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.
This is sticky. The patient still has a right to privacy, regardless of their police situation. If the patient is already in police custody, but then come down with something that requires a visit to the local ED, then an officer needs to come and stay with said patient, as the patient is in the custody of the police.
If the police show up and you have someone who may or may not be guilty of a crime, it is up to your policies and procedures. Most of the time, the patient has the right to decline certain visitors, we can not confirm that the patient is even in the ER, that type of thing.
I find it really uncomfortable when the police show up and start asking questions regarding a patient--they have the absolute right to privacy in the facility, just like every other patient.
HIPPA laws specifically cover law enforcement and the rules of privacy do not apply IF law enforcement needs the information in regards to their investigation etc.
HIPPA laws specifically cover law enforcement and the rules of privacy do not apply IF law enforcement needs the information in regards to their investigation etc.
I've never had a patient in custody that was not actually in police custody...actually I've never heard of such a thing, period. We've had suspects in gang wars that come to us w/ a GSW, we've had people who had attempted to assault the wrong person and then got injured themselves, suspects of vehicular homicides etc. And then people who were already incarcerated before their admission. They are ALWAYS under armed guard and shackled to the bed; in the case of some, with not one officer but a gaggle of sheriff's deputies.
I agree, that's all kinds of messed up to expect us to be nurse AND law enforcement. If nothing else, like you said these people could be desperate to avoid jail and I'm NOT putting myself in danger to keep them in the hospital. But like others have stated (only read through pg 1), we as nurses don't have the legal authority to detain people. What is the job for law enforcement, is called false imprisonment for others.
we are not a jail. If they want the patient monitored they need to be there
What she said. If they want to know when the person is discharged, they need to provide a guard. In our county, they don't really want to pay to have a guard stay with the patient so they expect the nurses to let them know when the person is discharged. Our hospital does not require us to call anyone. The local law enforcement are aware that we won't call them but will always try to sucker someone into doing. If the person needs to be under watch, that is not in my job description. We are short-staffed enough as it is without having to keep an eyeball on a person that law enforcement doesn't want to bother to put a guard on.
Thanks for the input. I agree that an issue is probably that the county doesn't want to spend money paying an officer to sit in the hospital.
To clarify, prisoners (already convicted/sentenced) are sent to another local facility, not mine. I'm meaning people who were not incarcerated prior to their alleged crime but who require medical care before going into police custody. In at least one instance, the alleged crime was murder and the police still weren't present. I mean, the victim's family could have showed up and tried to get revenge! Local news had released names, etc. so it would have been easy to do without police presence. We are too busy doing our jobs to deal with policing the unit too.
We get these - call them 'detainers'. For whatever reason, the police place the detainer and make us aware when we accept the patient into the ED. They leave and we treat the patient. When dispo approaches, we call and advise same and two officers arrive to take the patient into custody. If the patient figures this out and decides to elope, we don't stop them but we do call the police immediately to advise.
While hospital staff can hold a patient on a medical or safety basis, they can't hold a patient for legal reasons as they have no authority do so. Everywhere I've worked it's up to law enforcement to remain with the patient throughout their stay if they want to ensure that the patient remains securely held in the hospital. That doesn't mean they don't try and get hospital staff to do their job for them, but every facility I've worked at knows better and tells law enforcement that hospital staff can't hold them. Law enforcement agencies often don't want to staff for a jail hold hospitalized patient, which is fine, but the risk the patient might flee is on them. For low risk patients it's not unusual for law enforcement to not stay at the hospital and just tell the patient to self-report back to jail, otherwise they'll get a warrant out on them.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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.
Yes rape kits are the hospitals responsibility if they do not have a sane nurse at their disposal. A person on a "policehold" has not officially been charged and is therefore free to go.
A police "hold" is technically not under arrest (depending on the state of course).
If they are officially charged the police department must provide the officer. If they have not been officially charged....which I have seen so the departments can save money on OT....and it is a pain in the behind to process/charge a hospital patient (however, it can be done)....so they tell the hospital to call them when the patient is to be discharged....which is not protected under HIPAA as it is a legal request from law enforcement.
I have had a huge brewHaHa about this very subject and after much deliberation and research, in my state, the facility is not obligated to hold the person unless it is physically/medically necessary. Unless a psych hold is placed the "prisoner to be" is simply another patient and they are free to leave however you are obligated to call the police department.
The facility that I worked for made a legal decision that these "police holds" without official charges are not allowed and the department requesting is made fully aware that the patient can leave at anytime but we will cal the police department. They are told if they feel that this person is going to be arrested on the day of discharge, they must press charges and arraign the patient in the hospital room AND provide police guard and they are now incarcerated and in police custody.
In other words if you want him three days from now you arrest him now and stay with the prisoner or they are free to walk.
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?
This. Yes, it's a strange situation, but they haven't been arrested yet. If a patient in my facility is in police custody, then there is an officer there at all times. The pt might even be cuffed/shackled to the bed. The one time I can remember that this didn't apply was on a pt who hadn't been arrested *yet* and was brought to the hospital by police. They tried to have him arraigned by phone, and the judge basically said "no, you haven't arrested him yet, so he's not in custody. Since he's not in custody, what in the **** are you doing there anyway?" On top of all that, the judge told our nursing staff that we were NOT to call the police upon discharge because this would violate HIPAA, and that he would just issue a bench warrant.
I can't say I've ever seen this situation. I am a pediatric nurse so I have rarely had patients who were prisoners. (Rarely, not never.) I think twice I had patients who were transported to the hospital from juvie. Both times, they were handcuffed and shackled and had 2 prison guards with them at all times. It's not the hospital/nurses' responsibility to guard the patient. We're not law enforcement. I know that when they arrested the kid who did the Boston Marathon bombing, he was immediately transported to the hospital. He was then guarded by the Boston Police ATC until he was discharged into federal custody. He was charged at the bedside so I think was remanded to federal custody while hospitalized.
jadelpn, LPN, EMT-B
9 Articles; 4,800 Posts
This is sticky. The patient still has a right to privacy, regardless of their police situation. If the patient is already in police custody, but then come down with something that requires a visit to the local ED, then an officer needs to come and stay with said patient, as the patient is in the custody of the police.
If the police show up and you have someone who may or may not be guilty of a crime, it is up to your policies and procedures. Most of the time, the patient has the right to decline certain visitors, we can not confirm that the patient is even in the ER, that type of thing.
I find it really uncomfortable when the police show up and start asking questions regarding a patient--they have the absolute right to privacy in the facility, just like every other patient.