opinion needed

[302queen]

hi this was sent to me by a friend. I do not know how she got it or if it is a true expernice just want peoples opinions after reading it what do you think etc.

My mental hospital experience.

I had been feeling down lately and very depressed I decided to seek treatment at a local mental hospital in the city.

I arrived by taxi and walked up to the door marked intake crisis and rang the bell a woman whose id tag said ***** and the letters RN let me in and asked what the issue was

I explained and was asked do I hears voices want to hurt myself etc etc I was ushered into a room I was made to empty all my pockets and my id was taken she also took a set of vitals

When the door shut I thought I heard it lock but was unsure I was waiting in there about 20 minutes when I heard some screaming and another nurse I assume yelling for ***** to bring something called Haldol to a room called seclusion 2 I saw ***** get something from a tray behind her and go running from the little window in the door to the room I am in

Well another maybe 40 minutes passes and I am getting inpatient I try to open the door and realize it's locked Impatiently I bang the door hard ***** comes to the door telling me to calm down and asking if I want something to relax me till they doctor comes in to see me in about and hour well at this I bang the door again hard trying to open it yelling I want to ******* leave at this point I am told I can not

I keep banging the door and ***** yells for some nurses from the back I am shocked they are all women the door is opened and they quickly grab me one holding my legs two at my arms ***** tells them all 3 seclusion rooms are full so they are to take me to tie down rm 1 they drag me to this room and it is just a stretcher with restraints and nothing else I am forced onto the bed and tied down still screaming like hell ***** returns with a needle a not small one I might add and says it is time for me to have a Haldol nap she jabs me quickly and with a bit of force in my opinion Perhaps due to my behavior and I begin to feel drowsy and drift off to sleep

[MrChicagoRN, RN]

Hard to say. We have a one sided recollection. Was she suicidal, hearing voices, expressing threats or extreme delusions? What are the laws in that state?

Several possibilities

1. It's someone attempting fiction writing.

2. It's an egregious violation of patient rights.

3. It's written by a patient lacking in insight. I sometimes see patients who came in with extreme psychosis or acting out, and then days later minimizing and denying pathology.

Which is the truth?

I haven't a clue

[302queen]

It was a story a friend was sent who is a not a mental health nurse I am unsure where she got it offhand. but I believe it was written as a story. she sent it to me to read and I figured I would post it here for insight and opinions and sheer entertainment lol.

[Juli4310]

If it is the truth, I agree it is a violation of patient rights left and right. However, it sounds like a fabrication of someone who has watched "One Flew Over the Cookoos Nest" and "Girl Interrupted". Most places don't use tie down restraints anymore and giving a medication without physicians approval is grounds for termination of license.

[elkpark]

The entire scenario sounds highly unlikely to me, more like a bad Lifetime movie than anything I've seen in my almost 30 years of psychiatric nursing practice. I have heard of some really scary practices at some of the proprietary (private-for-profit) psych hospitals -- I suppose that might be a possibility. I've never worked at one (would never be willing to), so I don't have any first-hand experience.

[Meriwhen, ASN, BSN, MSN, RN]

With all due respect to the OP, I see too many red flags here that make me think this is an attempt at fiction...and an inaccurate one at that. First of all, unless an admit poses an immediate danger to themselves or others, they're not going to be locked in a room (i.e., placed into seclusion) within minutes of showing up at the front door WITHOUT even seeing a doctor. That's a big human rights violation. The rest of the story continues to go factually downhill from there.

Elkpark: I have worked at a private psych hospital and trust me, this stuff the OP describes wouldn't fly there either.

I agree, this could be a possibility because in this world, anything is possible...but IMO the OP's scenario is far more likely to occur only on FearNET than in real life.

[chevyv, BSN, RN]

I agree that I too believe this is full of stink. Unless the pt was a danger to themselves or others, they would not have been locked in a room, especially alone unless they were violent or suicidal. We line them all up in the waiting room unless they are brought in and are violent. Most places don't have enough rooms to put everyone who walks in the door in. Even in crisis there is a wait time to see the doc. Giving haldol without the doc at least laying eyes on the pt and asking allergies would be grounds for termination for sure. The banging on the door would be a good time for some therapeutic communication not a shot. Big needles are common for any pt to say, as most dislike getting IM's. Also, in crisis we wouldn't normally give just haldol to a pt who was becoming physical. They would get the coctail (ativan, benadryl, and haldol).

[New Angel]

I don't necessarily think the whole story is fiction...It sounds like a typical scenario: If you are hitting walls/kicking or banging doors and cannot stop yourself you are at a risk of self harm and are escalating into severe agitation with some violent behavior. The woman may have escalated herself into a seclusion & restraint situation, because staff asked her to wait for the doctor, offered her medicine and she refused meds/was too agitated to wait. You're not allowed to hurt yourself inside of a locked psychiatric unit, so if you are banging/kicking walls/doors, and cannot stop yourself, then Seclusion/Restraint is appropriate. It is meant as an intervention to prevent self harm & assaultive behavior, and keep people from physical harm, exactly what the person describes doing.

People think that just because you walk into a psychiatric facility voluntarily that you will be released voluntarily at any time you wish,,,,,that is not the case if you become a danger to yourself or others while you are in the facility. The criteria for discharge is that the person is not a danger to themselves, to others or gravely disabled. Kicking/Hitting a door without stopping when staff asks, is dangerous to yourself and demonsrates physcially agitating/aggressive behavior.

You walked into an emergency psychiatric facility for a reason: you were in crisis. When you didn't get to see the doctor immediately, you flipped out and became psychotic enough to not be able to sit down and wait an hour for a doctor or take an a medicine orally that will help you relax until then. It's not burger king, and you don't get everything your way.

Tie down restraints are unlikely, they have proven to cause CSM issues and have been largely upgraded, so I see this story as an exaggeration of what may have happened. Often, the moments before you are restrained and given injected emergency medication, are very confusing and blurred for people, partly because of the haldol nap you referred to. I will say, that being physically restrained feels awful for people, and I don't doubt that she felt like the situation felt much worse then it may actually have been. Staff are legally able to apply restraints to people to contain their behavior for a very VERY short time while obtaining physician's orders for restraint {CA}. And by short time, I mean less then 5 minutes you are on the phone getting physicians orders.

Take the time to read up on your own facilities seclusion and restraint policies, as well as the state laws. What you do with your individual license may be where the blame falls during legal issues, and you want to be sure you have upheld patient rights and policy perfectly.