Patients throwing things?

[Minnesota123]

I have a few psychiatric ped pateints who throw things. Obviously we don't encourage this or let them have access to dangerous objects, especially when they start throwing stuff.

I have this one patient who is 15, she is old enough and has the mental capacity to know that she shouldn't throw stuff, but she chucks stuff like clothes, pillows, and whatever is in reach, especially when she's agitated. She hasn't thrown anything dangerous, but what would you do with her?

Does this warrant seclusion, restraint, or consequences?

[Double-Helix, BSN, RN]

Has the patient been evaluated by psych? Is there an agitation plan in place? It sounds like this child needs to learn some coping skills. Working with a psychiatrist to identify redirection and deescalation strategies that the entire care team can reinforce would be beneficial.

In the meantime, allow the child a safe way to express her frustration. A stress ball, hitting a pillow, etc. But firmly explain that throwing things is not acceptable because you need to keep the patient and the staff safe. Everyone should be reinforcing this with her. "Jane, I see that you are angry, but throwing things is not allowed. Let's squeeze your stress ball and take some deep breaths together. Then we can talk about what is bothering you." Social work or the therapist can work on developing some rewards or consequences for good behavior, such as granting computer time when Jane demonstrates good coping skills and doesn't throw things.

Physical restraint and seclusion (a form of restraint) are extreme responses and are likely to only escalate the situation further.

[BeenThereDoneThat74, MSN, RN]

A behavior plan? Some sort of contract that rewards positive behavior and takes privileges away when she does throw things? If she is cognizant enough to know what she is doing is wrong, this should work (but I'm no psych nurse :) )