jojo

Thanks to all who have replied. I suppose that there are no overall guidelines for the use of restraints in the US, a point which I find surprising since the US tends to regulate most things. However, thanks again. If I can be of any help to anyone looking for information on mental health nursing in the UK then please put in another reply.

Hi Las Thankyou so much for your reply. This information is very useful. What I am really looking for are descriptions of what is actually permitted by the current rules what these rules are and who is responsible for formulating these. The restraint practices in the UK are a little different and the reason for my enquiry. Since 1959 all forms of artificial restraint devices are banned. Restraint may be used legally to prevent injury to the patient, other patients and property but this takes the form of physical contact, holding the patients wrists usually. In extreme cases several nurses may assist in physical restraint. Clearly this is a short term measure though. Isolation rooms are still used in some hospitals but these may only be used for a maximum of 1 hour after which a doctor must attend. In the past 10 years this physical restraint has been gradually phased out, except to protect other people from harm and then only sufficient to remove that harm. 'Cot sides', rails applied to the side of beds and chairs which have special tables which can be secured to make standing up difficult are now outlawed. The result has been that actual violence is comparitively rare in most psychiatric hospitals. My own experience from working in forensic (legal), long stay, mentally acute and elderly is that I have rarely if ever been attacked with the exception of elderly confused and in this case any such attacks usually ammount to grabbing, throwing something, or an agressive gesture and are easily resisted, usually by diverting the patients attention. I should say that there are a few hospitals where old habits amoung staff do surface but over the last 20 or so years these old hospitals have been closed down. Now this is very important. I discovered the existence of restraint practices in US psychiatric hospitals while reading some articles on the internet. I have discussed this with some colleagues and the consensus is this: Care of the mentally ill is a social matter. While progessive approaches are to be applauded such progress is a matter for the local society and it is not our place to criticise or place judgement upon another society's practices. Clearly, in the UK society has a more developed attitude to mental illness than in other countries but this is down to UK society and any lack of progress in this regard is not an criticism of psychiartic nurses elsewhere, though it may be a criticism of leadership. Secondly, we are all jointly interested in the approach curently used in the US. We appreciate that many issues are currently a mater for local debate. I have managed to access some American Nursing Magazines and down-loaded articles on reforming the current practices in relation to restraint. However we are very interested in learning what the current regulations and practices are and the equipment used. I hope you can help. If you want any further information from our side of the pond, please don't hesitate to ask. Jojo

Looking for information on use of restraints for acute patients in psychiatric nursing in USA. What sort of restraints are available What are the rules? What are the feelings of American nurses reguarding the use of restraints? What is the ethical position? What is the legal position? Any information and references, especially web references. Thanks.