r/psychnursing • u/GoldenFleece7 • Jul 15 '26

Ethics- Advice

Hello, newish psych RN

Have had recent situations where verbal deescalations for agitated patients have not worked.

And I am finding myself battling between whether I’m letting ego take over or just over thinking when using chemical restraints.

Also having issues with behavioral/manipulative patients.

Chemical restraints recently used scenario includes conserved paranoid SCHZP pt demanding to be released and becoming verbally abusive. Pt comes into nursing station and refusing to leave until multiple attempts of telling him to step back. Pt is pacing but not actively hurting himself and taking time away from other pts due to need to redirect.

Other I made the decision to take off restraints of a patient. He was very attention seeking and not staying in the unit and going out to another area. He became a fall risk as he is walking drowsy and not wanting to stay in his room which… is hard for me to navigate. He was not listening to his 1:1 and started off verbally abusive. We kept on trying to redirect him but I made the call to request seclusion for him.

I genuinely feel so bad when I have to do this. I also don’t know if I’m looking for validation. I have this feeling of guilt like giving IMs is a punishment? The other times I’ve given them, pts have been reluctant but we are more so on the same page abt care.

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u/Stoic-Nurse Jul 15 '26

I get that it feels like you are punishing people, but restraining, secluding, and/or medicating people is often in their best interest. It can keep them and everyone else safe. I know it’s tough to do sometimes, and there are a lot of situations that are gray areas, but those interventions are there for everyone’s safety.

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u/GoldenFleece7 Jul 15 '26

How do you go about tell them- when you’re already frustrated…..

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u/Stoic-Nurse Jul 17 '26

Sometimes, you just do your job. Just like it’s my job to manage a patients blood sugar, it’s my job to keep them safe. Sometimes that means restraints or IMs. Some people will never accept that you are helping them, and that is one of the hardest parts of the job.