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  #11  
Old 07-04-2007, 05:48 PM
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Originally Posted by MyOwnWoman View Post
Fortunately, I am not seeing the trend to reduce "chemical restraints" in the department in which I work; but then again, I work the ER and sometimes it's either chemical, physical or both kinds of restraints that are needed to keep everyone safe, including other patients.

You might find it amusing, but some of our patients come into the ER asking to be restrained because they can feel themselves getting out of control. They don't want to hurt anyone, and they certainly don't want to know they have hurt anyone after the fact. Yes, those patients are few and far between; but they should tell us something.......that chemical restraint is necessary in some situations.

Now, to all of you out there who think we are talking about "snowing" our patients, I can assure you, I am not. I'm just talking about getting them "in control" so when the medication kicks in, the law of reasoning is once again instilled (somewhat) in these patients.

Don't forget, mental illness is a DISEASE. Would you withhold Nitroglycerin to a heart attack? It's the same thing. Get what is out of control in control and let's deal with the disease process.

Sorry, I didn't realize I carried my soap box with me this morning.
You make a fantastic point!!! Mental illness is a disease! And the more we talk about it the less stigma is attached.

It is also devastating to those who suffer from it. I have a niece who has been diagnosed with Borderline Personality Disorder and that is one of the hardest to get a handle on.

But we talk about it, discuss it - and we have to remember there is a person, someone's daughter, wife, mother, niece under that diagnosis. Sometimes it is hard to do.

I just realized I used only female examples up there. My only experiences wit BPD, either professionally or personally have been with females!

Ah, move over on the soapbox - there is room for all!
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  #12  
Old 07-05-2007, 03:57 PM
Judy Pelfrey
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Hi Mother Jones and all, I've worked in a state psych facility for 26 years. 22 years on the units and the last 3.5 in QM. We used to use the Haldol/Cogentin cocktail til IM Geodon arrived. Now I see a lot of Geodon/Ativan being used. The only problem I've seen is the limitations on number of doses of IM Geodon being allowed. Sometimes our patients receive the 2 they are allowed in 24 hours then it's back to the Haldol. While not all of our patients go this route, there are enough who are sufficently aggressive to be in restraints for up to 12 hours while the care staff struggle to find the right medicine combination to allow them out again.
BTW I'm in QM now due to patient injuries that resulted in an impaired shoulder and no more direct patient care allowed. I'm all for using meds and restraints as needed, even if the party line is to reduce use of all restraints. The reduction would come if we could train our attendants to interact with patients appropriately, not needle them into rage, or fight with them over who's in control, or remind them of their limitations. Where are the nurses? Trying to take care of all the 'other stuff' they have to do.
Oh, there is that soap box again.
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  #13  
Old 07-05-2007, 04:23 PM
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Oh Judy, your go Sista! You're right. We need to free nurses of the tons of paperwork, so we can--do I dare say this--take care of the patients. Sorry about your injury. I've also had some very bad injuries in my day, too. The people who make the rules about not restraining patients make those rules because they DON’T work with patients. Let them get seriously injured, and I bet the rules would start changing in a heartbeat.

MJ
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  #14  
Old 07-05-2007, 04:49 PM
Judy Pelfrey
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Default Hello Haldol

You are so right Mother Jones! Those who make these rules are not 'out there'. The guiltiest of those people are The Joint Commission. Every year rules change and we have come up with yet another piece of paper to show that we complied.
One of our nurses recently complained that she has to fill out 15 pieces of paper to admit a patient. Some of the info collected is collected on more than one piece of paper. So yours truely will be taking that list of redundancies to the Policy Committee to see if there can't be some changes made. (My body may not be able to do patient care, but my heart will always be there.)
So while not on the lines I still try to represent the lines. I see nursing being eaten up by paper and often wonder if I would be a nurse again. Yep, it's all I ever wanted to do. Well except when I was 4 and thought I'd like to be a ballerina. Then my Gramma convinced me I didn't want that, as I would have to practice all the time and would get headaches! Gee Gramma did you think nursing was easier? (Now that she's in Heaven I hope she's learned The Truth.)
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