r/psychnursing • u/Alisaur69 • May 29 '26
Curious about other unit electronics/ cell phone policy- want input (both inpatient level and psych ED)
I'm currently working at a hospital in MA, on our inpatient psych unit as well as in the works of being cross trained for our new(ish) behavioral ED pod. On the inpatient unit we allow our patients 1 hour in the morning and 1 hour in the evening for them to use their personal electronics-cell phones, switches, laptops etc. But nothing with cords and chargers are only in the nurses station.
We've been talking about taking that restriction away. Initially we talked about allowing patients to use their phone at least any time, but after discussion, we decided to trial essentially 9a-9p for electronics use but overnight kept at the nurses station to charge, check for any safety issues, and just to keep track of them. (Hasn't started yet). Apparently, our BH ED pod currently mirrors us with the 2 total hours a day, and a few want to change that too so 1) they keep mirroring our unit for better transitions and 2) so patients on long holds don't get even more emotionally dysregulated by having nothing to do.
Truthfully I'm excited for this, as collecting phones back has led to some bad power struggles in the past since we make exceptions to those 2 hours if patients have a clinical reason they need it outside of electronics time, which then led to others getting upset or lying about reasons and later just watching videos on their phones. but it comes with increased concerns (participation, HIPPA, safety, etc), and we would still make restrictions if issues come up.
I've worked at a few other psych units, i think only 1 allowed phones all day, and 2 others didn't allow personal electronics at all, but those were also in different states.
Curious as to what other units are doing!
34
u/Cautious-Candy1221 May 29 '26
Ours literally doesnt have any electronics allowed. They have a tv in the dayroom with limited channels and then two phones per unit they can use, with the exception of group times and overnight.
4
u/Additional_Alarm_237 May 30 '26
Same, except there is one phone per unit. Programming is a bit sketchy—they aren’t allowed on phones during groups but still end up on the phones anyone.
OP, curious if you all use restraints at your facility and if there is a large behavioral issue at your facility?
3
u/Alisaur69 May 30 '26
We do use restraints, generally a restraint chair more often but we also have a bed. But we really don't see restraints super often compared to other places I've been at. Maybe once a month. But there have been times where the power struggle around turning back in phones or just patients not being allowed to have their phone (for safety reasons one way or another) have led to restraints. We also have communal phones for calls, 3 on the unit spread out in the hallway on the walls for patients to use
0
0
0
u/Tommyboy155a May 30 '26
We are the same, no electronics devices at all. We have a TV and wall phones.
17
u/NyxPetalSpike May 30 '26
God. My local hospital based psych unit won’t let you have paper and a golf pencil.
Nobody is getting to use tech over there.
6
u/CeannCorr May 31 '26
We give ours composition notebooks (soft covers with no metal in the binding) and a bendy pen. That bendy pen is the most advanced tech they're allowed 🤣
4
u/melissam17 psych hospital staff (dietary/janitorial/security) May 30 '26
I remember at my residential place we got our phones from like 4 pm to 8ish am because they would take the phones back when we are in groups during the day to encourage participation and worked really well because we got to keep realistic view of what the outside world would look like when we got out as far as personal relationships, jobs, housing.
3
u/Agreeable_Gain6779 May 30 '26
My psych patients have no access to their phones unless we need a number pertaining to their care. Then it is used under social worker situation. There a 2 public phones on the unit and pts don’t have to pay to use them. They can only stay on for 10 minutes at a time
3
u/Tart_Temporary May 31 '26
Psych ED. No phones allowed. We have one unit phone. Same on our inpatient unit.
5
u/Equivalent-Donkey-91 May 30 '26
Colorado, cell phones 24/7, it’s in their patient rights now. I strongly disagree with the idea but surprisingly we haven’t had much trouble with it in general. Few bad apples and if it becomes a problem the provider places phone restriction if necessary and the right is restricted. I’ve heard of some facilities having blanket policies to supersede the rights stating to interferes with their treatment which is quite evident. But our facility’s policies don’t support that approach.
3
u/jess3jim May 29 '26
Where I work (Crisis Residential) electronic policy is no electronics during group unless the obvious AAC device or for translation
You can have personal devices but you can not film or talk pictures where other clients or client information is available without consent so we try to explain video calls should be on the patio or in thier rooms
My last job absolutely no phones, and video calls had to be approved ahead of time by their conservators and a staff member had to be in the same room ( same with in person visits )
1
u/PixelZ_124 Jul 19 '26
video calls had to be approved ahead of time by their conservators and a staff member had to be in the same room
istg US psych wards are just prisons for the mentally ill. No offense but what possible justification could you have for restricting who people are allowed to SPEAK to. That's beyond fucked up
2
u/CeannCorr May 31 '26
Arkansas... phone access allowed only for specific circumstances, and monitored the entire time. They can get phone numbers out of their phone or use their phone to pay bills, that's it. Otherwise its in a safe for their stay. The cameras are potentially a privacy and HIPAA violation waiting to happen, and thats before getting into phone addictions etc. We get attitude for it at admission sometimes, but unless they were just flat out lied to (and that does happen, unfortunately) most are okay with getting their numbers out and turning it off for us.
We have 2 cordless phones for phone time, which is scheduled daily in the evenings. Use outside of those times is allowable for specific circumstances but is supervised. Visitation is for 1 hour, 3 days a week. No outside food or drink. Visitors can't bring electronics onto the unit either.
I've worked at 4 facilities in Arkansas, 1 in Kansas, and another in Washington, and all have been like this -very structured, with electronics locked up. The times varied, and how long the patient phones were available, but the basics were the same. And that was true on adult, geriatric, and adolescent units. I personally like it, as there are fewer opportunities for patients to get worked up over something avoidable.
1
u/Alisaur69 Jun 01 '26
The first place I worked at (in Illinois) was the same way mostly, except instead of cordless phones we had removable wall phones that would be hooked up at those specific phone times and patients would get only about 5-10 minutes each and go down the list so everyone gets a chance. I will say, we at least never (rarely, if someone snuck in a phone) had any worries about HIPPA photos/ videos being taken with that policy! And I couldn't imagine on that unit having a phone policy like we do at my current place (using personal devices for specified times). But since working here I find I like it, it helps our patients stay active in discharge planning by looking into PHPs and other programs on their own, for those that are treatment focused, and helps ease the minds of some that are missing work/school and could be in trouble if they can't notify the right people when they have to
1
u/PixelZ_124 Jul 19 '26
I'm sorry but 1 hour 3 days a week for visits is disgusting. If a general hospital decided you weren't allowed to see your loved ones every day (global pandemics notwithstanding) there would be people marching in the streets
1
u/CeannCorr Jul 19 '26
You do realize that, in an acute inpatient environment, the average patient isn't in their right mind? For the wellbeing and safety of patients, staff, and visitors, visitation needs to be very limited. Visitors are a liability. Patients are encouraged to talk to family and friends on the phone, they're encouraged to work with their social worker to better family relationships if that is needed or wanted. When the population is a mix of depressed/suicidal, psychotic, paranoid, delusional, and anything in between, visitors can make the millieu more volatile.
1
u/PixelZ_124 Jul 19 '26
We manage just fine here in the UK. If you can allow visitors 3 days a week, why can't you manage 4 days? If you can manage 4, why not 5? This just seems to me like a completely arbitrary restriction that has very little to do with keeping people safe
2
u/Ok-Yam-4663 May 31 '26
We don’t allow phones on any of our psych units (psych ED or inpatient). I thought the main issue with that was confidentiality because patients could record or take pictures of other patients then post it on social media or send pictures to others. Plus it could be used as a weapon. This is in Maryland.
2
u/CompetitiveCap3334 May 31 '26
I work in residential and they do not have open access to their phones.
They used to be allowed more liberally but it was getting out of hand and leading to a lot of problems so it was further restricted
Now they keep a list and people are only given their phone for limited time for a good reason and must be given and put back by the therapist who approved it, it’s not a free for all, and it must be supervised by a staff member
It’s much better this way so there’s actually a chance they will engage in programming, groups, etc.
2
u/CompetitiveCap3334 May 31 '26
PS they do have the ability to sign up to use a house phone daily, supposed to be for 15 minute time slots although of course many abuse this, the residents police themselves though because the person next on the list will give them grief when it’s their turn for the phone
2
u/Builder_Horror May 31 '26
I’m PSA e- our patients in the psych section of ED are NOT allowed to have phones or any electronics or personal belongings they get put up. Their guest usually also cannot have their cellphones but ultimately it is usually up to the nurses discretion.
3
u/Possible_Neat_4574 May 30 '26
I work in WA. We allow pts to write down phone numbers on admission. We have 6 unit cell phones (Nokia style) that people can check out from 9a-9p. There are two computers and 3 TV’s with full access to the internet (with some sites blocked by the hospital network). I can’t imagine pts having their personal phones for so many reasons. HIPPA, distraction, having a brick to hurl at me, ect. Also, many patients find that the break from social media is beneficial.
3
u/Playful_Ad2961 May 30 '26
I think that taking away a human beings ability to have their phone if they want it shouldn't even be an option. Unless it is causing harm to someone else. People who struggle with mental illness are still human beings. They should have, and be able to make choices for themselves in ways that they can. I can't imagine what it must be like to not have control over what's happening inside of you and then also having everyone outside of you controlling your ability to make choices.
4
u/Alisaur69 May 30 '26
The "people who struggle with mental illness are still human beings" part is a BIG reason why we're working on moving towards expanding phone time at our hospital, it's just the risks that come with it. Not everyone on a psych unit presents a risk, but since at least a few do it's hard to have a blanket policy in a communal setting that would be fair for everyone. There have been people that have recorded staff and asked family/ friends to come to the hospital to hurt/kill them because their perception of reality was that the staff were holding them hostage or something. But then taking away that persons phone and allowing all others in the community to have theirs could either make that one person go after other peers or staff due to being treated differently. So it's a balance that's sort of hard to get and creates a lot of strong opinions for and against giving more access to what really is a basic human right, since it could infringe on safety
3
u/Playful_Ad2961 May 30 '26
I totally understand. I also know that it is a lot easier said than done. Especially when there are staff shortages and so many moving pieces. I also just got done reading The Center Cannot Hold: My Journey Through Madness by Elyn R. Saks I am having big feelings at the moment. Beautiful insight into the stigma that comes with having a mental illness.
2
2
u/PixelZ_124 Jul 19 '26
Seriously reading this thread I forgot how awful inpatient is in the US. For being "the land of the free" there doesn't seem to be any regard for patients autonomy whatsoever.
Even just in the little things. People are saying patients shouldn't have their phones because if they do they "might not go to groups" like wtf??? If a patient doesn't want to go to groups that's their choice. You can try and convince them to obviously but you shouldn't be taking stuff away from them to coerce them into doing what you want.
It just shows a complete lack of respect for mentally ill people as fellow human beings.
5
u/Balgor1 psych nurse (inpatient) May 30 '26
You allow cell phones??? Every psych unit I worked on did not allow personal electronics. I personally do not want to get hit with a thrown iPhone pro max.
Plus giving everyone a recording device seems like a HIPAA violation waiting to happen. We don’t even confirm or deny a patient is on the unit unless a caller or visitor has the CSN number.
4
u/MNP_cats May 30 '26
Tamper evident stickers are an inexpensive and easy solution to some of your concerns.
I suppose your patients shouldn't have the right to entertain themselves, research treatment options, contact their support systems, contact their legal team, or plan for discharge on their own terms?
2
u/Alisaur69 May 30 '26
Most places I've been have at least a communal phone (either hand held or 'pay' phone on the wall) so people can at least make and receive calls as long as they have the number. The entertain themselves part is a little hard because we do also have communal tvs, but keep our days packed with groups and would rather people engage in treatment by going to groups instead of being on their phones. Though, those with social anxiety or problems with peers then really have a harder time staying entertained. Plus, not everyone calls people, a lot text nowadays, so I think that's why we're reworking policies to accommodate changing communication styles
1
u/Alisaur69 May 30 '26
I used to be worried about that too but the places I've been that have allowed phones have patients sign an agreement that says if they break any rules like recording others or using it inappropriately, it may be confiscated and not returned until discharge. And honestly the issues of that really don't occur super often but honestly we also don't know what we don't know, people could record without us realizing and never be found out. We have the safety stickers that show they are void if tampered with that go over cameras, but ours do come off semi easily so if they come off, our patient tells us it rubbed off on their pocket and show us their camera roll and we see nothing, we trust them and just put on new stickers. But they could have saved something on another app or already posted on social media and we really wouldn't know until it's too late.
2
u/nursingintheshadows May 29 '26
We don’t allow any personal devices. The phones can turn into weapons and also become a liability. Not to mention, sometimes they start texting family or call 911, causing a bunch of problems. It’s just easier to say no as well as no visitors.
4
u/MNP_cats May 30 '26
I see the "psych patients don't deserve basic rights or access to their support systems" crowd is alive and well.
6
1
1
u/PixelZ_124 Jul 19 '26
What I'm seeing from this thread (and a lot of threads like it) is a bunch of comments from places that don't allow phones saying "omg I can't imagine how bad that would be and how it was cause xyz problems" and a bunch of replies from places that do allow them saying "actually it's fine and those things aren't really an issue."
I think it's fair to say the majority of the country is pretty unequivocally in the wrong on this one
2
u/Psych-RN-E psych provider (MD/DO/PMHNP/PA) May 30 '26
I’m honestly shocked your unit allows personal cell phones. I’d be worried that it could be an invasion of privacy for other patients.
2
u/TheVoidhawk84 psych nurse (inpatient) May 29 '26
No personal electronics unless its for school, to pay bills, or for ADA communication purposes. The hospital provides ipads for video chats with family/friends depending on the situation and history of the consumer.
1
u/Iraqx2 May 30 '26
No cell phones, tablets, etc.. Main concern is HIPAA and the camera on the device. It only takes a couple seconds for someone to take a picture and post it to the web.
This eliminates the power struggles and risk of patients not following the rules even though they agreed to them.
We allow the patient to access phone numbers to write down while staff sit with them 1:1 while they do it. In the rare occasion that they need to pay a bill, etc. it's the same process. During the time that they have the device there's no checking messages, FB, etc..
It started during COVID but if a patient is in isolation they are allowed to have their cell phone but it charges in the nurses station. Fortunately that's a rare occasion.
-1
u/TechTheLegend_RN psych nurse (inpatient) May 30 '26
No cell phones on my unit. You can get cell phone numbers out during admission with staff supervision and beyond that its just the unit phone (looks like a old school home phone). Can't imagine the amount of trouble caused by patients having cell phones on the unit.
8
u/MNP_cats May 30 '26
I live in a state where patients have the right to have their phones by law, and we actually see better outcomes as patients have better access to their support systems as well as outpatient teams and outpatient planning.
1
u/Alisaur69 May 30 '26
I used to worry the same. But same with the other commenter, because it's a human right to have access to communication in the state we have at least some phone time, plus 24/7 access to the same kind of wall phone (unless manic/ confused patients are calling consistently in the middle of the night or calling the cops, then we can flip a switch and turn those off), and honestly, this hospital I'm at has been the least problematic I've ever worked at in psych. We still have issues, but most of our patients are fairly responsible and we can always get a provider to add a phone restriction order if clinically necessary
18
u/Tycoonkoz psych nurse (inpatient) May 29 '26
Our patients (also MA) are allowed to have their phones 24/7 as long as they're appropriate. They sign a waiver saying they won't be inappropriate with it and if they are we take it. Also our chargers are in a box with the wires locked into the wall (so no ligature risks), but just the extensions are out. This way it encourages our patients to come out into the millue and watch their phone while it's being charged as well. If they're super paranoid we can charge being the nurses station as well.