I'm curious to find out how your hospital handles violence against nurses. Recently (within the last several months) we have had a FF/known and documented drug seeker pull a knife and threaten the life of the RN and the unarmed security guard. Two days ago after confronting another known FF/drug seeker (professionally), this patient returned to the ER and threatened to bring a gun and kill the doctor and the nurses(me specifically) involved in the patient care. We have also had a known non-compliant schizophrenic become fixated o n one nurse and began stalking and threatening her. All of these were investigated by the police but to my knowledge no charges were filed because no actual crime was commited.
According to our current policy, we still HAVE to see and treat these patients, regardless of the personal and very real danger to ourselves. Our ED is not equipped with metal detectors, nor is it a locked unit. The doors are locked, but security is lax and all anyone must say is "My sister/brother/parent/friend is in room #9" and in they go. Our triage area has only one exit and it is behind the patient, not the nurse, leaving them essentially trapped.
I know that Emtala states that everyone is entitled to emergency care (to paraphase), but am I wrong in thinking that we should have a zero tolerance policy on accepting patients who have threatened to KILL us if they get the chance? I have been very verbal to my management that as the charge nurse I refuse to let these people through the doors and they will never get the opportunity to harm one of my nurses. The physician in question agrees with me. But upper management is sticking to the motto, "everyone reacts differently to being sick or in pain, some lash out and say things they don't mean."
So I ask, what are your policies, how is it handled? If I can piece together enough real information, maybe I can do a better job at protecting my staff. Thanks in advance for any replies.