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The use of nurses' power to detain

 

Cases of nurses' power to detain pending medical examination, by hospital and gender of patient 2009-10

 

 AR-09-10-Table16_v2

 

Our interest in this

Nurses have the power to detain people in hospital pending medical examination, in situations where that person, or others, may be at risk. This is often described as 'nurses' holding power'. Last year we continued to note a marked variation in the use of this power across Scotland and a significant difference in the way it was used with men and women. We looked closely at the figures this year to see if this pattern continued, or if there was any change.

What we found

We continue to find significant variation in the use of this power between hospitals across the country. As in previous years the notifications received from the Royal Edinburgh Hospital indicate a higher use compared to similar services elsewhere. The use of the nurses' power to detain may be influenced by a number of factors such a local understanding of the power, variations in nursing practices and the availability of approved medical practitioners and mental health officers.

Since we started reporting on the use of this power, its use has been higher for women than for men. One explanation for this may be that nurses are more likely to prevent a woman from leaving. It may be that nurses do not prevent a man from leaving, but may consider futher action, for example involving the police if they think there is  serious risk. This year however, although the power is still used more with women than with men, we have noticed a marked increase (25.9%) in the number of men detained by nurses pending medical examination which has contributed to a noticeable overall increase (11.7%) in the number of people detained by nurses.

We will continue to monitor the use of this power and in particular to see if this year's figures are a 'one off' or part of an indicative trend towards more equitable use.

Managers should examine the use of this power in their areas and ensure nursing staff have a clear understanding of the appropriate use of their power to detain. We are concerned that some people may be unlawfully deprived of their liberty where this power is not being invoked where it should.