Pressing charges on a psych patient?

[linearthinker, DNP, RN]

No kidding Leslie.

[sevensonnets]

Sniper, chill honey. We are all strangers here. From your very first post you accused us all of advocating hitting patients in the head with chairs when it has been pointed out to you (remember I told you to reread from the beginning) that none of the rest of us have said that. You curiously seem not to direct your ire toward the poster who actually did suggest that. You continue to insult and hammer away at the rest of us instead. Take a deep breath and realize IT AIN'T WORTH IT. Go make yourself a nice cup of tea and take a break from it. And, BTW, arguing with a cop is a bad habit to fall into.

[Sniper RN]

I did not mean to include everyone into my frustration.

I will leave this thread alone but I still have my opinion of it.

As far as arguing with a cop. It wont be the first or last time. They have a standard to hold that should be higher than others. I have seen from the countless videos and prosecution of some police officers that some feel they are above the law. I bet a good attorney trumps a bad cop any day. Not accusing 'imthatguy' of being a bad cop before that gets twisted. Just stating that arguing with a cop is within my rights and a cop can't see that then an attorney can show them the light.

I'm done with this thread.

[netglow, ASN, RN]

Wow, you sure do trust attorneys justa little too much. Ever sit on a big trial or do grand jury? If/when you do, you might change your mind a little bit.

[Altra, BSN, RN]

I pursued an assault case against a then-intoxicated patient with a history of multiple psych diagnoses, and I'm proud to say that it stuck and resulted in a trial and conviction of felony assault. I am well aware of how rare that is, especially given the hospital's perception of the ER as the front door to Disney World where nothing unpleasant should ever take place, and their agressive and open efforts to make the case go away.

I am grateful to the police officer whose professionalism went above and beyond when the stuff was really hitting the fan, and to my 5 coworkers, including 2 MDs, who also saw it through to the end.

[Belle Epoque]

And, BTW, arguing with a cop is a bad habit to fall into.

What is the point of this comment? Anybody can pretend to be whomever they wish in the online world. I could be the Queen of England and none of you would be the wiser. Besides, an online forum is supposed to encourage deliberation otherwise it would be a pretty damn boring place.

[Guest717236]

I pursued an assault case against a then-intoxicated patient with a history of multiple psych diagnoses, and I'm proud to say that it stuck and resulted in a trial and conviction of felony assault. I am well aware of how rare that is, especially given the hospital's perception of the ER as the front door to Disney World where nothing unpleasant should ever take place, and their agressive and open efforts to make the case go away.

I am grateful to the police officer whose professionalism went above and beyond when the stuff was really hitting the fan, and to my 5 coworkers, including 2 MDs, who also saw it through to the end.

Hats off to you for following through. No assault should be tolerated and standing up to the

administration with their "make it go away attitude", you are a heroine.

You are a leader and have showed your colleages and the administration the assertiveness to

make a safe working environment for you, your peers and your patients...

[Guest717236]

As for the police, you will not see on TV (due to poor ratings), the amount of work and professional presentation that many officers exhibit.

On an emergency team, I saw numerous situations where officers

of different ages and levels of experience worked to create/maintain

a safe environment..in extreme escalating situations.

When you are out in the real world as a nurse, dealing with a dangerous situation,

professional trained officers show up when called and are key to keeping everyone safe (including the escalating patient). If they didn't personally, I would not be writing this story. (No drama, just the truth..)

[VivaLasViejas, ASN, RN]

Moderator's Note: Everyone, please just take a deep breath and THINK before you push the "Post Reply" button. There's been a lot of heat but very little light shed in the past several pages of this thread, and if the issue cannot be debated civilly, the thread may be closed without further notice. Please review the Terms of Service regarding inflammatory language and personal attacks. Thank you.

[rn/writer, RN]

Some things to consider:

If you are hurt, you get to say ouch. That might include defending yourself physically, calling 911, reporting the event to the police, documenting like crazy (pardon the pun), and using worker's comp for any injuries sustained.

It's true that the outcome might be very different between a patient who is psychotic and another who has a personality disorder. You as the victim are probably not the best judge of that and should involve others in the decision, including law enforcement.

Neither you nor the police decide whom to file charges* against (different from pressing charges*). That is the prerogative of the DA. But the chance that those charges will be filed goes down to zero if they never hear about the incident.

There is more at stake than just making accusations stick and having a patient convicted of violent behavior. With truly psychotic patients whose grasp of reality is tenuous on a good day, consequences may not mean much, but, as others have said, there are patients (especially those with borderline personality or conduct disorders) who have learned to use their mental illness diagnoses as carte blanche to do whatever they want to anyone who gets in their way, in part because they have been given passes previously. For some this is a regular way of life, and threatening to "go off" is a tool they use to manipulate their environment.

People like this need to be faced with boundaries and serious consequences. Letting them continually wreak havoc enables them to hide behind their mental illness and use it as a weapon.

Reporting violent attacks to law enforcement gets this behavior put on the record. Another poster mentioned that this can help to establish a pattern which may, at some point, help to determine where this patient resides and what restrictions are placed on them, even if it doesn't directly help the staff person who was attacked at that time.

It is possible that their behavior--if it's officially reported and recorded--could determine things like future custody arrangements, job qualifications, and incarceration status. It may also have a bearing on current and future treatment. HIPAA may keep this information protected if it isn't reported to law enforcement.

If there are mitigating circumstances, let the person's attorney worry about that. We do not need to argue both sides. We do need to insist that our own situations be taken seriously.

Even if the person is psychotic, the facility needs to seriously evaluate whether staffing and security are adequate.

I would be wary of any facility that wants to intimidate, sweet talk, or bribe you into staying silent about violence. I'm not talking about a typical unruly take-down, but things like choking, beating, cutting, and so forth cross the line.

I had occasion to call police once at a free-standing psych hospital when a dozen adolescents ran amok on the third shift (with minimal staffing). I was exceedingly grateful to see them and thankful that they helped us to restore order. Yes, I was somewhat fearful that the powers that be would be upset, but they said I had done the right thing and the on-call supervisor made the decision to send two of the patients to more secure facilities. She said I had taken the necessary action to keep patients safe.

That's what this is ultimately about. Keeping everyone--including staff--safe. Yes, there needs to be a treatment team conference after the fact, but in the heat of the moment, you do whatever it takes to restore and maintain the safety of everyone involved. Even if the incident settles down quickly, you still need to take care of yourself, and that may mean pressing charges.*

*Pressing charges means that the victim of a crime wants the person to be charged. It is the District Attorney who ultimately files those charges. Sometimes the victim's wishes have a bearing on the decision. In other situations, the DA can file charges--or not--regardless of the victim wishes. Check with your local law enforcement for further information.

[ImThatGuy, BSN, RN]

Neither you nor the police decide whom to file charges* against (different from pressing charges*). That is the prerogative of the DA.

This is a true statement. The prosecutor decides whether or not to pursue criminal charges against someone, and the prosecutor can amend the charge to a lesser offense or drop it all together in the majority of instances. A judge can then dismiss it or nol prosse it as well. There are a few statutes here that can't be pled down, but they don't involve the psychotic scenario in question.

Pressing charges isn't a realistic phrase, but it's a part of the victim vernacular. Realistically, what happens when someone thinks they're pressing charges is either 1) they're filing a police report or 2) they're writing their own affidavit which will be handed to the prosecutor effectively eliminating the police. They do happen because I've written them.

Here, if you were "beat up" by a patient it would likely constitute third degree battery a class A misdemeanor which an officer couldn't immediately do anything about. We could write the report which might result in an arrest warrant warrant, or you could write an affidavit which might result in an arrest warrant. The arrest warrant would of course include the prosecutor and a judge/magistrate. If you were say beaten with something like a table leg (a club) or your ear were bitten off then that could constitute second degree battery thus a class D felony, and the officer at the time would thus be able to effect an arrest if the officer at that time and place felt an arrest was warranted.

The catch is that "most" places aren't going to want to arrest and hold a psychiatric patient because "most" jails aren't equipped or staffed to handle them. Regardless, of what happens, my first reply on this thread was to file a police report (or affidavit) and establish the paper trail. This may not immediately help you in "seeking justice," but in the future if the patient ever becomes more violent then that background has already been established and eventually something, possibly including an involuntary commitment at a secure facility (or jail/imprisonment), can be achieved to keep the patient away from the public and "typical" nurse who is unable to deal with violent offenders.

[Little_Mouse]

Thank you for the last two posts and bringing it back to the topic at hand regarding my initial post as well as answering my questions.

The psych pt that attacked my co worker (non-nurse) and "gave" him a broken nose was totally out of touch with reality (paranoid schizophrenic). The pt spoke some english, but even when we did have an interpreter the pt's speech and thought process was very disorganized. He was highly unpredictable--smiling one minute and literally the next would attack you.

No police report was filed (as far as I'm aware of), but my question was a general one--I wanted to know if it was possible or possible but "silly" to file a report on an assaultive psych pt since this topic was never brought up in nursing school and even working a year in a psych unit, I've never heard of anyone talk about it. All I know is that my DON told me that they had a nurse quit because of a pt (due to a similar issue) and she didn't want to see that happen to me....although not much was done to improve the situation. The pt was 1:1, but we hardly ever had an extra CNA to be a sitter...and of course they would be afraid to even get near the pt, plus we don't always have a male staff during our shift--it's usually just a bunch of petite women as staff.

Ever since the broken-nose incident, the pt didn't show any other aggressive signs, but then again we all made sure to keep a good distance away from the pt so he couldn't attack us. Since many of our pts are frequent-flyers, I would not be surprised to see this pt again and I would like to bet that the pt will be back within the next 4 months (it only took about 3 months before the pt was re-admitted to our facility because of the same **** issue).