responsibility to report threats?

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. Last edit by Silverdragon102 on Nov 11, '11 : Reason: changed to all **
Protect yourself, file a report with the police. Your place of employment obviously does not value you as much as you think. Good luck and stay safe.

I would bann them too ! I am guessing that this is LTC ? If you at a hospital I do not know if someone can be banned from a hospital ?

You should absolutely report this to the police. QC and corporate clearly don't care about your safety, if they did they would have taken some kind of action. Health care staff have been killed by patients -- these threats should be taken seriously!

I would probably make a police report, as well as attempt to go up a little higher up the corporate chain. Is it possible the QC person didn't take this seriously, or is this a breakdown with more than just her?

File the police report yourself. If the patient stated a specific death threatagainst the Doctor and , give the exact quote. Since you have a witness, have the nurse also file a police report.Threats should be taken seriously. Your management has failed to take appropriate steps to safe guard the Doctor and you by not reporting.Additionally, they may be in violation of the law. In many states it is lawthat if a threat has been made to an individual, that person must bedirectly 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.You may want to consult with an attorney to find out what the law is inyour state. Protect yourself you are right to be concerned aboutrunning into this couple around town. If you filed an incident reporthow did the couple find out?

Quote from TrekfanI would bann them too ! I am guessing that this is LTC ? If you at a hospital I do not know if someone can be banned from a hospital ?

Quote from trekfani would bann them too ! i am guessing that this is ltc ? if you at a hospital i do not know if someone can be banned from a hospital ?

Thanks for all the responses-that was my initial thought but I wasn't sure I should proceed with the police report until I did something else. I'm going to go by work today and contact corporate to see what they told our QC person, but honestly I think she dropped the ball and did nothing with this. (Not the first problem we've had with her-she's pretty useless.) I think though no matter what corporate says I'll file a police report, just so that if something does happen it was well documented that there were problems. On a similar note though, when the threatened doctor asked for my written statement he was told he couldn't have it because it was a violation of HIPPA. Does this sound right? I used the pt and wife's name specifically in my report, but I don't think I put any medically relevant info in there (I will check it today). If I take out any references to why he was in the hospital it's not a HIPPA violation right? (I ask because I think if my QC person did drop the ball like I think and I escalate it, she will try to "get me" on HIPPA stuff.)

Oh, and this actually happened in a surgical area. The threat was against a hospitalist, and the way the family found out was the surgeon went and told them directly before the pt even went to surgery (because the threat delayed the surgery), which of course placed us in harms way as we recovered the patient. The whole thing was/is just a mess.

"on a similar note though, when the threatened doctor asked for my written statement he was told he couldn't have it because it was a violation of hippa. does this sound right? i used the pt and wife's name specifically in my report, but i don't think i put any medically relevant info in there (i will check it today). if i take out any references to why he was in the hospital it's not a hippa violation right? (i ask because i think if my qc person did drop the ball like i think and i escalate it, she will try to "get me" on hippa stuff.)"horsepucky. hipaa (note correct acronym) is not a valid excuse for impeding legal action, qa, or public safety, and it says so on their website (http://www.hhs.gov/ocr/hipaa), and see attachment, to which i commend your attention so you will be armed with the facts and citations if this occurs. you can redact information about his medical condition without weakening the reporting process.

Quote from nursecassOn a similar note though, when the threatened doctor asked for my written statement he was told he couldn't have it because it was a violation of HIPPA. Does this sound right? I used the pt and wife's name specifically in my report, but I don't think I put any medically relevant info in there (I will check it today). If I take out any references to why he was in the hospital it's not a HIPPA violation right? (I ask because I think if my QC person did drop the ball like I think and I escalate it, she will try to "get me" on HIPPA stuff.)

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.../openItem/1628But first and formost...be safe.