Does non-violent crisis intervention really work?

[TazziRN, RN]

I spent all day today in the NVCI class. Some of the techniques made sense but some made me think "O-kaaaaaaay......whatever!"

Do the restraint techniques really work? They work in controlled settings like classrooms, but what about when someone is really out of control?

[MomNRN, BSN, RN]

I was certified in non-violent crisis intervention when I was a school nurse. Our school was for behavior disorder students.

The techniques did work, but then again we were dealing with children under the age of 14.

Would it work on a drugged out/drunk psycho? Highly unlikely, unless there were 12 of you to do the techniques.

It has its place, but I don't think the ER is one of them.

[TazziRN, RN]

Oh, it was stressed that the techniques would NOT work on someone who was chemically violent.

[MomNRN, BSN, RN]

Another one of the disadvantages of CPI, is if you don't use it you lose it.

There were some staff who used the techniques daily and were quite proficient at it. They were able to communicate non-verbally to other staff and collaborate on a safe "take down."

I assisted and never led a take down myself. The more you use it the better you become with it.

I can't see our ER using it very often.

[TazziRN, RN]

We've had 4-5 Code Grey's (assistance needed) in the last 4-5 months, so some kind of training is needed. So far we haven't needed to restrain anyone, though. For certain areas, like ER, we're required to recert every year.

[WannaBeNrse]

It only works if the person is smaller than you. But even then, i dont know if i could remember the right moves in the middle of the crisis..... when they're bigger than you you can maybe do a teamhold, but we had some kids where i work (grouphome) where even a teamhold was impossible...

[TazziRN, RN]

I got clocked during a practice session......practicing how to get out of a hair grab. I was holding my partner's ponytail and she moved back and down......and caught me right on the chin!

I kept hold of her hair, though!

[flashpoint]

I've never seen it work...I did, however get injured the first time I took the class. Two nurses who are much taller and much heavier than me were supposed to be taking me down. One got tangled in my feet causing her to fall on me and trip the other one, who also fell on me. I ended up with torn ligaments in my knee and an small tear in the meniscus. Nothing bad enough to warrant surgery, but bad enough to put me in an immobilizer for a month!

:)

[TrudyRN]

LOL, I think these techniques are thought up by people who never have to use them. I once interviewed for a job in Psych and the interviewer was telling me about how violence can occur and that staff were required to never be violent in return, rather always get out of messes by hollering for help, ducking, evading, and taking down if necessary. She wore heels and a suit. She never set foot on the floors, I'd bet. I asked her what I should do if I was alone and needed immediate help. She put her hands up, as if protecting her face, and said to yell loudly.

Those who work with these patients day in and day out need to learn to be as non-violent as possible with patients, to work in teams, etc. But there really does come a point when staff need to be free to protect themselves. Staff should have the right to go home in one piece. Law enforcers do, why not nurses? There need to be lots of strong males and very physically fit females for the ER and Psych and Security. I think if just one office type got hurt, things would change considerably.

All in all, it would probably be good to be a martial artist if one is going to work in these violent settings.

[BJLynn]

I love the non violent holds where I end up needing a tetnus shot. ...Not

I have the unfortunate reality of being shorter than 90% of my residents. It helps that the vast majority of the residents are nice non violent ladies and gentlemen. But then there are a few that every so often would rather punch you than look at you. Non violent holds, take downs, and verbal manuvering work 99% of the time with those residents that become violent or adgitated. When it doesn't work, or would be extrememly unsafe for resident or staff, we try to get the resident to a safe area and let them "scream it out" or otherwise work out what is wrong. Then then usually end up in a very tired mood and are much easier to talk with.

[TazziRN, RN]

The release moves from grabs really do work, I've actually been grabbed and got myself out of it by techniques taught in NVCI. The restraint moves, though.....they just don't look effective.

[acuteandresidential]

I have had experience with NVCI training from many different vendors--many of which teach really outdated, and ineffective techniques. You should get the Crisis Consultant Group to come teach at your facilities. Excellent techniques based on years of front line experience working with aggressive youth and adults. Check out their website (crisisconsultantgroup.com) --it lists the various courses they offer! Good luck!