Legal Eagle Eye Newsletter for the Nursing Profession (5)3 Mar 97  PDF Version

   Quick Summary: A nurse placing a patient temporarily in a posey vest to prevent self-harm is not patient abuse. The vest was discontinued when the nursing home’s medical director declined to order physical restraints on an ongoing basis.

   However, the medical director ratified the nurse’s decision after the fact as appropriate action in an emergency situation. SUPREME COURT OF WASHINGTON, 1996.


   A nursing home resident had become agitated, and was burning himself by putting lit cigarettes in his pants pockets. He tried to eat objects such as plastic pudding containers, began scratching himself to the point of causing open sores on his arms, and smeared his feces on himself and the walls of his room.

   According to the Supreme Court of Washington, the nursing home had a sound policy of allowing nurses to use their professional judgment in applying physical restraints to patients under emergency circumstances to prevent patients from harming themselves, provided the nurses’ decision was promptly reviewed by the nursing home’s medical director, and provided further that restraints would be discontinued if the medical director refused to order physical restraints continued on an ongoing basis. The court said a staff member who claimed she was fired for reporting this incident as abusive had no basis for a wrongful-discharge lawsuit. White vs. State of Washington, 929 P. 2d 396 (Wash., 1996).