No funny photo goes with this particular post.
In a comment to one of my “The Answer Nurse” posts, I received this disturbing question:
What is the correct response when a patient states “Something has to be done about this headache or I will come back with a gun and start shooting.”?
Recent events have made me think that this question needed to be handled with gravitas and responded to in a serious manner.
The following is just my opinion on what should be done, based on the scenario posted in the question. If you are ever in this situation, follow whatever your hospital policy dictates or whatever you have to do to save lives.
This is not to be taken as advice – simply what I would do if it were me.
ABOVE ALL ELSE, TAKE THE PATIENT SERIOUSLY!
- IMMEDIATELY notify your local police or sheriff’s department that an ACTUAL THREAT has been made. While awaiting a response:
- Inform hospital administration/nursing supervisor at once. Tell the ER doctor immediately.
- Utilize your hospital security to ascertain that your patient does not have a weapon in his posession at that time. Whether your hospital security carry weapons or walkie-talkies, you need to get them down there.
- Let the verbal terrorist think he/she is about ready to get the biggest dose of any narcotic they want on the face of the earth and that your sole reason for living is to cater to their every whim so that they do not leave your sight
- DO NOT
- Place the patient in the waiting room
- Place the patient in a multi-bed ward
- Stay calm
- Room the patient immediately if possible. Discharge/move other patients.
- If possible, register the patient as fast as possible at the bedside to get as much information as you can
- If the police don’t show up Code 3 (and they should), actually medicate the patient if you can with as much as you can get the doctor to ethically order. In other words, “do something about their headache”.
- Be alert to sudden changes in affect, signs of agitation or escalation:
- more threats
- You may be the only witness to that verbal threat
- What the patient says to you can be charted in quotes, verbatim and becomes a legal part of the medical record.
- Chart accordingly. The chances that what you write will be used in court are high. Especially in this day-and-age.
We have lost colleagues to ER shootings in the past.
For those of us who do not live in high-crime areas, we can be like “sitting ducks” in our work environment.
Get busy and get your department as safe as possible by:
- limiting the access to your department by making entry to the patient area difficult
- use a door code
- use a badge-swiping system
- Be especially aware of doors with access from the rest of the hosptial.
I don’t even want to think of this.
But better to think about it now before they are playing those “five funeral songs” you put in your last blog meme.
Again, this is just my opinion of what I would do if faced with this situation. Your milage may vary.
Make sure you have a policy/action plan in place.
And pray you never need it.