Question - page 2
Am I right in thinking that, over there in North America, you sometimes use physical restraints (leather straps and the like) to control violent behaviour? If I am right, I'd like to know what your... Read More
Nov 29, '02Occupation: Nurse Consultant Specialty: 24 year(s) of experience in Obstetrics, M/S, Psych ; Joined: Jun '02; Posts: 3,105; Likes: 49Interesting thread. I wonder how much our unique cultures have to do with the way we treat our psych patients? I bet there is a significant influence.
Nov 30, '02Occupation: Lecturer Joined: Nov '02; Posts: 78; Likes: 1I am a fluffy bunny nurse - make no mistake about that, but personally, I have no problem with sensitively-used restraint techniques. I have found that in some cases, being held by nurses has actually been therapeutic for people.
However, there are the odd few macho nurses (male AND female) who love a "bit of action", and that disturbs me.
Walking off the energy would be infinitely better, but sadly, when resources are few, this isn't an option. Also, it doesn't help when you have to give someone medication against their will, and they are determined to fight you all the way.
Nov 30, '02Occupation: Retired Specialty: 15 year(s) of experience in Corrections, Psych, Med-Surg ; From: US ; Joined: Aug '02; Posts: 2,246; Likes: 48Clive--Many of our basic values are much the same. However, since the economic models and social/political foundations of our healthcare systems are much different, we can only expect substantial differences in actual practice.
Since US psych patients don't tend to vote in large numbers and don't tend to have high incomes or substantial political influence (perhaps that last item is simply redundant), their healthcare resources tend to be something less than substantial (or even adequate).
As your system now is encountering increasing financial problems, we may well find increasing similarities in treatment between our two systems. (Forgive me if I, for convenience here, refer to the US healthcare industry as a "system," as it is anything but that.)
In either case, my advice is: DON'T be a patient if you can help it.
Best wishes.Last edit by sjoe on Nov 30, '02
Nov 30, '02Occupation: RN - College Health Specialty: Geriatrics/Oncology/Psych/College Health ; Joined: Jun '02; Posts: 6,584; Likes: 70Sometimes there is no other alternative, altho the trauma to pt and staff, not to mention the extreme paperwork involved, certainly makes it the last option.
I have written up a doc who refused to come in as required by policy in an hour to visually assess the newly restrained pt. He told us to control the pt in some other way that didn't require him getting out of bed at 2am. Sorry - violent, assaultive pts with a skeleton crew on night shift get restrained and if that interrupts the doc'd sleep, he needs to find another line of work.
Nov 30, '02Joined: Oct '02; Posts: 1,671; Likes: 3what I wish would be to have available a safe seclusion room; no hard corners, no closets, padded surfaces. the design of our unit works against us.
Feb 6, '03Joined: Oct '02; Posts: 1,079; Likes: 53Hey iknow this thread is old but...
There was a psych hosp. in CT. that was well renowned (forget the name) where they used body bags. The individual was kept in the line of sight of all, other pts included. Resistance was futile,basicly. I have never seen these used elsewhere. I'm guessing there was an inherent problem with them. Anybody see this as an option/not
Feb 6, '03Occupation: RN Joined: Feb '03; Posts: 20I worked in a hospital in CT that used body bags. We did a good job with them although the patient really needs 1:1 observation due to potential for asphyxiation. They can get out too if they're small enough (really).
My last 2 hospitals haven't used them. We don't really need them with 4 points and chemical restraints. And we send violent, acting out types to the state hospital within 24 hours. They're incredibly dangerous but with some of the situations y'all seem to be facing out there one has to keep unit safety in consideration.
Feb 9, '03Occupation: Psych Joined: May '02; Posts: 66I'm the poor stiff who gets them when you send them to the state hospital! LOL. We use Full belt canvas and/or leather restraints. The reason I mention both is because depending on the situation, and where it occurs, we may need to walk the patient to a bed, or we may be able to bring the bed to them. When they are safely placed in full belt restraints in the bed, a chest posey is usually applied if they are out of control, to keep their upper torso stabalized. This is removed as soon as we feel they are not a threat to themselves (thrashing about) We also use chemical restraints with mechanical restraints, although, most of the time, I have already intervened and given the patient a p.o. prn of some kind to assist them in settling prior to them escalating to restraints. If we still feel the need for an IM injection, Ativan & Haldol (the "cocktail") and Thorazine are common drugs of choice.
Another Note: NEVER NEVER NEVER DO WE LAY ANYONE FACE DOWN IN RESTRAINTS!