Comments on: the wrist restraints http://www.aboutanurse.com/2008/04/the-wrist-restraints.html a nurse blog. Fri, 29 Aug 2008 05:39:30 +0000 http://wordpress.org/?v=2.0.7 by: death wish » about a nurse http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-76121 Thu, 01 May 2008 14:09:31 +0000 http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-76121 [...] it is unusual for  me to wish somebody’s death no matter what the circumstance. the only deal was, death was the very thing she wanted. i can even say there have been times when she was literally begging for it, but was too scared to change her own advance directives. [...] […] it is unusual for  me to wish somebody’s death no matter what the circumstance. the only deal was, death was the very thing she wanted. i can even say there have been times when she was literally begging for it, but was too scared to change her own advance directives. […]

]]> by: Molly http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-76070 Wed, 30 Apr 2008 16:01:05 +0000 http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-76070 I worked on an inpatient ortho/neuro rehab unit here in Vermont for about seven years. Restraints were used on the head injury patients (and other organic dementias) as a matter of routine, not last resort. It was so frustrating to watch staff slap all kinds of soft limb and cross-over belts on patients who didn't need them and were just agitated and humiliated by them. Of course, that's a vicious cycle as the patient's agita becomes justification for renewing the restraints for another 24h ad infinitum. I tried to get the assessment, ordering, monitoring, and documentation of restraints changed for years and got nothing but harassment and threats from administrators, and grief from staff whose jobs are made "easier" when they can simply restrain a patient instead of checking in with them more frequently. Very frustrating, to say the least. Human rights violation is more like it. The hospital didn't change anything until a patient committed suicide in inpatient psych which revealed the weaknesses of the whole system. It was horrible. I feel like that patient might be alive today if I had just pushed a little for changes to the system. Watching the phony PR show Senior Leadership put on after that made me sick. Bleah. I worked on an inpatient ortho/neuro rehab unit here in Vermont for about seven years. Restraints were used on the head injury patients (and other organic dementias) as a matter of routine, not last resort. It was so frustrating to watch staff slap all kinds of soft limb and cross-over belts on patients who didn’t need them and were just agitated and humiliated by them. Of course, that’s a vicious cycle as the patient’s agita becomes justification for renewing the restraints for another 24h ad infinitum. I tried to get the assessment, ordering, monitoring, and documentation of restraints changed for years and got nothing but harassment and threats from administrators, and grief from staff whose jobs are made “easier” when they can simply restrain a patient instead of checking in with them more frequently.

Very frustrating, to say the least. Human rights violation is more like it. The hospital didn’t change anything until a patient committed suicide in inpatient psych which revealed the weaknesses of the whole system. It was horrible. I feel like that patient might be alive today if I had just pushed a little for changes to the system. Watching the phony PR show Senior Leadership put on after that made me sick. Bleah.

]]> by: Grand Rounds Smack Down | Doc Gurley http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75959 Tue, 29 Apr 2008 07:03:55 +0000 http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75959 [...] The crowd quiets and the mood gets serious. Real heroes aren’t afraid to show their tender side. The author at About a Nurse proves it by sharing with us the toughest part of her job – being forced to use the wrist restraints on a patient. Check it out here. [...] […] The crowd quiets and the mood gets serious. Real heroes aren’t afraid to show their tender side. The author at About a Nurse proves it by sharing with us the toughest part of her job – being forced to use the wrist restraints on a patient. Check it out here. […]

]]> by: measured and found lacking » about a nurse http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75513 Tue, 22 Apr 2008 14:25:04 +0000 http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75513 [...] you probably remember her. L, the patient we had to restrain because she was consciously trying to pull out tubes so she can “rest”. [...] […] you probably remember her. L, the patient we had to restrain because she was consciously trying to pull out tubes so she can “rest”. […]

]]> by: angelite nurse http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75267 Fri, 18 Apr 2008 03:40:34 +0000 http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75267 i enjoy your blog... visit haunurses.blogspot.com i enjoy your blog…

visit haunurses.blogspot.com

]]> by: unsinkablemb http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75188 Thu, 17 Apr 2008 03:26:22 +0000 http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75188 I don't know how you do it, May... We hardly ever have to restrain a patient in the O.R. Somestimes they get a little ornery when they start waking up after the anesthesia starts wearing off, but it's not a frequent occurrence. I don’t know how you do it, May… We hardly ever have to restrain a patient in the O.R. Somestimes they get a little ornery when they start waking up after the anesthesia starts wearing off, but it’s not a frequent occurrence.

]]> by: Disappearingjohn http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75177 Thu, 17 Apr 2008 00:20:28 +0000 http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75177 I actually had a similar issue the other night, with a slight twist. At what point is a patient coherent enough that you are breaking the law by restraining them? Had a patient, legally intoxicated, but able to answer all orientation and thought test questions, wanting to go AMA. Surgeon said to restrain them... I disagreed with the doc, and was able to talk the patient down and didn't need too restrain the patient after all... but it got me thinking... I actually had a similar issue the other night, with a slight twist. At what point is a patient coherent enough that you are breaking the law by restraining them?

Had a patient, legally intoxicated, but able to answer all orientation and thought test questions, wanting to go AMA. Surgeon said to restrain them…

I disagreed with the doc, and was able to talk the patient down and didn’t need too restrain the patient after all… but it got me thinking…

]]> by: shrimplate http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75174 Thu, 17 Apr 2008 00:10:29 +0000 http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75174 I watched a woman get up out of her chair and fall once. Right in the hallway where all staff could watch her and interact. It only took a moment. And she broke her hip. It was awful. I still remember that sound. I watched a woman get up out of her chair and fall once. Right in the hallway where all staff could watch her and interact. It only took a moment. And she broke her hip. It was awful. I still remember that sound.

]]> by: Kj http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75165 Wed, 16 Apr 2008 22:34:54 +0000 http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75165 So I got the pleasure of restraints last year after a head injury.... I hate to put them on patients and although i don't remember much I do remember waking up and finding I was fully restrained and fighting like a hell cat... It was scary and humiliating and frustrating and downright crappy all at the same time... I was completely confused and just wanted to get up and go home but had given myself a rather serious head smack falling down some concrete stairs.... Apparently security had been called when I was first admitted and had spent 2 hours holding me on the bed before restraints were installed, I was in them for 18 hours but don't remember more than about 2 of that, "patient fought restraints constantly" I absolutely hate to see patients in them but some times they are all you can do to prevent worse from happening... But I will be exhausting ever avenue before I call for them again, I don't ever want any other human being to feel like I did... It sucks. So I got the pleasure of restraints last year after a head injury….
I hate to put them on patients and although i don’t remember much I do remember waking up and finding I was fully restrained and fighting like a hell cat…
It was scary and humiliating and frustrating and downright crappy all at the same time…
I was completely confused and just wanted to get up and go home but had given myself a rather serious head smack falling down some concrete stairs….
Apparently security had been called when I was first admitted and had spent 2 hours holding me on the bed before restraints were installed,
I was in them for 18 hours but don’t remember more than about 2 of that,
“patient fought restraints constantly”

I absolutely hate to see patients in them but some times they are all you can do to prevent worse from happening…

But I will be exhausting ever avenue before I call for them again, I don’t ever want any other human being to feel like I did…
It sucks.

]]> by: Dana http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75131 Tue, 15 Apr 2008 20:22:58 +0000 http://www.aboutanurse.com/2008/04/the-wrist-restraints.html#comment-75131 Hi I just came across your blog and saw this post. I'm currently in nursing school and can't even imagine yet what it must feel like to do this. While observing in the ICU, we did have a patient that had to have one of his wrists restrained, he was sedated, but kept trying to use that one hand to pull out his breathing tube. That was scary enough for me and doesn't even compare to what you discussed. I look forward to reading more on your site! Hi I just came across your blog and saw this post. I’m currently in nursing school and can’t even imagine yet what it must feel like to do this. While observing in the ICU, we did have a patient that had to have one of his wrists restrained, he was sedated, but kept trying to use that one hand to pull out his breathing tube. That was scary enough for me and doesn’t even compare to what you discussed. I look forward to reading more on your site!

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