new restraint regs

[PGH70]

hello from florida- we are frustrated with the regs our hospital psych unit enforces. Chemical and physical restraints, the patient must be evaluated by a doc within 1 hour. Physical restraint orders are good for 4 hours, renewable x 1. this means on night shift, when there are no docs around, we cannot use restraints. I understand this has evolved from overuse, but help! Is anyone else having this problem? thank, PGH 70

[PGH70]

dear aerolizing : its 11 PM, a night off, and here we are discussing night shift on the psycho ward.

I hope you have some power, your unit sounds like it needs some changes. Do you pass JACHO inspections?

We have 3 levels of precautions, and yes, on the best level, level 1 we allow the pt to have a razor briefly. Level 2 and 1 patients

must be observed.

I guess I am lucky. Our staffing is not too bad most of the time, and we have a brand new unit, not perfect, but OK. We have monitors in quiet rooms, public rooms, hallways and nurses stations(3 of them)

Do all of your staff get mandatory crisis intervention training yearly. and personal defense classes, and how to subdue a violent patien? Of course, with the monitors and everything is video taped, for critiqueing by the big boys, after the fact. We do not always respond as trained, and we are gently criticized for that.

I wish you success in trying to change an unsafe unit. But I feel that as a staff nurse, I have very little power.

[mamabear]

I work on a 14-bed locked adult psych unit. We are a satellite facility of a medium-size hospital about 25 miles away and we're lucky if we get the docs to make rounds in the morning, much less have one on the premises at all times. True, they do have to evaluate a patient in 4-ways within an hour but that, I believe, is the law in Indiana:o

We have security from 2200 to 0600, but that's it. The agency we rent the building from did away with 24/7 security when we signed our latest lease agreement as a cost-saving:( There are innumerable occasions when there is no male staff , 3 females of varying ages and competencies, and 14 psychotic patients. Assaults on staff are the rule rather than the exception, and the higher-ups do their best to blame staff.

[KaraLea, LVN]

We are not allowed to use any "chemical restraints" here and the only physical restraint we can use is the body net