chemical restraints

[alfa-sierra, BSN, RN]

Is it legal to administer a standing IM antipsychotic medication PRN severe agitation to adults in psychiatric units against the patient's will? If not, in the absence of a clear hospital policy, what state or federal organization rules, provide unequivocal guidance in respect to this specific practice? In my workplace, the medical director, the unit manager and most staff RNs insist the practice is correct and legal, and that there is no need to call the psychiatrist to give, by force or coercion, a IM antipsychotic or benzo for agitation when the patient refuses. Anywhere else I worked, a standing prn antipsychotic order for severe agitation could not be used against the pt's will. Without the pt's consent the psychiatrist had to give a one time emergency order on the basis of danger to self or others. It is my understanding that without such an order or the pt's consent, it leaves the staff and the hospital open to charges of assault and battery. Could you enlighten me with your experience in your practices and, if possible cite authoritative, legally binding sources? Thanks.

[inthesky]

at my facility,

We need an emergency doc order. Also, unless the pt is court-ordered, it would have to be a danger to self/others emergency.

[medsurgrnco, BSN, RN]

In my facility, you need either a court order or a doctor's emergency order to give a med that a patient refuses.

[alfa-sierra, BSN, RN]

In my facility, you need either a court order or a doctor's emergency order to give a med that a patient refuses.

Beautifully said. Thank you.

[alfa-sierra, BSN, RN]

at my facility,

We need an emergency doc order. Also, unless the pt is court-ordered, it would have to be a danger to self/others emergency.

Thanks for sharing your experience in this subject.