The homicidal patient: when a plan of care violates standards of care

1. The nursing care of an extraordinarily dangerous patient may necessitate implementing a treatment plan that should never be used under normal circumstances. 2. The subject whose case is described in this article presented management problems that required a plan violating accepted standards of care. 3. Although ultimately successful, the plan's restrictive mode (and the stress of coping with this patient) wearied nursing staff members and caused divisions among the staff and multidisciplinary team.