No Restraint Policy

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What are your thoughts about this scenario?

You are working in the ER for a local hospital when police officers brought in a client with a large gash in his head. The police officers restrained him with handcuffs but you r facility has a "no restraint policy". You were able to assess and treat the client but the restraints make you feel uncomfortable. You asked the officers to remove the restraint but they refused. As the nurse on the unit, what will you do?

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Specializes in Palliative, Onc, Med-Surg, Home Hospice.

Let me guess, scenario for school?

What would YOU do? And FTR, I've been attacked by a prisoner before.

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"Client" is a dead giveaway for a homework assignment.

But if this was real life, questions to ask yourself would be: why was the patient handcuffed? How would you describe his mental status now? Would you feel safe in this situation without the restraints (my safety matters more than hospital policy- not sorry).

If there is conflict with the officers, you involve the house supervisor or manager for situations like this.

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The police have a responsibility to not lose the prisoner. Also, to keep themselves and the public and the prisoner safe. If they think someone needs cuffs, you don't want to interfere with that.

Find out from the powers that be at your facility if a handcuffed or shackled prisoner is considered restrained and if the restraint policy applies in that situation.

Women prisoners in labor at hospitals are still shackled in some places, I think. Is it right? I guess as long as they can get into the most comfortable and effective positions for care and labor, it's not so unreasonable. Again, safety of all involved is paramount.

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Let me guess, scenario for school?

What would YOU do? And FTR, I've been attacked by a prisoner before.

Yes, it is. I have my own thoughts about the situation but I also want to ask whoever wants to answer about what you are going to do when in that situation. It is better to see different points of views. The more information, means more broader way of looking at a situation.

Is it not allowed to post assignment questions here? I know lots of experienced nurses are in this group that is why I want your knowledge and input. If you would like to comment then thank you, if not then thank you as well.

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The facility I work for has inmates all the time. They are handcuffed to the bed, one arm and on foot minimum. The officer brings them to the bathroom and accompanies any testing. If there are more than one officer there is no way they are going to break any part of the handcuff policy. That person did/may have done if not yet convicted something really bad (had one for murder).

Their handcuffs are not considered physical restraints in the medical sense and the "no restraints" policy would not apply in this case.

As a nurse you should still be checking skin integrity around the site of the cuff and doing appropriate interventions to help decrease the likelihood of skin breakdown. Mobility will also need to be addressed in charting. The facility that I work for does not require restraints charting since they are not something that we are implementing for medical reasons. I do not know if that is the case at other facilities.

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Yes, it is. I have my own thoughts about the situation but I also want to ask whoever wants to answer about what you are going to do when in that situation. It is better to see different points of views. The more information, means more broader way of looking at a situation.

Is it not allowed to post assignment questions here? I know lots of experienced nurses are in this group that is why I want your knowledge and input. If you would like to comment then thank you, if not then thank you as well.

Posting assigned questions is not specifically against the terms of service (as far as I know). But most of us are pretty wary of providing answers to students that they can then cut and paste or paraphrase in lieu of doing their own work.

I think if you were to post your own answer first in such a way that it looks like you have already put some thought into the question, then other posters here would be more comfortable discussing the matter further, refining your thoughts, and acting as a sounding board for you. We like discussing nursing issues and helping others in their practice; we don't like doing other people's homework for them.

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Posting assigned questions is not specifically against the terms of service (as far as I know). But most of us are pretty wary of providing answers to students that they can then cut and paste or paraphrase in lieu of doing their own work.

I think if you were to post your own answer first in such a way that it looks like you have already put some thought into the question, then other posters here would be more comfortable discussing the matter further, refining your thoughts, and acting as a sounding board for you. We like discussing nursing issues and helping others in their practice; we don't like doing other people's homework for them.

Thank you for your feedback. I will put my own thoughts next time prior to asking your thoughts about it. You guys really helped me a lot and appreciate the knowledge base from this group. I will surely modify my postings next time.

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What are your thoughts about this scenario?

You are working in the ER for a local hospital when police officers brought in a client with a large gash in his head. The police officers restrained him with handcuffs but you r facility has a "no restraint policy". You were able to assess and treat the client but the restraints make you feel uncomfortable. You asked the officers to remove the restraint but they refused. As the nurse on the unit, what will you do?

Easy. I often ask for handcuffs to be removed. Very often they are able to do that. If they tell me a good reason why they can't remove their restraints that they are using according to their protocols/policies, I wouldn't even consider that to be against hospital policy unless handcuffs were specifically addressed as being included in the policy. That would be interesting since it would require some pre-arranged understanding between the hospital and the police department that is way out of my purview.

I would notify my supervisor that the police are not comfortable removing the handcuffs and move on with my work.

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The officer also has a job to do. We get handcuffed prisoners on occasion and they stay they way for the duration of their stay with an officer right at the bedside. I would document the cuffs and also that it was asked to remove but they weren't per the officer. Skin integrity and pulses I would assess same as if the patient were in soft or leather restraints.

We also have specific signage that goes over the bed and we have to know at all times where exactly the cuff key is at on the officer in case the patient were to need defibrillation.

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Police powers to restrain arrestees/detainees supercedes hospital policy. It really is that simple.

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Kiss the officer. Law enforcement trumps hospital rules.

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