This is actually 2 questions: What are your policies and procedures regarding calling the police to assist with an acting out patient? It used to be part of our policy as a last resort as our psychiatric unit is actually in a separate building from our main hospital. Due to some changes in management, our hospital hired a consulting firm from out of state, and now they tell us it is prohibited to call the police unless grave bodily harm has already occurred. They tell us that nowhere they have been have they ever called the police. They don't seem to understand the acuity of patients we sometimes have (although they claim they do). We recently had an episode where a very large patient was agitated on a weekend. There were only 6 staff located in the entire building, so the police were called to assist, but luckily they weren't utilized. Being the charge nurse on duty I was called to a "meeting" about this. I feel I took proactive methods to keep everyone safe. I want to know how other psych units function in this aspect.
Question 2 is related to observation of patients. Is close observation considered a doctor's order? Or a nursing intervention? We were told by our past director that nurses have the capability of placing patients on more intense supervision without a doctor order, such as changing from 15 minute checks to close obs or 1:1, but we require a Dr. order to place them on less frequent obs. such as from close obs to 15 checks. The consulting firm is now telling us that it is not in our scope of practice to order more frequent supervision. Can others please weigh in on how you handle this?