r/nursing • u/strawbqu • 3d ago
Nursing Hacks Verbal approach to involuntary psych patients
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..
3
u/whatsabuttfore 3d ago
Focus on the goal of the intervention: (X behavior) needs to stop to restore safety to the unit.
I try to communicate that (X behavior) cannot continue because it is unsafe for themselves or others. It is my job, and the rest of the staff’s job, to ensure that the unit is safe for everyone.
If the patient can stop the behavior themselves, that’s ideal. I am happy to support them however I can, and one of those options is with medication that can help with feelings of restlessness, anxiety and rapid thoughts. I can address any immediate needs they have, as long as they can be addressed safely.
If the patient continues the behavior, I have to assume that they are not able to control the behavior themselves and need emergency intervention to restore safety.
The goal is to assist and support the patient in managing their behavior to maintain a level of safety. Keeping that in the forefront of your mind will never steer you wrong.