mikenmim

I always use a 1 1/2" needle for IM's.

Does your agency use syringes with retractable needles. My preference is Vanish Point brand. The needle retracts while it is still in the patient. This dramatically reduces chances of a stick. Also, talking to the patient may seem like the most humane approach but the situation is already out of control. It is unlikely that your efforts will matter once you are at this point. No amount of reason is likely to work. Best to focus on the task at hand. Security does their job and nursing does theirs. Get the job done and let the patient sleep. Things will get better.

Remember that they are people too! So many people walk on to the floor and are afraid of the psych patients. Over time you will develop the ability to know when you are over your head and need help. Your preceptorship and the long time psych nurses can be your best tool. Sometimes you may have to throw away the text book and follow your instincts. Above all, remain professional and always show respect both through your words and your demeanor. It's a great field. I've been working with psych patients for 35 years. It has become my passion and I learn new things every day.

We have an obligation to provide treatment. There can be no effective treatment if staff are in fear.

We always used HA HA therapy. Haldol (5 or 10) and Ativan (2). Repeat in an hour if needed. Of course, if you can head off the emergency and your patient agrees to take po meds then everybody wins. My preferred po med is Haldol or Thorazine.

No harm in asking, "would you like something to help you relax?" The patient still has the option of refusing the PRN. he does not have to present a danger to self or others for you to offer. If he accepts, the PRN med ma help to lower his BP until he is willing to submit to BP checks.

Keys should be on a ring and kept in your pocket, out of sight of patients. On my unit, we are required to wear an ID badge. This is also the magnetic key for access/egress to the unit. A lanyard is not permitted unless it is a "break away", supposedly for staff's safety. Not an ideal situation as patients have come to me with staff ID's left in their rooms and asked what to do with them. Simple solution? Disable staff keys to access/egress and assign that function to a single person in a secure area.