Police Holds

[ICURN3020]

Just curious what other hospitals policy is when an admitted patient is under a police hold, meaning they are to go into police custody/jail upon their discharge. Where I work it has been an issue of discontent among staff caring for these patients because many local police departments expect us to enforce the hold they have placed on the individual.

The majority of the time, we are instructed to avoid informing the patient of any discharge details. We are told to call the police department when we have a discharge date and time and they'll arrive to transport them to jail. We are also supposed to keep their street clothes out of the room.

Only twice have I seen the arresting police department arrange for an officer to stay with the patient 24/7 until discharge. Won't go into too much detail, but both of these people had allegedly committed very serious crimes which resulted in the injury/death of another person. However, we had another patient accused of the same type of crime and I never once saw the police. Also, I've never seen the police present for the many holds they place on people accused of less serious offenses.

I'm just wondering what or who determines when the police are required to stay with the patient as I've seen inconsistencies. I haven't seen anything official in our policy that addresses this issue. I think the hospital is taking on a huge liability by not requiring the police to enforce their holds.

I do not agree that it is my responsibility to stand guard for these people, who are often desperate to avoid going to jail. I will not chase them through the halls and out the door as they'd probably assault anyone getting in their way. I'm there to provide medical care, not to act as a free security guard for the police.

[blondy2061h, MSN, RN]

Wow! I've never heard of this. There's no way I'm holding patients prisoner in the hospital. That's outside my pay grade, outside my time priorities, almost certainly against the nurse practice act, and may even be illegal (unlawful imprisonment). No way. Either the patient is under arrest and the police can worry about it, or they're a free citizen and have the rights afforded as such, including being able to leave AMA at any time.

[ixchel]

What in the world! That is crazy! This must be a state thing??? In Maryland, an armed corrections officer stays with the prisoner at all times. My spouse is a corrections officer, and apparently the nurses at the hospital they use really treat the inmates like crap, too. Not that that answers your questions, but anyway, if the person is a risk to society, law enforcement should be REQUIRED to remain present. As a nurse, I think I would actually consider refusing the patient assignment.

[K+MgSO4, BSN]

The police have to provide a gaurd, security will not do it. We tell the pt that they are being discharged into police custody giving time for police to arrange anything they need for the escort. Apparently we are supposed to offer the officers a place to stow their weapon! Only once have I done this when he dropped it on the floor twice in an hour holster it properly or stow it downstairs in the security safe. Some nights on the trauma and plastic wards their have been state police and federal police at various rooms and nurse special on other pts. It was like walking through a train station! As the house manager I had to reprimanded some of them for talking on thier phones at 3 am when people are trying to sleep, looking at at obs charts (paper system) not that they should be worried if thier prisoner had a bowel action unless they were federal police gaurding a body packer and then it is all thier responsibility (chain of evidence).

If they were wanted for questioning we have no right to inform them that a pt is being discharged, that is a breach of confidentially. Nor do they have a eight to know what is wrong with the pt. Despite them ringing multiple times to me the residents and surgeons.

[Red Kryptonite]

How is enforcing a police hold, of a person who is under arrest and therefore in police custody, unlawful imprisonment? That would actually be lawful imprisonment.

If your P&P needs to be updated or clarified, then by all means advocate for that. But just as performing a rape kit in the ER is is the hospital's job, so is keeping a suspect in custody until they no longer need medical care.

[AJJKRN]

At my hospital, our local police department stopped arresting patients long ago prior to their admit because then a police officer has to stay around the clock and then the city is responsible for the prisoners hospital bill...which is probably why your hospital gets "holds" instead of arrests too. We also are suppose to call prior to discharge so the patient can be arrested on there way out of the hospital...sad huh. I think it's only a strong suggestion to do so though but if the patient committed a crime I don't see a reason not to keep the police informed.

[Red Kryptonite]

That's true, AJJKRN. A more accurate way to say it would be that they have a warrant for their arrest.

[JBudd, MSN]

If they are under arrest, an officer must stay with them. Sometimes officers in our ED will issue a ticket or summons rather than have to stay hours in the ED for a full arrest and go to jail. Sometimes they have asked if we will call before discharge but we don't usually; if you want them under arrest, you stay. In house? same thing.

Over thirty years ago, I worked at a major city hospital, with the big rooms with 4 beds. I actually had patients chained to the foot of the bed, would have to call downstairs to get an officer to come up and unlock so I could ambulate them (and if it wasn't convenient for them, it didn't happen). I would have the guy sit in a chair and have to keep stepping over the chain to go around the bed to change the linens. It was then my last name came off my badge, few too many personal questions. Rumor had it on the ortho floor, a person in a full body cast was being released (the jail infirmary was on the grounds) but the officers wouldn't come right away. Friends came in, took a bolt cutter to the chains and carried their friend out while the nurse was at lunch.

[dah doh, BSN, RN]

If the patient is under arrest, a police officer will stay with the patient at all times & the patient is usually handcuffed to the bed. The police will uncuff the patient when the staff has to perform patient care. The police officer doesn't leave the patient without being relieved by another officer.

If the patient is not under arrest, but has an outstanding warrant, the police will speak to the staff & ask them to notify the police when the patient gets discharged. The staff call out of professional courtesy, not because our facility forces us to. None of the times I've called have actually resulted in the police coming to arrest anyone though.

[blondy2061h, MSN, RN]

How is enforcing a police hold, of a person who is under arrest and therefore in police custody, unlawful imprisonment? That would actually be lawful imprisonment.

If your P&P needs to be updated or clarified, then by all means advocate for that. But just as performing a rape kit in the ER is is the hospital's job, so is keeping a suspect in custody until they no longer need medical care.

Because if the police aren't there, they aren't in police custody. Mim not the police or a corrections officer. I don't know the legalities of me as a nurse holding them captive. I don't have to. Of all the things in my job description, I can safely say that's not my job.

[blondy2061h, MSN, RN]

And couldn't informing the police of a discharge be a HIPAA violation if they're still a free citizen and not actually in police custody?

[Loo17]

When police do this, the patient is not yet under arrest. They are looking to arrest/book the patient after discharge because they could not do so prior due to the person needing medical attention first. At least that is what I am assuming the OP means.