Tasers being used on mentally ill patients.

Emergency RN · Dec 18, 2009

there have been two incidents where patients with know mental conditions were tasered multiple times.this occurred at two different area hospitals.one of the patients died.the autopsy ruled that he died of natural causes.according to the police report this patient was combative.he died from bilateral pe.i question how combative someone with bilateral pe's could be.i would like everyones opinion on the use of tasers to control a patient.who should make the call medical personel or law enforcment.?
thanks

once a call is made to the police, whether to taser or not is solely at the discretion of the police officer and his or her protocols. it's their weapon; no doctor or nurse has authority in ordering an officer to discharge or safe a weapon. the officer is legally an armed representative of the state specifically authorized to keep the peace, even at the cost of deadly force.

that said, by your version of the story, i arrive at the conclusion that the police were called to respond to incidents at mental facilities.

now, let's break that down; do the police routinely go into psychiatric facilities? in my area, new york city; the answer is an emphatic no. not usually; not unless there was a very serious situation that had already spiraled out of control and is beyond the ability of the staff to handle or to recover from safely.

"tasered multiple times."

what does that say to you? did the cops hit him once and then as the patient fell to the floor unconscious, poured it on, stinging him repeatedly again and again as the patient laid there helpless? i doubt it. they likely kept firing because the initial jolt didn't have any effect on the patient; nor did the second, or maybe even a third. in other words, even the taser's powerful electrical jolts were not really effective unless they were used in repeated and rapid sequential doses. further, this was despite the fact that the patient had bilateral pulmonary emboli. could one imagine if he didn't? the taser may not have worked at all, and the police may have then needed to resort to projectile weapons; ie guns with real bullets and deadly force.

your comments quite obviously leans towards the allusion of excessive or unwarranted use of force. well, you're certainly entitled to your opinion. but based on the scenario that you provided, i would hesitate to judge any situation that i was not a party or witness too, especially one that required such extreme use of force. that said, i've personally seen psychotic patients burst leather straps and punch through walls. it is exactly these kinds of patients that have been known to have injured, maimed, and even killed nurses in their fits of psychotic rage.

so far as i'm concerned, delivery of patient care does not come at the expense of staff safety. if given a hard and very unpleasant choice of a patient potentially dying to ensure my staff or a colleague's safety? no question, i would allow a patient to risk death before allowing myself or another staff member to risk harm to ourselves. if we need to call the police to protect ourselves from a patient, we will call the police, even if this means that the police may then have to resort to extreme or even deadly force to provide for our safety.

we are there to render care to patients; not to become martyrs for their illness.

columbiaetp04 · Dec 18, 2009

Its pretty basic to me. Yes you should avoid tasing mental patients. However just because a patient has a mental condition does not mean that staff are required to accept physical abuse. As a psych RN I have seen patients who are volitionally violent. They are perfectly capable of controlling themselves enough to not injure others, yet they choose to do so anyway. In my mind that is as much of a criminal act as if I went out and punched someone.

DeeAngel · Dec 18, 2009

I as an RN have every right and expectation not to be put in physical danger while doing my job. If it takes tasering to get them to behave then so be it.

fridayannelpn1974 · Dec 18, 2009

Over the years I have seen all kinds of patients injure nursing personnel or other patients. Before "mainstreaming" became popular, I worked in a facility with 90 mentally retarded patients. Now they are called Developmentally Disabled. If not for the fast action of my co-worker, one of the pts. would have taken my head off with a 1"x6"x 3foot piece of shelving he took from his room. Another pt. was taken off Depo (it's concidered a chemical restraint) and he got sexually aroused by another pt. and bit her earlobe off. Another pt. kicked a tech in the groin with his pointed cowboy boot - really bad outcome on that one. I have seen elderly patients severly injure staff. I isn't just mental patient's who have the capacity for violence. NO NURSE SHOULD HAVE TO RISK INJURY OR DEATH TO CARE FOR THESE KIND OF PATIENTS. Resident's rights have gone way too far. What about health care workers rights? I guarantee if you went off like this at the driver's license bureau the police would be there in minutes. If the taser is indicated - Use it as many times as needed. H-m-m? Why is the phrase "Spare the rod and spoil the child" coming to mind?

mmtk · Dec 18, 2009

I appriciate everyones response.However having dealt with mentally ill patients for 20 + years and worked closley with law enforcement a taser has never been used.

The incident I referred to did not mention any staff being in danger.I question if "tasering" isn't used prematurley before other methods that have worked are utilized.

mmtk · Dec 18, 2009

For the record it was used by hospital security not law enforcement.So I should have stated does hosp. security have the authority.My error please accept my apology

Guest219794 · Dec 18, 2009

I am not sure why it is relevant that they are mentally ill. Sometimes force is needed to safely control a situation. It seems to me that is more likely to be needed is somebody's mental illness contributes to their violence or lack of control.

Yesterday I was grabbed by a mentally ill man man- a strong one- faking a seizure. I was able to release his grip by grabbing one finger, and moving it away from me. the rest of his hand followed. I am a 200 lb man, physically fit, who has been involved in multiple restraints. Had the situation escalated, more force might have been needed.

Later, I dealt with a prisoner diagnosed with rage disorder. 250 lbs. Arrived from jail with his own police officer. Had he grabbed me, I would have appreciated any force needed to put him under control.

Where I am, I don't see excessive force used. If there is even a small chance of myself or a coworker getting hurt, I have no problem with a pt getting tasered.

elkpark · Dec 18, 2009

For the record it was used by hospital security not law enforcement.So I should have stated does hosp. security have the authority.My error please accept my apology

That would be entirely up to the individual facility, within any contraints imposed by state law. I have been aware of facilities where security would "mace" (pepper gas) clients -- this was before tasers were invented; I suspect that security at those facilities might well now be using tasers. I've worked in facilities where, if you called security, the nurse in charge directed the security staff as to how they could assist staff; I've worked in other facilities where, if you called security for help, they took control of the situation when they arrived, did whatever they thought was best, and nursing staff no longer had any say-so in the matter (gee, somehow I never needed to call security for help in that facility ... )

There's a wide range of (legal) possibilities out there. I guess the best we can do as individual nurses is make sure we're comfortable with the security policies of the facility in which we work (or look for work elsewhere).

I know there has been a lot of controversy over deaths related to use of tasers, and whether or not they are much more dangerous than the manufacturers and advocates claim.

mmtk · Dec 18, 2009

Thank you elpark.If a staff member is in immediate danger then yes force is necessary.BUT I do not think it should be a taze first then ask questions world.I as an individual nurse still believe "Patient first.":heartbeat not myself

GilaRRT · Dec 18, 2009

I as an individual nurse still believe "Patient first.":heartbeat not myself

That kind of thinking can get you seriously injured or killed. We should always put ourselves first regarding safety and security. At the end of the day, I have a family to return home to and people who depend on me, therefore there is no doubt who number one is at work or otherwise.

fridayannelpn1974 · Dec 18, 2009

The Florence Nightingale era is gone! Wake up Nurses!