No Restraints

My life and nursing experience says that if one starts to get repeated thinkings about GETTING THE HECK OUT OF THERE WHATEVER IT TAKES, then it is most possibly the time to do just that and get the heck out of there.

Restraints are sometimes neccesary for safety, but are never theraputic. They are nor the be all and end all. In fact, they are considered to be a therapeutic failure by many.

If they won't restrain, please Share What Was done, and tell us how that worked out.

This particular patient was given an Ativan-Haldol-Benadryl cocktail, which didn't even make him yawn. He was also put on 1:1 observation, yet he still made an attempt to attack another nurse. Even the veteran psych nurses were taken aback.

Do you have seclusion available?

Regarding the meds, sounds like they,should've then moved up to something like Thorazine or Zypexà if still agitated

I agree. The practitioner keeps increasing Haldol rather than trying a different antipsychotic. That's the real problem. We do have a quiet room and a seclusion room. He has been in neither, just because.

I work in a psychiatric facility that does not have physical restraints on the property, we simply do not believe in them. If a patient is actively at risk of harming others he/she should not be running around the unit "on a rampage." A code should be called, staff should strategize how they'll do the take down, CPI/non violent intervention strategies should be utilized appropriately, and the patient should be escorted to the seclusion room/given IM injections until he/she is no longer a threat to others. He should definitely not be given the opportunity to leave the seclusion room if he is still attempting to strike nurses. Your staff can do a physical hold/restraint on the patient to allow you time to administer the IM injection if he is actively a threat to self or others. If you do not have access to an adequate seclusion room or consistently do not get adequate support from staff throughout the facility when you call a code, you've got a big problem. With the little information you've given, it doesn't seem like the patient is the problem (lots of aggressive psych patients in the world) but training/teamwork may be lacking. Decide if it's worth sticking through process improvement on the new unit!

Edit: No seclusion just because? Oh my goodness he should have been in seclusion for awhile it seems like! There's the problem.

Such BS when they are using retsraints...chemical restraints. I worked on one of those units and there was more harm than good with the amount of psych meds they were using...

Medications are a form of restraint absolutely!

I'm finding that facilities are more focused on days without seclusions/restraints and will chastise the staff member who makes the call to use either of those. It "messes up the numbers", regardless if staff have been injured or not.