Someone today threatened the lives of my coworkers.
He was a wanted man, and the sheriff had been clued in to his presence in the emergency department by his terrified wife. The nurse who brought him in from triage felt something "off" about him and notified security. At the sight of their badges he tried to bolt, thrusting his hand into his pocket as if to grab a gun.
They slammed him into the wall and he elbowed one out of the way, trying to pull something out of his pocket. When fully restrained, an unsheathed bowie knife slipped from his outstretched hand. The knife was cursorily kicked away as he was wrestled to a gurney.
He finally calmed down enough for me to evaluate him. I did my duty as his doctor and checked him over for signs of illness. Apparently he had ingested some 40 tylenol, a ton of cocaine, and some PCP as a suicide attempt a few hours prior. I drew some bloodwork and started him on treatment for tylenol overdose. At the sight of the needle he started screaming obscenities and thrashing about in his bed. At some point a nurse got kicked. The restraints went on.
It's difficult when medicine and law intersect. Every part of me was screaming "THIS IS A BAD MAN", except for a tiny doctor voice in the background saying "he also overdosed on tylenol." And so, I did my job, treating him carefully, cutting no corners in the process.
A while later I heard a ruckus outside of his room. The nursing manager was mentioning big words like "QA" and "patient satisfaction", and was demanding that his restraints be lifted.
It's rare that I take a stand against my higher-ups, as usually they have good reasons for their requests. This time, on the other hand? Nobody threatens my friends, and fists and feet can be lethal weapons in a person high on PCP and crack.
"Ma'am," I said, "this man pulled a knife on our security guards and kicked a nurse in the arm. I don't care what 'patient satisfaction' measures or 'quality assurance' protocols you think I'm violating. He is a threat to staff and he leaves this ER in police custody and cuffs, or onto a hospital floor with 4 point restraints and an escort."
She was a bit taken aback, but I think she got the point loud and clear. Staff safety comes first. On that point I will never budge.