302queen

Where i work it really depends on the unit. On the inpatient floors most cases we would go ahead and give the Po unless we have a reason to suspect it is a ploy on the patients part. In the crisis unit once we go hands on 9 times out of 10 the patient is put on a bed and in 4 points so we would give the im as releasing one of the 4 points or even 2 so they can sit up is a huge safety risk to us.

Until about 3 years ago we had a 65 to 70 percent release rate of voluntary's who give the 72 hr notice and they did have to sign a 2nd ama form. Then we had a patient released on an ama within 24 hrs of the 72 hr notice who killed himself and his wife since then once a patient files the 72 hr notice almost 80 percent of the time i'd say closer to 85 percent we will file and get involunatry hold rights on the patient.

It can be violent at times. Intake can be a bit more violent due to not knowing the patients as much as say a floor nurse knows their patients so it is harder for us to avoid triggers etc. That being said we probably restrain 1 to 2 times a shift depending on the day some more some less when i say restrain i mean full on 4point restraints or im sedation. We give oral meds to calm patients probably another 2 to 3 times a day for various reasons. You do have a chance to counsel as well depending on how busy you are etc.

I work intake now i work in a dedicated psych facility which makes it easier in some ways. Less concerns about having patients pushed on you prior to being medically safe due to shortness of beds or staff in the er. It can be interesting at times like others have said you are one on one with the patient and play a big big role in deciding there placement however it can also give you a chance to offer a lot to the patients physical and mental wellbeing i personally love it.

we use the posey ones in the op as 4 point restraints those are they only type of 4 point restraints we have we use to use those as soft restraints and leathers as hard restraints however we stopped using the leathers a few months ago although they are still in the nurses station for some reason.

i can picture a little sign next to it please ring bell once for im haldol ring twice for seclusion lol haha. relax people i am joking

psychosis patients and the invol holds tend to be the most problems for us.

tell him its a male one bend over haha

where i work pt we have 3 er's adult physch and peds we never ever put adults in the peds er however we use adult er beds for non violent physch patients when we really need to and have on occasion used a spare physch er bed for a non acute er patient

the first has a history of admits and gets sexually aroused by enemas we offered oral laxatives and we got a refusal and our charge nurse on the inpatient unit has a habit of accepting crisis admins before we discharge for the day sometimes

lol wow

Hi there in the past week i have had 3 incidents of weird patient demands. first was on a overnight shift in the crisis intake unit i had a female patient ask me for a enema i had asked why and her response was during the last few weeks all the stress left her constipated i was able to get orders for an oral laxative which she agreed to. i also on the same weekend had a male invol admit ask to be put in the padded room till we found him a bed and a female admit which was vol and turned invol ask to be strapped down like on tv i declined both requests and got them both to agree to an oral medicine which calmed them down neither was near the point of needing seclusion or restraints mind you. has anyone else had weird expernices like this?

i work the occasional medsurg or er shift at the hospital i work at usually 3 or 4 shifts a month

Well said.

being from philly area mind if i ask where you worked?