I work on an inpatient psychiatric unit. Currently, patients are allowed to have bras as long as they do not have an underwire.
Many staff are concerned that this creates a physically and emotionally uncomfortable environment for our patients (especially on a co-ed unit like ours) and believe that as long as a patient does not have a history of self injury or a suicidal plan/intent to hang self, they should be allowed to keep their bras.
What are your thoughts?
What is the policy on your unit?
My Nursing Director is curious to know what other units do before we make any changes to our policy, so I appreciate your input! Thanks!
I know of a patient who hung herself with a sweater. You can't take everything away. Especially things like bras which affect a patient's dignity so much. The best protective factor is connection.
There are many safety precautions that are in place now that were not deemed necessary back in the day. For example, we never strip searched patients on admission unless there was a particular issue like self-harm, suspicion of dangerous contraband (drugs, weapons), etc. Belts were not allowed, but bras were for everyone except patients on the highest level of suicide precautions, for example.
Like any psych nurse with experience under his or her belt, I've seen patients bite chunks out of their arms, gouge their eyes with their fingers, and more. As others have stated above - where there's a will there's a way.
We have to follow facility rules, of course, but as patient advocates we need to do everything possible to protect our patients' dignity and self-image. When we are in a position to influence policy, we should speak up for common sense and patient protection, even if "the suits" are primarily concerned with potential lawsuits and insurance rates. As psychiatric professionals we are well trained in communication skills, or should be. We can use those skills to negotiate with management on behalf of our patients and ourselves.
Safety first, of course, but dignity is a very close second.
We allow bras of any kind, unless the bra is falling apart and the wire is coming out. Patients on high suicide precautions are 1:1 and only allowed paper scrubs. I've seen someone try to strangle themself with the string to their paper scrub pants before, so we take those out now too. Ladies on the adult unit have to wear a bra since we are co ed.
Patients (esp adolescents) will self harm with anything if properly motivated. I've seen the give themselves burns with erasers or rubbing skin into the carpets. I've seen them cut with the metal part of pencil erasers. One pt broke up her toothbrush holder and used the pieces to cut (I see pencils and toothbrush holders to be contraband next). Definitely where there's a will........
Be careful with the paper gowns, tissue, ect too, because patient's may shove them down their throats in order to suffocate themselves...true story. (Yes, we were able to save them thank goodness!)
Where I work we will take out the underwire if the bra has one (with the client's permission!). It is necessary for the client's safety since some of them really cannot be trusted with anything!
Where I work we will take out the underwire if the bra has one (with the client's permission!). It is necessary for the client's safety since some of them really cannot be trusted with anything!
Women need to have their bras. As a top heavy female myself , a bra without wire would not help me at all I can not imagine doing that to another woman. Do we really want females walking around without bras on? It is a dignity issue and support for your body.
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imapsychrn
85 Posts
We allow bras of any kind on our unit.