SO- Patients in Gowns

UM Review RN, ASN, RN · May 8, 2006

I'd love to do that for some of my "drug-seekers" whose purses I legally cannot look through for "home meds" unless they're so out of it, they're about to be Narcan'd. :stone

What are the legal ramifications? Anyone having a problem with it so far?

DusktilDawn · May 8, 2006

We're trending towards placing all psych patients into gowns, placing their belonings into labeled belongings bags and keeping those bags at the nurses station.
They're trying to do this to keep the chances of having a psych patient leave when they shouldn't to a minimum. No sentinal event yet, but just waiting for the suicidal patient to slip out and come back as a code.
The logic is that way it's harder for a patient to sneak out. Kinda hard to sneak out when you're in a gown, your clothes are locked away. Makes you very easy to spot in a crowd. :)
Anyone else doing this?

This reminds me of something that occurred years ago. A patient from a unit I had floated to had left the unit using the back stairwell, which lead outside of the building. This guy walked across the parking lot, across the street to the Knights of Columbus. He ordered and was served a beer, despite having a hospital gown on and an armband on. This occurred in broad daylight, I kind of wonder how many people this patient passed on his way across the parking lot to the K of C, how many patrons were already in the K of C that also saw this man. It also makes me wonder why a bartender would serve anyone with a hospital ID band on his wrist and dressed in a hospital gown.

I guess I think that there should be more safeguards in place than removing a paitent's clothing and dressing them in a hospital gown. If a patient really wants to leave, being dressed in a hospital gown won't stop them.

Altra, BSN, RN · May 8, 2006

This has been the policy at the 2 hospitals where I've worked in the ER. Our psych patients are also wanded before going back to Psych.

susi_q · May 8, 2006

Ditto ... we gown and remove belongings from all psych, intoxicated, aggressive patients. Belongings are not searched though ... just bagged and tagged.

babynurselsa, RN · May 8, 2006

If is is an EOD and they are remotely noncooperative we gown and keep their belongings at the desk. If they are voluntary and cooperative we usually have security go through their bags and they can keep all items that are not on te no-no list.

Over the years we have had guns, knives, razorblades, ETOH, you name it removed from patients belongings. THe most original one hid his knife in his rectum. We found nothing in his bags and as soon as we left him alone he removed it a then sliced himself. When the new ER was built we the had cameras installed into our quiet rooms.

TraumaLPN · May 10, 2006

My "true" psych pts. and my suicidal pts. ALL go into a gown and I take ALL of their belongings; cell, phone, car keys, wallet, ect....I have never had a pt elope in 17 years. It is our hospital policy to place all psych pts. in a gown and take their belongings. I've seen other nurses not do that and they end up with pts. running. One psych pt. that eloped came back via EMS because he went down the road and jumped in front of a car. When you take their belongings it makes it safer for ER staff and other pts. as well. They also don't fight so hard against the "psych work up process."

burn out · May 10, 2006

I am not so sure that gowns will prevent any psych patient from eloping. When I did my psych rotation we had one patient elope into a wildlife refuge, when he came to the river he took his clothes off so they wouldn't get wet and swam across the river. However, when he got on the other side he realized he had no clothes and when he went back he couldn't find his clothes. The techs searched all afternoon for him and as the sun was setting as I went home I saw them bringing him back wearing garbage bags.

Aneroo, LPN · May 11, 2006

I'm not saying it won't keep them from eloping. But it sure makes them a whole lot more visible if they're running down the street, than if they were in street clothes.

Luckily, we have a metal detector at the front door. Anyone who comes in via traige has already been checked for weapons and such. Nothing in place to check folks who come in through EMS though. Depending on the patient, we do get our hospital police to come check through their belongings, and patient rep locks away the appropriate belongings (valuables).

TraumaLPN · May 11, 2006

Most of our psych pts. come in with PD or SO or EMS so it is up to the nurse to make sure they have no weapons or keys or cell phone. It is ultimately the primary nurses responsibility to ensure that she/he is safe, the pt. is safe, ED staff is safe and all ED pts. are safe. Over the past 17 years I have seen some wild **** pulled by psych pts. Even though I treat them with respect I don't trust them for one minute. I have found that if you put them in a gown and take all their belongings they are much more cooperative also. They also calm down faster and stay calm if they know you have the advantage. I also have found if you are truthful and honest from the start and don't keep anything from them they are much more calm and cooperative. I've seen nurses keep information from pts. like "you are being 1013ed to a mental hospital" and when it's time to go the wild rompas starts. THAT is what gets people hurt!

Ivanna_Nurse, BSN, RN · May 11, 2006

Ours are dressed in blue paper scrubs, same material as the isolation gowns. All items are removed from their possession and itemized then locked away. Pts. are wanded before being escorted to the unit and those are worn for the initial 24-36 hours regardless of suicide status.

allnurses Guide · May 12, 2006

They're trying to do this to keep the chances of having a psych patient leave when they shouldn't to a minimum. No sentinal event yet, but just waiting for the suicidal patient to slip out and come back as a code.

We had a man brought in for suicidal ideation, security was told to keep an eye on him because the seclusion room was in use. Sec. guard sat down, no line of sight. Guy went out the front door, stole a taxi while the driver was inside looking for his fare, and drove it home.