Verbal approach to involuntary psych patients

[u/strawbqu]

I am a newer ER RN in Canada, I’m looking for advice on approaching patients that are placed on an involuntary hold. Specifically with approaching an individual with restraining and chemical sedation (I know.. seems brutal but if you know you know. I’m not sure if this is legally relevant in all countries but it’s how we do it here). I find it difficult particularly with paranoid and manic patients. What is your spiel for the reasoning of the intervention, when you especially know they need it and they are refusing (and ultimately will have no choice but to take the medication and/or be restrained)

I tend to start off with the fact that the doctor needs them to take sedation.. if they are compliant they will not need to be restrained etc..

[u/strawbqu]

Do you believe you’d have the same opinion if you or a loved one was being assaulted while hospital staff watched and waited 10-15 minutes for police to arrive while you fend for yourself?

[u/Old_Glove9292 → u/strawbqu]

Absolutely. Two wrongs don't make a right, and security should be equipped to handle unruly patients until the authorities arrive. Don't take my word for it. It's the official stance of the World Health Organization.

[u/strawbqu → u/Old_Glove9292]

I genuinely hope for the safety of both the public and the patient that this does not become the standard. I would not expect anyone who has not experienced what it’s like to understand why.

[u/Old_Glove9292 → u/strawbqu]

I would expect a prison guard who has abused criminals to use the same line of reasoning... Wrong is wrong. Period.

[u/flannellavallamp → u/Old_Glove9292]

Do you think the police aren’t restraining them? They’re getting restrained one way or another - it’s better to be restrained under the care of medical professionals than put in a straight jacket in a prison cell.  Your being a bit delusional here.

[u/Old_Glove9292 → u/flannellavallamp]

No. What's delusional is thinking that there's any reasonable justification for human rights abuses... Detention and prosecution are functions of law enforcement and not medicine-- period. This is basic common sense, which unfortunately, I'm realizing many clinicians desperately lack. Don't be Nurse Ratchet...

[u/flannellavallamp → u/Old_Glove9292]

Restraint is a function of medicine. People can and will hurt themselves and others in a variety of situations.  Prison and jails literally employ nurses to administer chemical restraints.

[u/Old_Glove9292 → u/flannellavallamp]

Then you just answered your own question. That function should be performed in a correction facility following due process and a court order. It absolutely should not be subject to the whims of "clinical judgement" in a hospital.

[u/flannellavallamp → u/Old_Glove9292]

They’re not giving court orders to restrain people in prison lmao. You are being incredibly naive. Once one is detained your restrained as necessary chemically and physically to protect employees, prisoners and yourself at the discretion of corrections staff and clinical judgement of a nurse. 

[u/Old_Glove9292 → u/flannellavallamp]

Obviously... but court orders are required for sustained detention including involuntary treatment, and once detained, individuals are ultimately under the supervision of the judicial system, which follows due process. You are being incredibly dense.

[u/Old_Glove9292 → u/flannellavallamp]

Obviously... but court orders are required for sustained detention including involuntary treatment, and once detained, individuals are ultimately under the supervision of the judicial system, which follows due process. You are being incredibly dense.

[u/flannellavallamp → u/Old_Glove9292]

Your dense if you think court orders are any better than a medical professionals clinical judgement on whether a person should be restrained LOL  you have a weird amount of faith in the courts.

[u/Old_Glove9292 → u/flannellavallamp]

The courts aren't perfect, but I trust them 1,000% more than clinicians or hospital systems where the abuses are well documented and there is virtually zero accountability. This is just a sample of sources. There are countless more, and they document the first-hand experiences of victims in harrowing detail. These individuals had their lives destroyed at the hands of greedy hospitals and power hungry clinicians who deluded themselves into thinking that they're "saving patients". It's absolutely deplorable.

Trapped in a psych ward: Michigan doc pre-signed blank forms that can rob you of your freedom

How a Leading Chain of Psychiatric Hospitals Traps Patients

For patients or profit? Tampa Bay woman says she was stuck in a mental health facility and kept there

Trapped in a Psych Ward: ‘I felt kidnapped.' New patient speaks after 7 report

Four Tops singer sues hospital alleging racial discrimination after he says he was placed in a ‘restraining jacket’