The patient had a history of multiple psychiatric admissions at the same hospital. Her diagnoses included dissociative identity disorder and substance abuse. She had eloped from the same hospital on a previous psych admission and was caught by hospital security and escorted back. She also had a history of self-mutilation.
This time she had an argument with her domestic partner, started drinking and then slashed her own arm with a kitchen knife. Paramedics took her to the hospital.
At the hospital she was placed in four-point restraints on orders from a psychiatric resident on duty.
The rationale for restraining her was to allow the nurses and a physician's assistant to treat her wound, to prevent further self-harm and to prevent elopement.
The emergency room nurse gave her an IM injection of Ativan. Once the patient calmed down the nurse removed the restraint strap on the...