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When nurses and law enforcement collide


December 1, 2017

Violent incident in Utah highlights professional responsibility, patient privacy, and ethics

In a profession where staff members are four times as likely to be assaulted on the job compared to other professions, one would like to think nurses wouldn’t have to worry about that kind of violence coming from a police officer.

A July incident in a Salt Lake City hospital shows that’s not always the case.

The July 26 incident took place at the University of Utah Hospital between Jeff Payne, a detective with the Salt Lake City Police Department, and Alex Wubbels, a nurse in the burn unit of the hospital. In footage of the incident captured by the officer’s body camera, Wubbels politely but firmly insisted that police could not collect blood samples from a badly injured patient, and she refused to comply with the officer’s request for a blood draw. Payne didn’t have a warrant, Wubbels pointed out, and the patient wasn’t conscious, so he couldn’t give consent.

That alone should have been the end of it, as Wubbels also cited hospital policy in the video and showed the officer a printout of the policy. Payne, clearly agitated, proceeded to grab the nurse in a violent manner, shove her out of the building, and cuff her hands behind her back. Wubbels, clearly scared on the video, screamed “Help me!” and “You’re assaulting me!” as the detective forced her into an unmarked car and accused her of interfering with an investigation.

Wubbels ultimately was not criminally charged in the incident, but she immediately went public with the case, playing the footage at news conferences with her attorney. The incident led to a public apology from the Salt Lake City police chief, and Payne was later fired from the police department.

“The decision [to fire Payne] is in keeping with the high level of accountability we owe the people of Salt Lake City,” Mayor Jackie Biskupski said in a report on CNN. “In making his decision, I am confident Chief Brown balanced the unique stresses each of our police officers deal with daily, and the responsibility they have as leaders in our community.”

Biskupski said the internal investigation found that Payne violated several city and department policies, including those pertaining to arrests, ethics, and officer conduct.

Support for nurse rights

While Wubbels ultimately won the day in the Salt Lake City incident, the way she was treated attracted a loud response from the Utah Nurses Association, which issued a statement that it was “deeply disturbed” by the video and raised attention to the fact that nurses have an “ethical duty to act in the best interest of our patients at all times and in all settings.”

Nurses are bound by a code of ethics that dictates they must first promote the rights, health, and safety of the patient, according to the American Nurses Association.

In a report from The Washington Post, ANA Executive Director Debbie Hatmaker said that nurses usually learn about informed consent as part of their basic training, and most hospitals have clear policies about getting consent from patients. In the case of the Salt Lake City hospital, not only was the officer specifically shown a printout of the hospital’s policy, but he was also in violation of a decision by the U.S. Supreme Court, which explicitly ruled last year that blood can be drawn from drivers only for probable cause, with a warrant.

“You would expect law enforcement to be clear about what the law is, about consent,” Hatmaker told the paper. “Of course, if there’s any question, they should be able to go through their chain of command, all the way up to their chief of police … The fact that it escalated as quickly as it did in that moment seemed particularly outrageous.”

Nurses vs. the police

For the most part, law enforcement and staff in hospitals work very closely together and have a peaceful symbiotic relationship. But it’s important to remember that while both are in the profession of saving lives, police officers also need to collect and preserve evidence, so it’s not difficult to see why police officers might request a nurse to draw a blood sample from a patient. In this case, William Gray, the patient that Payne sought a blood sample from, was a commercial truck driver and reserve police officer severely injured in an accident in which a pickup truck speeding away from police crossed the center line and hit his truck head-on, causing an explosion. State police had been trying to pull over the pickup driver after several people called 911 to report he was driving recklessly. That pickup driver died in the accident, and Gray, who never regained consciousness and suffered burns over nearly half his body, died about a week later.

Published reports have indicated that Gray was not a suspect in any crime or accused of any wrongdoing, so it is unclear what exactly Payne needed the blood sample for. However, the incident demonstrated the need to highlight the laws regarding nurses’ rights when responding to requests—or demands—from law enforcement officials.

“At the moment, if a police officer wants a blood draw, he would need a blood warrant issued by a court of law,” says Tom Salamone, director of healthcare services with Telgian Corporation in Tempe, Arizona, and a security consultant for more than 30 years. “If a doctor does not write a script, the nurses are not going to comply with the officer’s order.”

He pointed to an act known as the New York State Vehicle and Traffic Law, which was amended in 2010 and took effect in January 2011, which states clearly that Advanced Emergency Medical Technicians and nurses are “authorized to legally obtain a blood sample at the request of a police officer for the purpose of alcohol/drug screening, but … [are] not mandated to perform the procedure.”

Basically, a nurse is required by sworn oath to protect a patient’s rights first, especially when that patient can’t speak or consent for themselves. A police officer demanding a blood draw without a warrant basically is violating the Fourth Amendment of the Constitution, argues attorney and regular CNN contributor Dan Abrams in his blog, www.lawnews.com.

“Recall that Detective Payne did not have a warrant and could not get a warrant because there was–admittedly–no probable cause,” Abrams wrote. “Probable cause is a necessary component for a valid search and seizure warrant. And a search and seizure warrant is a constitutional requirement for the court room admissibility of blood removed from someone without their consent.”

Police officers certainly are in a profession that can have violent confrontations, but so are nurses. According to the U.S. Bureau of Labor Statistics, healthcare workers experience the most incidents of non-fatal workplace violence compared to other professionals, and account for 70% of all non-fatal workplace assaults. A survey conducted by the Massachusetts Nurses Association found that 75% of nurses reported violence was a problem in their workplace, and the Emergency Nurses Association reports that 80% of emergency department nurses have been a victim of workplace violence.

In general, patient violence against nurses has historically been an accepted, if not welcomed, part of the job, and as a result many nurses have been injured or even killed. With that in mind, many nurse advocacy groups have developed no-tolerance policies and are crafting legislation to help protect nurses exposed to violent incidents in hospitals.

The California Nurses Association took the issue of preventing workplace violence to the state legislature in 2015 after two nurses were injured in two separate incidents on April 20 in Los Angeles–area hospitals.
Published reports in the Los Angeles Times indicated that Romero Carnalla of Los Angeles bypassed the weapons screening area at Olive View-UCLA Medical Center in Sylmar, California, and stabbed a nurse several times in the torso, leaving her in critical condition. Some hours later in a separate incident, Thomas Fredette of Santee, California, walked into Harbor-UCLA Medical Center in Torrance, California, grabbed a nurse, and stabbed her in the ear with a pencil. The nurse was treated for non-life-threatening injuries, the Times reported.

Subsequently, Senate Bill 1299, as it became known (and became law in April 2016), was introduced and required hospitals to have systems to improve hospital security and staffing. In addition, hospitals are required to report incidents of violence and to provide education and training programs to help workers recognize and respond to violent incidents, and are required to report incidents to the state’s OSHA agency, otherwise known as Cal/OSHA.

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