The last thing a clinical healthcare provider wants to do is harm a patient. In most cases, clinical staff will put themselves in harm's way in hopes of resolving a problem rather than escalate things.
So, it's surprising to see a story like this; Hospital calls cops and feels the sting. (Securityinfowatch.com)
Basically, when a patient started showing some of the warning signs of violent behaivor - the staff called the police. To control the patient, the officers used a Taser and once he was on the floor he was injected with medications and transferred to the psychiatric unit in another hospital.
Except now, that hospital (Northfiled City Hospital - Minnesota) has been cited by federal and state health officials for violating that patient's rights.
Healthcare oversight agencies are notorious for this kind of let's make an example out of them thinking. Unfortunately, it works because hospitals have little to gain in fighting the system - but can loose everything. I've been in situations where a regulatory authority was clearly overstepping the bounds of their scope, but the hospital being reviewed decided not to push the issue - it just wasn't worth the trouble and risk.
Aside from the regulatory agencies, interpretations of rules and political angles at play, the use of force in a clinical environment is a nightmare topic. The conflict of interest between protecting one patient or protecting other patients and staff is a hard balance to achieve.
To make matters worse, the trend over the last 20 years has been to decrease the clinical staff positions that would serve an "orderly" role and physically restrain patients. An orderly is clinical staff and in most cases, is not subject to the same restrictions that security staff is - or the same obligations as law enforcement (to protect other patients and staff, first - and than address the clinical concerns secondly)
Sadly, these details often are lost in the thinking of auditors, inspectors or regulatory authorities. It bothers me when one hospital is made an example, with no regard to the overcompensation that occurs in the other institutions. How do you think the incident in Minnesota effects clinical staff's thinking when there is a potentially violent patient in their wards? Although they would usually call the police for help - they don't want to be cited for violating patient's rights.
There is no easy fix for this topic, but one thing is sure -- there needs to be solid planning, communication and training between clinical and security staff. Action plans should be developed by all stakeholders to make sure problems are addressed on each front. If you lay out all the hard topics on the table - and work out your solutions together (making sure your legal folks have a say as well) than you're less susceptible to the auditor's interpretation of rules and guidelines .
