r/emergencymedicine 3d ago

Advice Verbal approach to involuntary psych patients

/r/nursing/comments/1n0op3b/verbal_approach_to_involuntary_psych_patients/
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u/Old_Glove9292 3d ago

Gentle reminder that the World Health Organization considers both forced restraints and involuntary hospitalization to be human rights abuses, and is advocating for those interventions to be banned globally:

https://www.who.int/news/item/10-06-2021-new-who-guidance-seeks-to-put-an-end-to-human-rights-violations-in-mental-health-care

18

u/Throwawayyawaworth9 3d ago

I’m thinking about the time that I was sexually assaulted by a patient.

After every possible attempt at verbal deescalation and medical sedation was made, should we have left them unrestrained to continue assaulting me and other staff? Or should we have let them out into the community to continue those behaviours elsewhere?

It sucks for patients, but restraint is sometimes necessary to protect both patient and staff safety. Unless you or members of the WHO have had their skulls smashed in or have been SA’d by a patient, I don’t think your opinion really matters.

11

u/Negative_Way8350 BSN 3d ago

This is exactly what people who don't do the job understand. De-escalation fails. A lot. More than we are all willing to accept.

I submit the idea is that it's because these assaults are not driven by being "out of control" but in fact being very in control with rage and animus directed in a surgical way towards medical staff. The patient is not a victim helplessly acting out their feelings. The patient is an assailant who sees medical staff as non-human and thus deserving of pain, suffering, and profound boundary violations.

In that sense, we as human beings have every right to respond to such force with such reasonable force to keep ourselves safe.

1

u/Competitive-Use-3555 2d ago

AMEN to that! People outside of the profession just shout be writing policy about contingencies like if Bobbi Sue punches you in the breast, then attempt to escalate Bobbie Sue for 10 minutes even if she continues to use your breasts for punching bags, blah blah blah blah blah…it’s all absurd.