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Today a patient came in to the ED with a minor injury. When I was assessing him, I found that he was carrying a box cutter. Although he didn't seem violent, I removed it because removing potential weapons was policy at other EDs where I've worked. But my manager said I'd violated the patient's rights by "searching" him. Who's right? -D. L., TEX.


It's never safe practice to assume that the protocols you followed at another facility apply in your current position. Every facility has its own policies and procedures. Even though they may differ from facility to facility, these standards must comply with state and federal laws.


Was your supervisor reacting from an informed position, or did he just assume that what you'd done was illegal? According to our legal consultant, case law generally supports your action in removing a potentially dangerous item from a patient in a private health care setting. As long as you weren't searching him on behalf of the police, you were using your professional judgment to maintain a safe environment. But case law can change, so check with your hospital's risk manager.


If your employer has a policy that doesn't permit you to take dangerous items from patients, you'll need to abide by that policy. If your employer's policy endangers staff or patients, you and your colleagues should have a backup plan or protocol, such as calling security to remove dangerous items from patients. Then work together to have the policy changed for a safer work environment.