Restraints and You

Restraints and You
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  • I have a really confused patient!
  • Describe to me what behaviors you have observed.
  • The patient ingested an unknown substance at a dance party at 0200 last night.
  • Someone dropped him off in the parking lot unconscious.
  • The patient is now pulling at his IV catheter and foley.  He is attempting to kick and hit the staff.  I am concerned for his safety.
  • What non-physical interventions have you tried to de-escalate this patient's behavior?
  • I have attempted diversional activity, verbal instruction, reorientation, environmental modifications...
  • Comfort measures, closer observation, placed a bed alarm and reviewed medications.
  • It sounds like it is time to call the doctor.
  • Hello, this is Dr. Smith, how can I help you?
  • Dr. Smith, your patient has become violent to staff, is dislodging tubes, and is confused.
  • Please apply soft wrist restraints for violent self-destructive behavior and give Ativan 2mg IV x 1.
  • I will be in within the hour for a face to face
  • I hope I get my documentation correct!
  • The intervention guides you on the elements needed for the correct documentation.
  • Always be sure to use the least restrictive intervention when possible.
  • The frequency of your intervention is even on the intervention list!
  • Just follow the intervention to cover the required documentation.
  • There is even a comments section you can use to "paint a picture" of patient behaviors.
  • Can I do a trial release when he gets better?
  • I am afraid not, you must get a new order.
  • Be sure to monitor the physical and psychological well-being of the patient
  • It is important to monitor the respiratory and circulatory status, skin integrity, vital signs, and social requirements.
  • Yes, that will help me identify and respond quickly to signs of physical and psychological distress!
  • I will add a care plan and monitor for behavioral changes so I can remove the restraints as soon as possible.
  • Before you know it he will be back to normal!
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