Violent Sex Offender on our unit (long)...

[SheriLynnRN]

I work on a surgical unit, and we currently have a pt who is a registered "level 3" sex offender, designated as a "sexually violent predator." He was released from prison about a year ago after serving three years for the rape of a teenaged girl. According to the sex offender registry web site he was determined to be very likely to reoffend.

I expect that he will be a pt on our unit for at least another week or two, he's already been there 2 wks or so. He's got GI issues, TPN, that sort of thing.

Recently, his parole officer had to be called to come to the unit and confiscate a disposable camera that he was using to take pictures of staff, specifically the young female nurses and CNAs. At first he was asking permission, saying that he really appreciated the care he was getting, wanted to remember us, etc. Then he started snapping pics without warning. Before this incident, his history hadn't been communicated to everyone, so a lot of the staff had no reason to be suspicious of him.

The past few days, it has really been creeping me out to be on the unit. He is taking his doctor's order to ambulate a little overboard in my opinion. He walks the loop around our unit for an hour every shift. I'm not exaggerating, he has stated that he is timing himself for an hour. While he is walking, it seems to me that he is intently watching everything. A few days ago, we had a young female pt, and he kept stopping at her room to talk. Her nurse made a point to go in the room and interrupt each time, but we couldn't warn her about him.

Our nurse manager has assigned male nurses and CNA's to him as much as possible, and female staff are not supposed to enter his room alone, always in pairs and keep the door open if possible, just shut the curtain. We were also given permission to remove our badges before going in, because they have our last names on them.

Personally, I would feel safer if a security officer were posted outside his door. This guy is physically ill, but he is not incompacitated. He certainly has the ability to hurt someone if he wants to.

I feel like I am constantly looking over my shoulder, especially later in the evenings when it is quieter and we dim the hall lights.

Has anyone else had this experience? How did your unit handle it?

[fergus51]

We had a dad on our unit who was a violent offender. (His baby was the result of a consensual relationship though). Security was posted in the unit the whole time his baby was there as they were any time the staff felt threatenned. What has your manager said?

[LauraF, RN, ASN, CNA, LPN, RN]

I think that you need to remember he did his time. He may be at greater risk to be a repeat offender, so take precautions, but placing a security guard there would be an invasion of his privacy. I would continue to monitor him when he is doing his laps around the unit, monitor his interactions.

[UM Review RN, ASN, RN]

I think you should have a chat with your manager, the patient's case manager or social worker, AND Risk Management as to how to proceed. There might also be a need to contact the patient's parole officer.

In our state, a registered sex offender has certain limitations that he must comply with. The meeting should determine what those limitations are and how to implement them.

Obviously, your concern is that this patient could be a danger staff as well as other patients, so you're advocating for the staff as well as the patients.

[SheriLynnRN]

I'm sure the reason that they haven't had a security guard on the unit is because he is a free man. I am glad that we know his history. As far as i know, none of us have broached the subject with him, but he must know that we are aware, since his parole officer was called to confiscate the camera.

He stops at the nurse's station during his walks, and cracks stupid jokes with a weird grin on his face.

I know I am being less than professional about this, but it just bothers me. We can't possibly monitor him all the time. When he's at his home, his neighbors have been notified that he lives there, they have the right to be aware. What about all the unsuspecting people who are sharing a hospital floor with him? I know, I know, right to privacy, etc.

[ktwlpn, LPN]

that's a tough one-imho every other patient on that unit has the right to know he is there.it is a matter of public record so i don't see how it is a violation of his privacy. i would think your nurse manager should be working closely with his parole officer to establish his boundaries while in hospital.he does need to ambulate or you'll never see the end of him but i'm quite sure the terms of his parole minimize his exposure to young females.maybe she and any other underage girls should be on the peds unit? you nurses should not have the responsibilty of monitoring him-shessh-if you have a code can't you see him beelining to the room of the young girl? i bet he is "watching everything" he may be just looking for a chance....between the po,your nurse manager and his md you should be able to set specific times for him to amb,times when he is not to leave his room and rules limiting his contact with the other pts....let us know how this works out...on one hand-the guy served his time,right? but he is a registered offender and some of his behavior is suspicious.who has rights here? him or his potential victims? (meaning patients and staff)

[fergus51]

I think that you need to remember he did his time. He may be at greater risk to be a repeat offender, so take precautions, but placing a security guard there would be an invasion of his privacy. I would continue to monitor him when he is doing his laps around the unit, monitor his interactions.

I would think the picture taking incidents would be enough to justify having a security guard around. I don't see how it's an invasion of his privacy. They don't even need to be told anything about him. We involve security in lots of cases with people who haven't broken any laws.

[wooh, BSN, RN]

If staff can't warn other patients r/t HIPPA, I believe his parole officer could if he felt the need to. (Just like when family members ramble on to other families about patients.) But do the other patients need the stress of knowing he's there. What can they do about it except raise their own BPs and have longer stays? Tough call. Does his PO know about him pestering the female pt?

[RunnerRN, BSN, RN]

I don't know if a security guard needs to be assigned to him, but I do think your NM or his parole officer needs to approach him regarding his apparent need to go talk to the young lady, as well as his overfamiliarity to the female NAs and RNs. A simple "given your history, this isn't appropriate" might suffice if he is a reasonable person (caveat - I'm not seeing how a sex offender could be a reasonable person, but you never know).

[indigo girl]

Perhaps addressing the safety concerns regarding other patients, and staff members in a care plan would be appropriate because of his very real history of violence. I do not think you could EVER be TOO CAREFUL with someone like this. There is such a history of relapse in this type of crime, that I think it justifies protecting patients and staff from him. Strict guidelines should be applied. Get psych involved for help in care plan, and do it quickly. Doesn't your gut tell you, this is a very bad situation? You can still respect his privacy, but you must get have social work, and other professionals on board to develop a unified approach for everyone's safety. Make some noise about this. I am very concerned for all of you!!

[Daye]

I think that you need to remember he did his time. He may be at greater risk to be a repeat offender, so take precautions, but placing a security guard there would be an invasion of his privacy. I would continue to monitor him when he is doing his laps around the unit, monitor his interactions.

[HappyNurse2005, RN]

originally posted by lpn,rnnow

i think that you need to remember he did his time. he may be at greater risk to be a repeat offender, so take precautions, but placing a security guard there would be an invasion of his privacy. i would continue to monitor him when he is doing his laps around the unit, monitor his interactions.

what a beautiful family! what a big little baby

what??