Transition Case Manager; Nurse Ross, was able to build a rapid, trusting therapeutic relationship with a newly scheduled Veteran. During a VA Video Connect (VVC) appointment, the Veteran began actively expressing homicidal intent towards his former Navy supervisors. The Veteran was aware of their physical location, and contact information.
Because of Nurse Ross's prompt, exceptional nurse-patient relationship and assessment skills, the Veteran was successively, and safely "warmly handed off " into the ED with a subsequent admission to 2N for safety, and continued assessment. Positive outcomes were established for the Veteran, family, and possible victims. The Veteran and wife were most appreciative and he is now followed by Transition Case Management for his Complex care needs.
The actions of Nurse Ross demonstrated the true meaning of, giving the "gift of self". By her actively listening with genuine interest and empathy, the Veteran, in turn, felt safe enough to disclose his plans/ preparations to commit Homicide against at least two other people. His plans were averted, and lives were saved!
The following are examples of the situation using the ICARE acronym:
I- Maintained the integrity, trust, and confidence of the Vet who felt safe enough to disclose his feelings to harm others.
C- Commitment to maintain diligent communication with the Veteran for approximately 3 hours. Until he arrived safely to the HAMVAMC/ED.
A- Through skillful advocacy/assessment was able to identify the Veteran to be an imminent risk to others and unable to contract for safety. This resulted in advocacy for the veteran to the wife to drive the Veteran into the HAMVAMC/ED for evaluation.
R- Continued to convey to the Veteran unconditional, non-judgmental, accepting attitude, despite him disclosing his plans to commit homicide. Resulting in the Veteran developing a trusting respectful rapport with Nurse Ross. Thus, finally coming to HAMVAMC/ED.
Excellence- During this encounter, the goal to keep everyone safe was met.