Question

• What steps would you take in de-escalating a situation? What interventions and in what order to you use them? Please respond to at least 2 of your peers.
• Restraints – When the appropriate use. What Assessment is needed and what Documentation

Discussion Board Question – How do you ensure your safety as a psych RN on an inpatient psych unit?

Answer 1

Restraints are protective devices used to limit the physical activity of a client or to immobilize a client or an extremity.

Physical restraints restrict client movement through the application of a device.

Chemical restraints are medications given to inhibit a specific behavior or movement.

Interventions......

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> when restraints are necessary, the physician 's orders should state the type of restraint, identify specific client behaviors for which restraints are to be used, and identify a limited time frame for use.

> physicians orders for restraints should be renewed within a specific time frame according to the policy of the agency.

> Restraints are not to be ordered PRN - that is as needed.

>the reason for the restraints should be given to the client and the family, and their permission should be sought.

> Restraints should not interfere with any treatment or affect the clients health problem.

>Use a half - bow or safety knot (quick release tie) to secure the device to the bed frame or chair, not to the side rails.

>Ensure that enough slack is on the straps to allow some movement on the body part.

>Asess skin integrity and neuro vascular and circulatory status every 30 minutes and remove the restraint at least every 2 hours to permit muscle exercise and to promote circulation.

>continually asess and document the need for restraints.

DOCUMENTATION POINTS WITH THE USE OF A RESTRAINT.

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Reason for restraint.

Method of restraint.

Date and time of application of restraint.

Duration of use of restraint and client's response.

Release from restraint with periodic exercise and circulatory, Neuro vascular, and skin assessment.

Asessment of continued need for restraint

Evaluation of clients response.

Psychiatric nurses and psychiatric nurse practitioners have a very specialized carrier. They often care for mentally ill and unstable patients. While any area of nursing has its risks, psychiatric nursing has specific risks that need to be considered.

First, it's essential to describe what type of patients and diagnose psychiatric nurses and NPs handle. For some, the image of psychiatric nursing is that of a locked, sterile facility with confused patients wandering the halls. While some psychiatric nurses and NPs work in inpatient mental health facilities and address severe illness like schizophrenia and bipolar disorder, they also care for and manage patients with diagnoses such as

Dementia

Depression

Anxiety

Eating disorders

Autism.

Psychiatric nurses and NPs can have a challenging career. However, while different fields of nursing focus on various patients populations, it all boils down to one of the basics nursing : advocate for patients while maintaining the safety of the individual, other patients, and staff.