The University of Utah Hospital continues to refine its policies for encounters with law enforcement, recently rolling out a new policy that requires police to go through the hospital’s customer service office with any request.

The customer service office will page the hospital’s house supervisor, who will respond with the university police officer who normally is present in the ED. “The officer will explain their needs, present any legal process (i.e., search warrant), if applicable, and complete the Law Enforcement Not In Custody Patient Access Form,” the policy states. “The House Supervisor will facilitate the officer’s needs, as appropriate. If there is disagreement between the officer and the House Supervisor, both parties shall contact their respective supervisors to facilitate resolution.”

The policy says patients in police custody will be guarded in compliance with existing policies, but it does not address disputes regarding blood draws or other access. If a patient is not in custody but police want to place the patient in custody, they must go through the customer service department and a house supervisor to gain access.

Noting that interactions between police personnel and ED staff are inherently different from other areas of the hospital, the policy states that law enforcement must notify the university police officer stationed in the ED and the charge nurse when they enter. If there is disagreement between officers and ED personnel about the officer’s request for patient access or information, the hospital house supervisor will be paged and respond.

“Officers and Emergency Department personnel shall not argue to resolve the issue, and will wait to resolve any problems that arise with the House Supervisor. If the situation cannot be resolved between the officer and the House Supervisor, both parties shall contact their respective supervisors to facilitate resolution,” according to the policy. “The University Police Officer will advocate that all parties involved follow these procedures.”

Attorney Karra J. Porter, JD, with the law firm of Christensen & Jensen in Salt Lake City, notes that the Salt Lake City police officials agreed to abide by the new policy, but they also had agreed to the policy that her client, Alex Wubbels, RN, was trying to follow when arrested.

Porter also says that although the hospital claims to fully support Wubbels, the new policy seems to suggest the nurse is to blame for the incident.

When she pointed out that the house supervisor was at Wubbels’ side the whole time and referring police to that person wouldn’t change anything, Porter says hospitals leaders responded that they would make sure the house supervisor was well trained to handle such situations.

“So, I told them they were suggesting Alex did something wrong, something that with better training she would do differently,” Porter says. “I feel like they are blaming Alex with this new policy.”

A policy prohibiting law enforcement from working directly with clinicians would not be effective for many hospitals, says Gordon Lee Gillespie, PhD, DNP, RN, CEN, CNE, CPEN, PHCNS-BC, FAEN, FAAN, associate professor and deputy director of the Occupational Health Nursing Program at the University of Cincinnati. Smaller and more rural hospitals might not have a senior administrator available at all times, and getting one to the hospital might take an hour or more, he says.

“When the nurse calls the administrator on the phone, and the police officer is telling you to hang up and do what he asked for, then what? It’s a good idea to not have the nurse involved, but that nurse is going to be involved if the officer shows up on the unit and says he’s going to draw blood from your patient,” he says. “And what does the nurse do when the administrator on the phone says no and the police officer is still standing there saying he doesn’t care and he still wants that blood draw?”

In such situations, clinicians must be able to escalate through the chain of command quickly, Gillespie says. That means not waiting for an administrator to return a phone call in 10 minutes. If the first is not immediately available, the clinician should be able to move to the next higher administrator.

“If that means calling the hospital president at 3 a.m., the clinician should be empowered to do that,” he says. “This is a special circumstance when you have an armed officer acting irrationally and threatening a nurse, so standard administrative procedures may not be enough. You have to have procedures in place for the nurse who is suddenly in that terrible situation.”