patient's sake. Ignoring the presence of the monitor could be detrimental to the patient's care as well as disruptive to staff and other patients if a plan is not in place with the monitoring agency that makes it possible for them to continue their monitoring while the patient is hospitalized.

While the fact that this patient is on the sex offender registry isn't necessarily pertinent to his care while in the hospital, it is very pertinent to discharge planning. If he is able to discharged to home I would think his discharge will need to be reported to his parole or probation office. If he needs follow up care at a rehab or skilled nursing facility placement in one can prove to be difficult at best and again, needs to be coordinated with the probation or parole officer. Legally these issues will need to be addressed eventually. Unless the patient was a direct admit to your floor why weren't these concerns addressed in the ED so a care plan could be initiated that addresses his legal concerns as well as his physical illness?

[jablester]

Sorry, you are all wrong. You need to ask your manager or SW to deal with it. Your State law will determine what if anything you need to do. Law enforcement will tell you if you need to report the admission, and whether it is the registrant who has to do the reporting. In Kansas, such reporting is not required unless the admission is for psych or drug treatment. Being registered is often for stupid reasons, such as public urination. Do not assume this is a dangerous person. The bracelet must be kept quiet unless it has a direct bearing on patient care or unless you have a legal requirement. Find something else to freak out about

[jablester]

By the way, the sex offender registry is theoretically not for punishment. It is possible that the person is on probation or parole but probably not. In all likelihood it is the patient who needs to deal directly with the probation or parole officer. Do not breach confidentiality in that situation.

[KelRN215, BSN, RN]

Go ahead and put it in the cart, that way when he needs to request his medical records for something, he can see it and consult his attorney. He can then sue you, coworker and the hospital for violating his privacy.

You guys have NO right to look up his legal history. If he was a danger to other patients, he would have a sheriff by the door. Also, you should hope nothing goes wrong during his stay there, or they may also accuse you of treating him differently after you and the coworker violated his privacy. You discussed it, so it's going to be your burden to prove you weren't the one checking on it.

How in the world is this even something that's being questioned. He has a right to privacy from the people providing his medical care. His community control officer knows where he is, and if he was a risk, you would have been notified.

You may want to notify your supervisor what your coworker did, because it can come back on you. Either tell her up front, or drop an anonymous note.

Sexual offender registries are public record for a reason. The general public has every right to look it up, that's why the state publishes the registry and gives the general public access to it. There is no right to privacy when one has committed a sexual crime- that's why the state keeps a registry of these people. I just checked my state's and found 89 sexual offenders registered within 3 miles of my house.

[AngelKissed857, BSN, RN]

The ankle bracelet may have nothing to do with the registry. Could very well be something else entirely.

[Castiela]

Just to throw my two cents in, what does your board say about it? Hospital policy? I know our governing body has strict rules to not search for a patients information online. I would note the presence of the ankle band, note skin condition, and alert the charge and SW. They would be able to escalate the concerns to ensure proper bed placement and protection of the nurses.