Need web site for latest restraint regs

pattyjo, MSN, RN · Nov 19, 2001

On the site for the Bazelon Center for Mental Health Law (http://www.bazelon.org) there is a section called "Safeguards on the use of restraint and seclusion." Perhaps that might be useful. Also, did you try the American Pychiatric Nurses Assoc. site? (http://www.apna.org)

And BTW, from a few threads ago, I loved your explanation of how you got "aerolizing"!!

Patty

PGH70 · Nov 19, 2001

dear aerolizing,

A few web sites I found, but I haven't checked them out yet.

http://www.access.gpo.gov. this is the federal register,

think you want to look at 64 Fed Reg 36, 070

http://www.jcaho.org/standard

/restraint/restraint_stds.html

HFCA has a different set of restraint regs, also

for some articles look at http://www.courant.com/news/special/restraint/day 2.STM

the national alliance for mentally ill http://www.nami.org

is very into lobbying for restraint regs.

I am surprised your institution does not have these regs on file, unless my institution is paranoid. but they tell us this is the law, and we be looked into at inspection time. I think the jcaho regs came out Jan, 2001. If this is not helpful, I can snail mail to you

some pages of the regs.

your psycho colleague, PGH70

Aerolizing · Nov 20, 2001

I have found a site that not only has the regs but it lists in plain language how to institute the new changes and be within the new guidelines. It is First.gov, Medicare which used to be HCFA. I have the guidelines printed out now so I have no question to what the regulations say.

Thanks for the responses.

I have walked into a nightmare. I work with nurses who really have no idea what they are doing. I have a very low tolerance for stupid who wish to stay stupid. Those sorts of people need to be sterilized so they don't reproduce. And I am talking about the staff.

There is no standard on file or display anywhere on my unit for seclusion and restraints. The director for my dept is looking into it. I have lots of ideas on how to take this unit into the new millenium but administration has to want to go there.

I also have to be reimbursed for my knowledge and for my experience and any work product. I don't work for free. I am a nurse, not a volunteer.

I do love to teach too. But you can't teach those who don't want to learn. I guess I was very lucky to train in a nursing friendly environment. When I was a new grad, my old facility paired me up with a nurse CNS and we met once a week for strengthening and developing my clinical skills. I did not look at this as negative, I looked upon this as a learning experience. I was not an expert practicitoner as a new grad, no one is. I didn't realize how lucky I was.

I will see how things go when I meet with my director. She has known me for a long time and she knows my intolerance for stupidity. She is just like that herself. I have told her I would have written everyone up on the shift before me multiple times and they would be lucky only to receive that sort of disciplinary action. But I am in orientation. Go figure.

Aerolizing · Nov 22, 2001

Hey PattyJo,

Do you have people in Lone Pine????

pattyjo, MSN, RN · Nov 26, 2001

Hey Aerolizing: No folks in Lone Pine that I know of, although it *is* just about an hour down the highway from here. Why do you ask?

Hope the new position is going ok, still can't believe you can't find seclusion and restraints regs. posted: with JCAHO lookin' long and hard at those incidents, we practically have them glued to our foreheads!

Patty

Aerolizing · Nov 26, 2001

Hi PattyJo,

I have some distant relatives in Lone Pine and one of my second or third cousins was going to be a psych nurse. Been there a few times and everyone there knows everyone else. Pretty neat. Anyway..

In my experience as a nurse, those seclusion/restraint regs were memorized by all staff members, even the secretary. They were posted in the bathroom on the walls and I am not kidding. There were no mistakes. My assistant unit manager reviewed those daily. If we missed one piece of documentation, we were written up. No questions asked. As the charge nurse, we were also responsible for overseeing that the charting was done correctly. At my new job, no one even looks at the appropriateness of the seclusion/restraint episode. No one is clear on how to reorder S/R. No one knows how to chart on a person in S/R. I am telling you, this is not good.

It is not my job as a staff nurse to do administration's work. They don't seem worried about any of this. I looked up the regs on my own time to make sure I was doing it correctly. No, they are not available anywhere on my unit. When I have told the other staff members about the right way, they looked at me like who the heck are you? You are in orientation, what could you possibly know? They are resistant or stupid. No one in administration has taken the time to explain any of this to them. I walk around shaking my head. I ranted and raved the first couple of times to competent staff about how insane this is and that this place is going to be closed down. They just sit quietly and listen. I have made many complaints to the administration. Not sure what they are going to do. I am the new girl. Each complaint I have though, I also give a solution. If they want my help, they will pay me well for it. I may be a staff nurse, but I am a darn good staff nurse and if I were sick, I would want me taking care of me.

My boyfriend tells me it is not my problem and that I should not be looking up all this stuff on my own time and telling the other nurses how to do it correctly. He is telling me to get out before it gets ugly there. Too late, it is way ugly there. There are some really good staffers there. I have bonded with them. They are probably a little scared of me as I have gone off on many long tirades about how absurd this whole place is. They quietly tell me it is nothing they haven't said a hundred times before.

I was just offered a couple of jobs as a matter of fact. I am seriously thinking about taking one of them. I do want to hear from two other places though before I make my final decision. No job is worth this much stress.