Pillow Therapy

Someone told me that a patient wanted to leave. I asked if the patient was alert and oriented and she said yes. My response was that we had to let him go. To hold a patient against their will can lead to nasty things like lawsuits and hearing annoying phrases like false imprisonment. I wasn't in the mood, but I agreed to talk to the patient.

I didn't have to go far. The patient walked by, naked and barefoot except for his backless gown. He was a healthy man in his prime trying to walk with a walker due to orthopedic injuries. Smiling and trying to be friendlier than I was feeling, I asked him where he was going. He looked at me with terrified, wild eyes. His hands were trembling and he was drenched in sweat. He forced a smile and said that he needed to go outside to make a phone call.

I asked him if he had a cell phone and he said no. I suggested that he go into his room and use the phone there, but he insisted that he had to go outside to make the call. I offered to let him use a phone in the nursing station. I offered to make the call for him if he wanted. It was useless. He couldn't explain how he would make a phone call outside, but he would not consider using one of our phones. He kept hobbling toward the elevators.

I had a difficult decision to make. If he was in his right mind and I prevented him from leaving, I/we could be sued. If he was not in his right mind and I let him go, I/we could be sued if he was harmed. I called three people above me for assistance and they declined to help. It was my call. I decided to error on the side of stopping him. I asked for security to be called and I caught up with the patient next to the elevator. I grabbed his walker and held it down between us. He couldn't walk without it and it kept a safe distance between us.

Soon, five security guards showed up. They tried to reason with him and even tried handing him a cell phone so that he could make his call. The patient was adamant that he was going to leave and make his call outside. Security asked me what to do and I said to bring him back to his room. We all knew what that meant. It was going to be really ugly.

I walked away to get restraints while the wrestling match ensued. Eventually, the patient was thrown down on the bed with five men on top of him. Another nurse and I tied down his torso, arms and legs. He immediately broke the restraints. The security guards laid on top of him until someone could get the leather restraints.

At some point in the struggle, one of the security guys smashed a pillow on the patient's face and held it there. The patient couldn't breathe. I don't like to tell people how to do their job and wondered if that was some kind of technique for controlling combative patients. Still, it didn't seem right. Several seconds went by and I was just stunned, not saying anything. Then, the pillow was slid up a bit so that his lower jaw was exposed. He couldn't see and his nose was still smashed, but at least he could breathe.

It took some effort to get a doctor to come, but after some begging someone agreed to help us. Long story short, we gave the patient a special cocktail which knocked him out until the next day. When he woke up, he was fine. He apologized for his behavior and we let his family take him home.

I have no idea what that craziness was all about and if it was appropriate to give pillow therapy. What do you think?