ETOH Safety

[askater11]

I'm concerned about ETOH and safety.

I work in the critical care unit. I get patients that have sitters on the floor. When they come to CCU for alcohol withdrawl b/c it cannot be controlled without ativan gtt or they're too out of control we'll on the floor we'll get the patient.

We are a restraint free hospital as of a few weeks ago. When these patients arrive to our unit the sitter has to leave b/c managers tell us we're not allowed safety sits in the unit.

We always have another patient with a person going through DT's. DT patients are so unpredictable as we all know. I can have them uncontrol resting and all quiet not qualifying for any Ativan per CIWA and 5 minutes later the patients a safety risk to themselves.

How does your CCU/ICU help protect these patients?

Thanks for any input!!

[herring_RN, ASN, BSN]

Yes we did use chemical restraints when we had to but it wasn't a standing order. I have also known situations when we have nursed a pt on a matress on the floor!!! I kid you not especially when pts have been known to thrown themselves out of the bed. We all know side rails dont achieve much when that confused pt wants to climb and fall over the top.

Since being in this country I have only once initiated restraints and that was for a pt who was violent. I really dont know how we managed some of the patients to be truthful but we did, and I can honestly say never once was my licence on the line in 17years. AS an RN in the UK you spend a lot of time managing on your own with very limited staff, I have been in a situation where I was only one of 2 RN's on a floor with 24pts and 2 PCT's and normally more than confused pt's.

I've learned excellent lifting techniques from nurses trained in the UK.

I only remember once that we were allowed to care for an ICU patient with the mattress on the floor.

Could we have a seminar or class to learn from each other?