Well, first of all that's a conversation that psych needs to be having with them. Not nursing.
But unfortunately I have been placed in the situation that goes like this: Psych walks in, states the fact that they are involuntarily admitted. Scurries away. Patient promptly loses every single shit possible and now it's my mess to clean up.
My spiel often goes: "Hey, I hear that this is really hard to listen to. You don't want to stay. I get it. However [and this part I usually need to raise my voice a bit for because they're screaming] this behavior will not change that fact and it can result in you being restrained. I don't want to do that. I want you to be able to have a sandwich, and a blanket, and go to bed. You do not have a choice about staying. You do have a choice about your behavior."
Then we usually go in circles for a little bit while they rage and scream and call me every name in the book. That I can deal with. Odds are about 50/50 that they will settle and we can get somewhere or I will need to break out the night-night juice.
I don't mind if they're angry about it. I sympathize, especially if they're held on a Friday because that will be a miserable weekend while they wait to have their hearing (and frankly, I think that's a violation of rights). But I don't tolerate them hurting themselves or threatening/trying to hurt me or anyone else.
If it's just meds and they don't want them, I say, "Hey, so not taking the medication is not an option. But I do want you to have choices. Which arm would you like it in?" Again, about 50/50 odds of them continuing to adamantly refuse and then we just have to go for it. But sometimes patients do say, "My right arm" and then we've retained some degree of rapport. I explain that their behavior is unsafe and I list specific examples so it doesn't just feel like they're getting drugs for no reason.
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u/Negative_Way8350 BSN 4d ago edited 4d ago
Well, first of all that's a conversation that psych needs to be having with them. Not nursing.
But unfortunately I have been placed in the situation that goes like this: Psych walks in, states the fact that they are involuntarily admitted. Scurries away. Patient promptly loses every single shit possible and now it's my mess to clean up.
My spiel often goes: "Hey, I hear that this is really hard to listen to. You don't want to stay. I get it. However [and this part I usually need to raise my voice a bit for because they're screaming] this behavior will not change that fact and it can result in you being restrained. I don't want to do that. I want you to be able to have a sandwich, and a blanket, and go to bed. You do not have a choice about staying. You do have a choice about your behavior."
Then we usually go in circles for a little bit while they rage and scream and call me every name in the book. That I can deal with. Odds are about 50/50 that they will settle and we can get somewhere or I will need to break out the night-night juice.
I don't mind if they're angry about it. I sympathize, especially if they're held on a Friday because that will be a miserable weekend while they wait to have their hearing (and frankly, I think that's a violation of rights). But I don't tolerate them hurting themselves or threatening/trying to hurt me or anyone else.
If it's just meds and they don't want them, I say, "Hey, so not taking the medication is not an option. But I do want you to have choices. Which arm would you like it in?" Again, about 50/50 odds of them continuing to adamantly refuse and then we just have to go for it. But sometimes patients do say, "My right arm" and then we've retained some degree of rapport. I explain that their behavior is unsafe and I list specific examples so it doesn't just feel like they're getting drugs for no reason.