The conditions you describe are unsafe to you and to your patients. If a patient is bent on self destruction or your destruction, they will accomplish their goal even if medicated. Ativan is only supposed to last for four hours. This is so crazy. I can't believe that this is going on in a hospital setting.
As for a solution, there is always someone on call. There has to be a doc in the ED or on a Med/Surg floor who can come see the patient and order restraints and be done in only a few minutes including the paperwork. I would find it hard to believe that there are no docs available at all during night shift at any hospital.
I am shocked that your administration did not back you up at all. This is so unsafe. Would they like it if you just closed down the psych unit while there are no docs there to cover? Sorry, all psych patients have to go home til the docs come in the morning. How can you be recertified by JCAHO when you don't have a doc available for emergencies? I am sitting here shaking my head. I just don't understand how this can happen. I would talk to my immediate supervisor and demand a solution before working again. If they offer you no answers, I would take it up as high as it goes. I would also call my state department of mental health. The states often have much stricter guidelines re: inpt psych units than JCAHO.
What happened to the forcing of medication when a patient is a harm to himself or to others? With or without a patient's consent on a paper. Geeze. This is crazier behavior than the patients display.
I love the wearing of helmets. What about full body armor? How insane. What state is doing this to its nurses? I would be getting myself a lawyer as well as my own malpractice insurance
. Do either of you have a legal department? If so, I would contact them at once and ask them your rights in this situation.
I would also start pressing charges against all who offend. Each and every time I would press charges. I would also highly encourage all those who are assaulted at work to do the same. When you start spending more time in court than working, maybe the administration would get the hint. I would also have each and every assault checked out by the emergency dept. That would mean that administration would have to cover the already unsafe working conditions til other help could arrive. How many administrators want to work psych? The last time I went to the ED for eval of work related patient inflicted injury it took me four hours to be seen. A patient had kicked out the safety glass with wires window from his door and somehow landed on my shin. I was out for five days as it somehow damaged my bone and five years later, I still have large overgrowth of bone on my shin where this happened. I would also encourage staff to take time to recoup from their injuries, making workman's comp claims when appropriate.
Or, you could just find another job that is safe and then report the unsafe working conditions to anyone who will listen including JCAHO, state dept of mental health, county dept of mental health, any local investigative reporters.
Get out before you get hurt.