DON's who are completely out of touch....

[deespoohbear]

Our DON needs to get a reality check, big time. Our hospital is trying to go restraint free and really are encouraging us not to use restraints. I am not a big fan of restraints, but every once in a great while they have to be used to protect your pt, or you and your fellow employees. Our DON is telling the night shift that if they put on a restraint on a pt for behavioral reasons (such as hitting staff, etc) the night shift is suppose to get the order signed in 4 hours by a physician. We are a small facility (70 beds) with one ER doctor in house during the evenings/nights. Our DON's suggestion is to have the ER doc come up and write the order for the restraints in the middle of the night. I just about fell off my chair!! We can't get the ER docs to respond to a critical situation (massive GI bleed, full code pt going down the tubes) on the floors, much less to come up and sign a restraint order in the middle of the night for a pt that they aren't even involved with!! Glad I am not working the night shift!! I feel for those nurses who have to deal with that nonsense every night.....

[SandyB]

There is some law about behavior restraints..doc has to see pt within 1 hr of pt restraint..do a face to face assesment of the pt and sign the order. A telephone order will do at first but the law says a doc has to see and document on the pt within the first hr.

If there is anyway to avoid behavior restraints and call it for safety of pt instead....like if the pt is hitting ya he is probably pulling out ivs, right? well, that kind of restraint takes less paperwork etc so ask ur DON to help ya understand the safety restraints rules and then figure out how to use them when necessary. Otherwise as far as behavior restraints it is beyond a hassle.

[montroyal]

Thereis a easy way to get around this. If a patient hits a staff memmber, call the police. They can place them in handcuffs for assault. Explain to the DON, this is your only recourse. I'm sure your policy will be redone.

[whipping girl in 07, RN]

We are not allowed to use "behavioral" restraints anywhere in the hospital except in psych. So if a patient is swinging at staff, but also has a foley or an IV (or both), they qualify for "safety" restraints. Safety restraints (in my state, at my facility) can be initiated by the RN and the MD has to see the patient within 8 hours to sign off on the order. Safety restraints are for the patient with "high potential for removing invasive lines." Hope this helps.

[deespoohbear]

montroyal-I like your way of thinking!!