Published Apr 18, 2014
i just took a new job with 2 padded isolation rooms on the floor. i have never seen one before. any advice from those who have used them. i thought these types of rooms were gone with the days of straight jackets haha.
Mandychelle79, ASN, RN
What do you want to know about them? We have one padded isolation/seclusion room and one restraint room that is also padded. I have allowed patients to go into " Open seclusion" where they can come out when they feel that they can be on the unit again. Patients have punched the padded walls as a way to let their anger out, much softer on the fists than the main walls on the unit.
As for restraints vs seclusion, I will go for seclusion first unless the patient is harming themselves with items that I cant remove... ie cutting self with their fingernails, biting self, things like that. If they are just being aggressive and need to removed from the unit, into the padded room. IF they are going to be in their for an extended period of time, ( most of my seclusions last less then 30 mins, once the meds kick in ) I will bring the mattress in from the bed in the restraint room.
We have one at my work. Honestly, I wouldn't want to work at a place without one. When we have patients who walk (work in Geri-psych) and obviously need reduced stimulation beyond what their own room can provide it is such a blessing. Better to use that room than have an injured patient or employee. Yes it's a lot of paperwork (it's still a restraint) but it's better than an altercation.
We do also use 1:1 but some people just can't handle someone in their space all the time.
Meriwhen, ASN, BSN, MSN, RN
We call such rooms "Time Out Rooms." They are used for seclusion...but more often that not, we use them for our high acuity medical patients who require more frequent monitoring (they have cameras and are located near the nurse's station), or we let patients go in their voluntarily if they want some quiet/alone time (the door isn't locked in this case so it's not seclusion).
The padding helps for those patients who are headbangers or otherwise violent, and like to take their frustrations out on their surroundings.
Good Question, prince. Enlightening Responses, Posters.
In my years as a Psych Nurse, I've seen only one Padded Isolation Room. That was back in the early 90's and was on the DD side of the State Facility, and I worked the MI side, so I never actually saw it used.
Now, at the Two Hospitals where I've worked Psych, there have been Seclusion or Quiet Rooms, as Meriwhen described above, only without the Padding.
On the Geri-Psych Unit where I predominately work, we have placed Mats on the Floor of the Seclusion Room for those Patients who are so Gone they crawl around like little Babies. This Room is Logically located next to the Nurses Station and is under constant Video Monitoring.
A Padded Seclusion Room is a Good Idea. I may go as far as to Question Administration as to the Reason we don't have such a Room. The Reason may be due to the Regs mandated by certain Accreditation or Benefitting Agencies.
I'll let you know what I find out.
I work on a pediatric psych unit. We have a padded room called the kid-zone. It is used for a "self time out" when the child is feeling agitated/ irritated or the staff may recommend use of the room to remove an aggressive child from the milieu for some 1:1 staff interaction. It is next to the nurses station and has constant video monitoring. We stress that the kid zone is a safe place and that going into the zone is not a punishment. It works well.
Straightjackets are still around, also, although you rarely see them anymore. They are considered a less restrictive restraint than strapping someone down to a bed.
My coworkers and I have talked about this recently and are requesting one for our new facility. If not for every unit at least for ours. We get the more aggressive patients, the self injurious patients, and the screamers so it would work well for us. For those that like to punch walls and all provided alternatives do not work, at least they could punch these walls and not cause as much harm. It would also help keep the other patients from being disrupted by all the screaming if it could help dampen some of the noise.
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