Restraints

Your bos is nuts.

Hey boss,

My pt keeps disconnecting herself from the vent, can I get some mittens?

Boss says, "no, we are a no restraint facility, just take a sheet, wrap it around her arms and then loop it around the mattress so she cant move"

Brilliant

How about a sitter if this patient is constantly requiring reconnection to the vent?

I have also seen a trick of twisting a rubber band to connect trach to vent for patients who tend to pop off the vent every time they turn or move, but are not actively pulling on their tubing.

Her suggestion is also a restraint!. I love how we are responsible for things when we are not allowed to have the proper tools and staffing to do so. What about chemical restraints? If the mitts are not tied to the bed and the fingers can freely move does your facility consider that a restraint?

Same, mitts are not a restraint where I work, but they only work well on certain types of patients. A lot of patients are crafty enough to slip them right off.

Properly applied soft wrist restraints sounds a lot more humane than tying someone up in bed linens. Your boss has issues.

Hey boss,

My pt keeps disconnecting herself from the vent, can I get some mittens?

Boss says, "no, we are a no restraint facility, just take a sheet, wrap it around her arms and then loop it around the mattress so she cant move"

Brilliant

Sounds like a straight jacket. Your boss is an idiot (no offense).

Boss says, "no, we are a no restraint facility, just take a sheet, wrap it around her arms and then loop it around the mattress so she cant move"

Well that's the exact definition of a restraint, not to mention illegal!

sounds like a long-term care facility?

sounds like a long-term care facility?

My experience is that LTC figures out many other ways of dealing without restraints. Side rails not used because people climb over them. Most hospitals are not as gifted in getting creative about ways of helping the person with restraints. You can restrain if necessary. Make sure you document other methods tried and do the rest of the protocol. Sitters are an easier choice.

How about some MJ juice? Sorry. Former icu nurse couldnt resist....

1. Acknowlege feelings

2.Orient patient

3. Remain Calm

Seroiusly though, you shoud be llowed to use mitts

Simple. (I am assuming that you can't wean 'er off the vent, which would really be the best thing.)

Have a family conference to explain why restraints should be used. Get their consent and buy-in. Get a physician order for restraints, and be damned sure you document them to the letter and spirit of the regs.

If no family, ask your social services people to start the process for a guardian ad litem.

I am reasonably sure that your boss would rather defend the use of restraints than a death.

sounds like a long-term care facility?

Really? You must not have any idea about the realities of LTC.