Pediatric psych

[JenniferG rN]

Recently I have had a number of peds patients 5-7 year olds brought in by parents for behavior/suicidal and or homicidal threats and parents are looking for placement.

When our adult patients come in for suicidal/homicidal ideations security is present, the patient is put in a gown and belongings are taken outside the room. And they are monitored by security at all times. My question is this I follow the same procedure for the kids that I do for the adults but some other staff members do not agree. They leave the child in their clothes, no security and pretty much cater to whatever the child wants. Does anyone have an opinion on this? We do not have mental health services for these children and they often spend hours in the ED until placement at another facility can b found, so there is no policy in process for pediatric psych pt's. I'm afraid that not putting them through the entire process makes them think it's not a serious issue as to what's going on, others think they have it tough enough and no need to traumatize the child. I'm curious if there are other places that deal with this and what is your process?

[sandyfeet]

We definitely follow the same policies for pedi psych. I haven't had any as young as yours; my youngest was an 11 year old SI. But if you think about it, the reasons for the policies are all the same. Children can conceal weapons, pills or whatever in their clothing. Children can elope if not watched by security. You can still go to court if your pedi psych is harmed in your care! It seems like a no-brainer to me.

[zmansc, ASN, RN]

I think the "trauma" is having to be in an ER room for hours on end, not having to wear a gown and pj pants! We have the same process for all ages. I'm a bit more accommodating to all my MH patients than some of the other nurses, for example I almost always let them keep their cell phones if they are cooperative. And I 'cater' to many MH patients, just because it's not a physical illness and they have been in before, doesn't mean it's not an illness. If they are uncooperative, then I redirect them as best I can, but cooperative patients get as much catering as I can provide.

[ADeks]

I do make them get undressed and into the hospital gown. I only let them play with their phones if a parent is present.

[elkpark]

While I agree with the idea that child and adult psych clients should be treated basically the same in terms of safety/security measures, I'm wondering -- what is your hospital's policy? That's what everyone should be following consistently.