pt's husband and sublte threats

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Specializes in Emergency, ICU, Psych, Hospice.

Can I please have your input?During an informational today, one of our nurses related the following. The patient was passive and quite weak and wanted her husband to do all the talking. He was described as intently staring at the nurse the entire time, "quietly angry" and made remarks, several times, that he "has all kinds of guns and knives." He made comments that we, in the north, gave his wife cancer. Expressed anger at the morals of the northerners and again made reference to "I have guns and knives and I usually carry one with me". Said that he'll return to the south once she dies.He did not sign any consents and said he'll see the nurse again tomorrow.

Ok, maybe I'm making a mountain out of a molehill. But, with my background in psych...and, just as a rational person, the red flags are waving! I suggested that the nurse bring the social worker with her tomorrow (the patient is in the hospital) and to never agree to meet with the husband as a lone staff member. It sure sounds like he has a lot of unexpressed anger...and, to me, a heck of a lot more bubbling up inside. Quite honestly, just from the description I received, I suggested they have hospital security near by. I also wondered why this man wasn't reported as he told one of the hospital nurses he "always carries a weapon on him at all times." I don't understand why this wasn't addressed!

So, am I over-reacting? I don't think I am and would appreciate your input.

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Specializes in Nephrology, Cardiology, ER, ICU.

Nope not over-reacting in the least, sorry to say. I would go for security and surely would never set foot in their home w/o a police officer.

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no, you are definitely not over-reacting.

he certainly made a point to share what he's carrying.

and we all know, how nuts families can go...

please em, proceed cautiously.

leslie

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Specializes in Emergency, ICU, Psych, Hospice.

Thanks...I will proceed with extreme caution. The patient is still hospitalized, so I have asked this nurse to bring this to the attention of the powers-that-be and to have security available. I think a psych consult is in order as my hunch is that this man has an underlying psychosis. And, given that his wife is dying here in the north and he is originally from the south, his fears are exacerbated by being so far away from home. I'm afraid that if she does die, he may get tipped over the edge and become violent.He also made a comment that the "9/11 people should have killed more New Yorkers" and "should have finished the job".I told this nurse that this is a very dangerous situation and that an ethics and psych intervention needs to take place asap. I'll bring this up at team tomorrow morning.

I am very acutely aware of the danger here. As an ER nurse, I was on the night a young man took an AK-47 and killed a teacher and a student at a small college in Massachusetts. I took care of 4 of the wounded students who were still able to talk and they all told me he said similar statements like the man in the above paragraph...only no one listened nor took him seriously.

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Listen to your inner voice. Even more important than the words are the fact that your hackles are raised by this guy. I once admitted a woman to hospice and the whole time I was very uncomfortable. The husband stood in the corner of the room and kept muttering things and was just a rather hostile presence. It was very weird. I was so relieved to get out of that house. He ended up shooting his wife and himself a couple weeks later.

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Specializes in pedi, pedi psych,dd, school ,home health.

as we have said before, " go with your gut" If you, with psych experience , feel threatened, imagine how someone with less experience will feel .

prayers that this man gets the help he needs so that his wife can too .

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