responsibility to report threats?

[nursecass]

I will try to make this as brief as possible. Last week I helped take care of a patient that we have had behavior problems with in the past. He and his wife both have numerous incidents within both our facility and a neighboring facility-in fact they have been banned from the other facility. So before caring for this patient it was decided to do team nursing-no one enters the room alone so that there would be a witness in case anything occurred (most of the previous problems came with pt/wife accusing staff of things/comments). Another nurse and I went in to the room to complete care when very detailed and thorough death threats against a physician in our hospital were verbalized to us. I immediately went to my manager who took me to the quality control person (we don't have security at our hospital). QC person told me to fill out a report and she would call corporate to "see how they want to handle this". I asked if the doc would be notified and she told me she would notify him. I went and wrote up the report and when I turned it in to her she reassured me that the doc knew and when I told her about how this particular couple worried me more than others she proceeded to dismiss me because I'm "just an ER nurse and probably haven't had to deal with death threats before." I told her this wasn't my first time but that I just had a bad feeling about this couple and asked if police would be notified. She told me she would take care of all of it.

Fast forward to today (my first day back) and I find out nothing has been done. No one has been talked to (myself, the other nurse, a CRNA that also felt threatened, the doc) and no one knows what's happening. The pt completed his stay and when the wife found out we had reported them they both started calling the other nurse and I **** and saying we would pay for that, etc to other nurses on the floor. I called the police department today and they have nothing on file about any of this-no report, no statement-nothing.

At this point I'm not sure how to proceed. Should I try to call our corporate number to find out what's being done about this? Do I file a report with the police? (The other piece of this is that myself and a few other staff members are now concerned about running into this couple around town and aren't sure how to handle them if we see them in public.) Besides writing up/reporting the incident to my supervisor is there anything else I should be doing? Sorry this is so long, but I've never worked in a facility that doesn't know how to handle threats like this so I'm pretty lost. Any advice/feedback would be greatly appreciated.

[Esme12, ASN, BSN, RN]

GreenTea, thanks for the HIPAA correction. I know it's ridiculous but it drives me batty!!!!!!

OP...Everyone is right here.......Illegal activity is not PHI (protected health information). Many administrations use HIPAA as an excuse (and everybody is terrified of HIPAA today) when they don't want to do something or because they are misguided in their interpretation of the law. You may report the threat against you and include whom ever else was mentioned n htat threat. Like I said though, be prepared for a bumpy ride with your present administration. Most administrators don't like to have their decision questioned and will strike back.

Nursing advocates say hospital administrators don't like to talk about workplace violence because it ruins the "hotel-like image" hospitals want to project.

"The mindset is, 'This is a hotel and the client—the patient—is always right,'" said Evelyn Bain, who studies workplace violence for the nurses association.

Last year Beverly Hospital tried to have security officers alter their uniforms, switching from a police-style shirt and pants to professional-looking suit jackets and ties. In response, campus security officers formed a union and successfully fought the change.

"In Richardson's case, she said, hospital management refused to talk to her about her assault, even after her attacker was convicted of indecent assault and battery and sentenced to 18 months in jail. She is still a nurse at Beverly Hospital, but Richardson is bitter about the way she says her employer treated her.

Richardson said she spoke publicly about her assault because she wants to improve safety for nurses.

Despite repeated requests, Beverly Hospital officials would not comment on Richardson's assault or on the general issue of workplace violence. Instead, the hospital released a prepared two-sentence statement praising its emergency room staff.

Silence on the subject of hospital violence is common. A study conducted by the U.S. Department of Justice this year showed that many assaults go unreported.

The study showed a "persistent perception within the health care industry that these assaults are part of the job. Under-reporting may reflect a lack of institutional reporting policies, employee beliefs that reporting will not benefit them or employee fears that employers may deem assaults the result of employee negligence or poor job performance," according to the federal study.

http://www.massnurses.org/health-and-safety/articles/workplace-violence/p/openItem/1628

But first and formost...be safe.

[Guest717236]

Let me clarify

Additionally, they may be in violation of the law. In many states it is law

that if a threat has been made to an individual, that person must be

directly and immediately notified and it needs to be documented by the healthcare staff as such. Your medical director should have been notified and he or she inform the MD.

This includes advising the individual who has been threatened harm, the name and any information

about the person who issued the threat and their current whereabouts if know.

Good grief, what was that surgeon thinking???????????????

Again,pin down what the law is in your state regarding an issue like this from a source other than the legal dept at your hospital.

Your hospital needs to get their act together around

a policy for these situations.

Sorry you have been placed in the middle..........