Police Holds

Nurses General Nursing

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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.

Specializes in Critical Care.
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've often had officers ask us to call them when a patient get's discharged, but I've never worked at a facility that allows that without a subpoena or court order. Otherwise it's up to the police to figure out where they are at.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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.
He was under arrest at the time of admission and under guard...he was officially charged with federal crimes while in the hospital
Specializes in MS, ED.

You might not always need consent to disclose to law enforcement though; know your state laws and hospital policy first. JME. Another link, this one specific to LE from HHS: http://www.hhs.gov/ocr/privacy/hipaa/understanding/special/emergency/final_hipaa_guide_law_enforcement.pdf

Specializes in Geriatrics, Dialysis.

Interesting topic for discussion. I've never run into this, but then I work in a SNF in a smallish area, so the risk of ever being confronted with a new admission that the law is interested in are pretty darn slim. Topics like this are yet another reason I'm glad I don't work in an urban ED.

Specializes in HH, Peds, Rehab, Clinical.

Sounds like a Snopes story to me... :banghead:

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.

As far as I know, we can keep the police informed but if the patient has not been committed for a Baker Act (psych involuntary in my state) we cannot physically hold them against their will. I have only seen 24/7 guards, but I left the hospital in 2009. Actually, only the police could force a Baker Act into the hospital, as any other transport could be charged with kidnapping if the individual refuses. This was per the fire dept when the patient refused and the POA was unreachable after a head trauma in an ALF. The facility tried to mandate an ER visit. However, they cannot because the resident did not want to go and that was their home. I would seriously look up what you can legally do, as holding someone against their will can get you into hot water and your facility will be the first to say that they never told you to do that.

Specializes in Surgical, quality,management.
But how does a nurse evaluate the legality?

Its not up to the nurse to decide that, the police can apply through the appropriate channels for a release of information.

Specializes in Emergency Room.
Just curious what other hospitals policy is when an admitted patient is under a police hold...

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.

Couldn't agree with you more! This is a safety concern for staff as well as for other patients! Our facility has a contract with a private security company. When we have a patient on any kind of a detention order, the hospital security supervisor contacts the security firm to dispatch an officer to stay with the patient until dispo/discharge.

Specializes in Acute Care - Adult, Med Surg, Neuro.

As another poster said, any patient in police custody has an officer with them in their room at all times. They are usually shackled and/or handcuffed. That is their job. It is only my responsibility to provide medical care. I have never dealt with a patient who wasn't in police custody but had outstanding warrants for their arrest (at least that I know of). As a floor nurse dealing with that scenario is above my pay grade and I would defer to management. If the person tried to run I wouldn't stop them (barring any time of psychiatric hold, which in that case the patient would have a sitter).

There have been a couple of pts on police hold in our facility, but it's been years. One had stolen a car, hit a pedestrian & killed them. The cops knew he did it because there were witnesses. This got really complicated because the pt. was actually a juvenile. What I remember about that is that the police said he had to stay on the unit & that only immediate family could visit. I don't remember much about his actual discharge, but I know law enforcement officials came for him. The other was an older guy who had been driving drunk, hit another car at high speed & killed all the occupants of that car. He didn't remember any of this when we first got him-the psychologist told him when he was close to being discharged that he was going to jail. That pt. was absolutely devastated when he found this out-he was actually a decent person in the hospital, but then, he wasn't drinking. I do remember both LE & hospital powers that be determined he wasn't a high elopement risk, so he was discharged to the police.

Specializes in 15 years in ICU, 22 years in PACU.

I work in PACU so our police holds are usually pretty banged up and don't need much "guarding" but the officers will cuff 'em to the bed anyway. This one fine officer, having done a splendid job of securely attaching the leg cuff to the foot board, was a little surprised when I easily lifted the plastic board demonstrating it wasn't attached to anything but the prisoner. We had a little chuckle. I just love these guys.

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