Clinicians' Experiences With Law Enforcement in a Pediatric Emergency Department

Law enforcement officers (LEOs) are frequently present in emergency departments, where their roles may include accompanying patients, investigating injuries, or responding to safety concerns. Existing research on LEO presence in health care has focused on adult populations, with limited attention to pediatric settings. Pediatric emergency departments (PEDs) represent a distinct clinical environment in which developmental vulnerability, caregiver involvement, and legal considerations related to minors may shape interactions. Despite these differences, little is known about how LEO presence is experienced in pediatric care or how it may influence clinical interactions and care delivery. The objective of this study is to explore how PED clinicians and staff perceive and navigate interactions with LEOs during clinical care.

We sampled physicians, nurses, and bedside staff at a level 1 pediatric trauma center for 60-minute semistructured qualitative interviews virtually and in person. Interviews were audio recorded, professionally transcribed, and coded and analyzed using qualitative content analysis.

Across 27 interviews (13 physicians, 11 nurses, 3 bedside staff) conducted April to August of 2024, 4 themes emerged: respectful collaboration supports effective encounters; communication breakdowns and role ambiguity undermine collaboration; concern that LEO presence could weaken patient trust and psychological safety; and gaps in policy and training leave clinicians unprepared. Across themes, clinicians emphasized developmental vulnerability, caregiver involvement, and ethical tensions unique to pediatric care.

PED clinicians and staff described challenging interactions with LEOs involving communication, role clarity, and patient trust. Pediatric-specific dynamics, particularly patient vulnerability and caregiver involvement, were prominent. Participants also identified potential strategies to improve these interactions.