ethical dilemma of restraints

Ethical Dilemma Factor in Regarding Physical Restraints to Elderly of Female Nurses with the Living Together Experience 330 . Duration: 102 minutes. In order to make sure that I was making an ethically right decision and staying within the boundaries of my limits, I asked the staff nurses for their suggestions to handle this situation. Refer to Disclaimer and Policies section for more details. Unintentionally, if a wrong decision is made, it would impact the patients’ outcomes dramatically; these decisions would also cause distress for families and the nursing staff (Moran, Cocoman, Scott, Mathews, Staniuliene, & Valimaki, 2009; Lai, & Wong, 2008). The goal of all nursing interventions, nursing theories, institutional values, country laws, and bioethics is to enhance the beneficence of such nursing interventions for patients (Oberle & Bouchal, 2009). Reflecting upon the situation, I came up with a positive opinion about the action of not restraining the patient. There have been very few moments in my life when I felt alone and that …, Our world today features marvels of science that make life simpler for us, and carry out various tasks in the blink of an eye. Restraints are applied against a patient’s aggressive behavior only when there is actual potential harm to the patient himself, to other patients or to staff members. restraints that are intended to protect the older adult. The importance of team work that was adapted to the situation cannot be denied. An informed consent was also obtained from the family to restrain the client for his beneficence and to provide the family with satisfaction regarding the expected outcome. Facebook Depression! Nursing Ethics, 16, 192-202. doi: 10.1177/0969733008100079, These articles have been written by Nasir Ahmad BSc. However, psychiatrists and nurses face patients in a quite different way since nurses are with the patients on the 24-h basis, and thus, their ethical dilemmas in using physical restraint may be more challenging. Many families are unaware of their rights to refuse the use of restraints and to ask for alternatives (Lai & Wong, 2008). •       Demir, A. Looking at the circumstances, the patient had dementia and there was no family member there at the moment to decide. It was nurses’ knowledge and experience which worked as a protective shield and prevented further harm to the patient and nurses. Nurses are accountable for their actions, as stated in the CNA codes of ethics (cited in Oberle & Bouchal, 2009). Archives of psychiatric nursing, 24(1), 3-14. Tackling the Dark Side of Social Networking – Can We Put an End to Cyberbullying? Both options seemed equally important to me for a split second. Definition of Ethical Dilemma . However, the social side of this intervention seems more important to be considered (Lai & Wong, 2008). According to the Canadian Nurses Association (2008), the nursing interventions are always there for patients’ well-being and more-being. When they observed that patient was not calmed, they used chemical restraining with haloperidol and medaziolam injection along with 4.0 physical restraints to limit her mobility and to get her aggression under control. Restraints and Alternatives. To ensure safety of the staff and patient herself, the psychiatrist decided to restraint the patient. These include, for example, decision-making in end-of-life care, use of restraints and a lack of resources. In practice, however, there is significant variability in use and many patients across the US … In nursing and medical ethics, restraining a client always presents a difficult question. Hine (2007) found that use of physical restraints is more common across North America and some other parts of the world, but is not practiced as much in the United Kingdom. Placing physical restraints on older people with dementia. In such situations, it may be ethically justifiable for physicians to order the use of chemical or physical restraint to protect the patient. no. There will be better outcomes if the interventions are set accordingly and in consideration with the standards of nursing practice (as cited in Oberle & Bouchal, 2009). The aim of this study was to explore factors behind ethical dilemmas for critical care nurses over using physical restraint for patients. Nurses can only be truly beneficent to their patients if they are honest, accountable for their actions, and morally at a great height (Obrele & Bouchal, 2009). This paper examines the ethical actions of nurses based on theories of nursing ethics, the codes of ethics, nursing standards, and views of nursing scholars for the use of restraints and some alternatives to cope with particular nursing scenarios. Ann Gallagher is a reader in nursing ethics, director of the International Centre for Nursing Ethics, University of Surrey, and editor of Nursing Ethics. He was already in discomfort because half of the PEG tube was out of his stomach. Patients’ families often believe that the hospital staff is restraining a client as punishment, retaliation or for their own conveniences. Significance Retrieved from http://cinahl.com/cgi-bin/refsvc?jid=1681&accno=2009 546326, Kontio, R., Valimaki, M., Putkonen, H., Kuosmanen, L., Scott, A., & Joffe, G. (2010). The client became aggressive as soon as the visitor left and he pulled his PEG tube half way out; he refused the nurse’s use of physical restraints on him. Beneficence means for the good of patient and non-maleficence simply means to do no harm, prevent harm, remove harm, and facilitate good (Mohr, 2010). This stage has its significance in lowering the application of restraints in aggressive patients. Join JPMS Medical Blogs Team as Editor or Contributor, email your cover letter and resume to blogs@jpmsonline.com, We welcome Guest posts. Response to the Situation for Patient’s Beneficence. The Mental Health Act (1983) dictates that restraint can be defined as placing a person under control when necessary so as to prevent serious bodily harm to the patient or to another person only by the minimal use of such force. Given that the ethical issue is an essential dimension of nursing practices, the use of physical restraints has caused an ethical dilemma because balancing the human rights, ethical value, and clinical effect is challenging. For example, codes of ethics give preference to patients’ choice if there is no harm involved in the situation. Many times the nursing care of clients places the nurse on a path which is further divided into two diverse pathways, quite in opposite directions. A Case Scenario College of Nurses of Ontario. The challenges and conflicting feelings faced by nurses in restraining elderly patients with dementia [9] can cause nurses to question their abilities to deliver high-quality care. Design: This is a qualitative study using conventional content analysis approach, as suggested by Graneheim and Lundman, to analyze the data. doi: 10.1111/j.1365-2850.2009.01419.x. The authors Obrele and Bouchal (2009) describe a strong bond between nursing morality, the healthcare, and patients’ beneficence. •       Gatens, C., & CRRN-A, M. N. R. N. (2007). Physical restraints provoke patients to become anxious and worried, lose their autonomy, freedom of choice, and dignity. Autonomy is the right to liberty and self determination; in restraining patients both these components are violated. Journal of Nursing Scholarship, 39(1), 38-45. The ethics of restraint The following example illustrates the application of ethical principles in practice. However, I had to single out one decision based on what was better for the patient. Nursing practice is for the beneficence of the people who are suffering and fighting for their lives against diseases. Due to the severity of the circumstances, he had a Percutaneous Endoscopic Gastrostomy (PEG) tube for his continuous feeding and medication. The client, Mr. A.C. had physical restraints placed on both of his arms because of his distressed behavior, as well as to provide safety and continuity of care for him. js.src = 'https://connect.facebook.net/en_US/sdk.js#xfbml=1&version=v3.0&appId=160541900690768&autoLogAppEvents=1'; if (d.getElementById(id)) return; For nurses to make ethical decisions about the use of restraints, involves high quality of nurse-client relationship, nurses’ morality, truthfulness with their profession, accountability, and team approach (Oberle & Bouchal, 2009). Psychiatric patients exhibiting violent, agitated or aggressive behavior are restrained in order to prevent harm to self and others. The position paper described ethical dilemmas inherent in the use of seclusion and restraint, and reviewed research that suggested ways to reduce the use of restrictive interventions and prevent violence. In general terms, to restrain is to limit someone’s liberty. The use of physical restraints poses dilemmas for die nursing staff. (Mohr, W., Petti., & Mohr, B., 2003). He was a demented patient, and had wrist restraints on both of his arms for his safety, not to pull on to the PEG tube. I did an assessment of the choices and compared the benefits versus the tribulations involved in the situation. The family was involved in this decision making. However in the case described, human rights and patient’s bill of rights were violated since the patient’s right of self determination was sacrificed. It gives the client an opportunity to ventilate their feelings regarding being restrained and also the chance to validate the reason of such violent behavior towards self or others (Bonner., Lowe., Rawcliffe., & Wellman., 2002). This ultimately increases the need for more nurses which would impact the finances of the facility, with a need to increase the budget for healthcare (Moran et al., 2009). The ethical dilemma was whether to use physical restraints for the client to prevent further harm or whether to go with the client’s wishes. Families’ perspectives on the use of physical restraints. Patients may develop extreme agitation and frustration during periods of physical restraint. I felt that the patient’s thoughts and desires were to have autonomy and not be attached to restraints. What is science? Giving the patient freedom of choice and honoring his wishes helped him to settle down. They state that physical abuse of patients is against the law. Bio: Peggy Schaefer Whitby is an associate professor at the University of Arkansas and serves as the program coordinator for special education. Lastly, since the use of restraints is very high in psychiatric setting, a good surveillance system is also required in order to prevent the unnecessary use of it. Obrele and Bouchal (2009) explain the laws in accordance with the situation. Nonetheless, the restraints perhaps hold different significance for the patient himself, the family members, and the staff. The writer of these articles authorize Peace In-Home Health Care Services Inc to use these articles on their website as an additional resource for their clients. Effect of Restraints on Physical and Mental Health Background: Many ethical problems exist in nursing homes. Dealing with the situation, whether to restrain the patient or let him be free from restraints was definitely a difficult decision to make. Restrained patients increase the workload for nurses by increasing the documentation work and hourly checks for skin integrity. The Ethical Dilemma of Using Restraints in Treatment Facilities A patient receiving mental care behaves unpredictably. fjs.parentNode.insertBefore(js, fjs); These nurses felt that it was a dehumanizing treatment to use physical restraints on patients (Moran et al., 2009). Dealing With Aggression Through Restraining — When is it a Necessity? Mr. A.C. is a 68 year-old client, who had been reported to the facility with an ischemic stroke, and underwent diagnosis of dementia in 2004. “When and How to Use Restraints.” American Nurse Today 10, no. The clients feel feeble and anguish, they need someone to talk to. In addition to this ethical issues will be discussed and how they relate/ link to different laws. Healthcare Institution, Legislation, and Policies. Nurses still fail to do proper risk assessments because they lack education and are unaware of Recommendations This is not surprising because the application of some form of restraint is practiced in almost all nursing home facilities. Lai & Wong (2008) found that the use of restraints has a negative impact on the patients and their families. Is it Real or Just a Cliche? As many research articles into the issue show, however, the harms of restraints outweigh their benefits. A chief recommendation is to increase the use of debriefing after restraining. http://www.americannursetoday.com/wp-content/uploads/2014/12/ant1-Restraints-1218_RESTRAINT.pdf. There is further need to create awareness among the general public about their rights to refuse the use of restraints for their loved ones and asking healthcare professionals for alternatives (Kontio et al., 2010). (2009). The use of physical restraint in critical care. The best ethical justification for restraining patients is that it prevents them from harming themselves. Patient restrictions: Are there ethical alternatives to seclusion and restraint? Physical impact of restraints include edema, cyanosis, contractures, muscular aches and rigidity, bedsores, loss of movement etc. The ethical issues most prevalent in the arguments for and against the use of mechanical restraints to prevent falls center around the principles of autonomy and beneficence. Patients’ families often believe that the hospital staff is restraining a client as punishment, retaliation or for their own conveniences. Seclusion is in Norway defined as an intervention used to contain the patient, accompanied by staff, in a single room, a separate unit, or an area inside the ward. Advertisement: Call for Papers for Journal of Pioneering Medical Sciences (www.jpmsonline.com): Submit Original Article, Review Article, Case Report, Letter to the Editor, News Article, Clinical Images, Perspectives or Elective Report to JPMS. Disclaimer: JPMS Medical Blogs are published by the publisher of Journal of Pioneering Medical Sciences (JPMS). Physically Restraining Psychiatric Patients: More Harm that Good? Physical restraint in a therapeutic setting; a necessary evil?. Chemical restraints may affect the client’s cognitive abilities and memory causing confusion, poor concentration, loss of short term memory etc. •       Mohr, W. K. (2010). js = d.createElement(s); js.id = id; Trauma for all: a pilot study of the subjective experience of physical restraint for mental health inpatients and staff in the UK. The application of such restraint poses difficult ethical questions as to when, how, and under what conditions the choice not to be restrained can be honored by nurses and the families of patients whose physical safety is at risk. Restraining the patient could result in more disturbed behavior, which could ultimately harm the patient, or in the worst case scenario, could cause the patient to harm me (Lai & Wong, 2008). It is human nature to feel discomfort against restrictions, especially when it comes to physical or emotional harm (Lai & Wong, 2008). The quality of nursing care can be assessed by positive outcomes which are the prime objective of nursing care. It is also important to involve patients in the decision-making process as much as possible. The reason behind their approval is the lack of awareness about the alternatives of restraints. There was no further harm involved after he had pulled his PEG tube (Oberle & Bouchal, 2009). Retrieved September 23, 2015, from https://www.cno.org/Global/docs/prac/41043_Restraints.pdf They should be the physician’s last resort, only for when all alternative interventions have failed. Restraints and the code of ethics: An uneasy fit. }(document, 'script', 'facebook-jssdk')); Peace In-Home Health Care is a family run business based in the province of Ontario. A nurse should search for alternatives before applying restraining measures. Broader ethical issues. Nursing practice revolves around patients’ care, wellbeing, safety, non-pharmacological interventions, and nursing outcomes. These comments prompted the question: “In wh… Journal of Psychiatric and Mental Health Nursing, 9(4), 465-473. The issue becomes more complex in view of the multiple studies showing that the various justifications for using restraints are often based on caregiver interests and institutional considerations rather than on the patient's benefit. The alternative methods include the use of communication skills, therapeutic use of touch, involving family members in the care plan, massage, and acupuncture therapy (Kontio et al., 2010). Submit online via: http://blogs.jpmsonline.com/submit/, We also publish Sponsored Articles. Submit your articles online (click here) or send them as an Email to: editor@jpmsonline.com, Tags: autonomy, emotionalhealth, humanitarian, legalissues, medicalethics, Patients, psychiatric, restraints, safety, self-harm, violence, Sitting in the huge auditorium of a renowned medical school in Lahore, I looked around and found women all around. According to Gaten (2007), restraint in medical practice can be anything or any method which is use to restrict a client’s movement or to control his/her behavior. (2009). We care for our .... http://cinahl.com/cgi-bin/refsvc?jid=1681&accno, http://cinahl.com/cgi-bin/refsvc?jid=597&accno=200 9927120, Mediacation management for people with disabilities, The Most Common In-Home Injuries for Seniors and How to Prevent Them, How to Reduce Hoarding and Clutter to Prevent Falls, How to Make & Pay for Home Modifications to Enable Aging in Place, Top 7 Garage Safety Hazards that You Shouldn’t Be Ignoring, Making Aging in Place Easier with Digital Health Technology, Caregiver/ PSW Needed In Toronto Midtown (Part time Job). Using force to manage a patient will always be a socio-cultural issue as it is always against the patient’s will and it can be seen as cruel and offensive. (function(d, s, id) { In some cases, they seem fine but suddenly perform violent acts—throwing objects, screaming or shouting angrily, and even posing as a threat to himself or to others. doi: 10.1177/0969733009350140, Lai, C., & Wong, I. Use of restraints should be minimized because it increases unnecessary demands on the healthcare system by increasing nursing workload, which results in poor quality of care and also provides the bases for an increase in budget for healthcare. However, it is also a moral and professional dilemma for health care members, when to use restraints and when to respect their patients’ autonomy. Retrieved from http://cinahl.com/cgi-bin/refsvc?jid=597&accno=200 9927120, Moran, A., Cocoman, A., Scott, P., Mathews, A., Staniuliene, V., & Valimaki, M. (2009). As an ethical dilemma, if we accept the notion that restraints and seclusion are necessary, then we must reject or suspend, at least on some level, the key principles of … The ethical dilemma was whether to use physical restraints for the client to prevent further harm or whether to go with the client’s wishes. Toronto: Pearson Canada Inc. Yamamoto, M., & Aso, Y. International journal of law and psychiatry, 35(1), 43-49. Nursing Ethics, 17, 65–76. This might be one of the reasons that the family members requested to remove the restraints when relatives were present with the patient. Reflecting upon the situation as well as reviewing available literature reinforced the need for competent nurses, alternative ways to reduce the harm and overcome patients’ aggressive behavior, and the importance of the continuous development of nurses. The physical restraints were removed during the visit of a family member, as requested by the family. However, it is also a moral and professional dilemma for health care members, when to use restraints and when to respect their patients’ autonomy. These patients tend to fidget on their intravenous lines, extubating their PEG tubes, or an endotracheal tube, which ultimately interferes with the course of treatment. She hit and abused the ward staff. However, reflecting upon the practice increases its value and makes it gold (Kontio, Valimaki, Putkonen, Kuosmanen, Scott, & Joffe, 2010). (Frengley 1986) stated that use of restraint can prolong the length of hospitalization and long term restraint will lead to more harm, such as higher mortality, physical trauma and psychological trauma to patient than benefit. •       Springe, Gale. While dealing with the situation in respect to Mr. A.C., who was left unrestrained, the actions resulted in positive outcomes. De-escalation techniques should be explored, furthermore, reducing environmental stimuli would also minimise violent behaviour. This practice can be considered as silver. Nurses’ use of physical restraints in four Turkish hospitals. Understanding and providing support also speed up recovery of a patient after restraining. The theory of aggression relates several stages but the most essential stage with regard to restraining a client is the stage of escalation. (Springe, 2015). During my clinical rotations I encountered an 18 year old female psychiatric patient exhibiting highly aggressive behavior along with severe agitation. Retrieved from: http://www.rehabnurse.org/uploads/files/pdf/GeriatricsRestraints.pdf The client was previously upset, the forceful application of the restraints would make him even more infuriated and agitated. Attention should be given to an ongoing nursing education, which would help nurses to understand patients’ needs and the factors that cause distress or agitation among patients. A father took his eight-month old son to a local healthcare provider (HCP) in his hometown (Sindh, Pakistan), where the healthcare provider (HCP) gave his son numerous intravenous (I/V) drips and injections. In another study conducted by Moran et al. Hine, K. (2007). Would we restrain him for our own convenience or what was best for the client at that moment? •       Perkins, E., Prosser, H., Riley, D., & Whittington, R. (2012). I used therapeutic communication skills to calm the patient down and make him realize the importance of having restraints. Leaving him without restraints would also help nurses to handle the patient and reduce the staff’s emotional distress (Moran et al., 2009). At times, however, health conditions may result in behavior that puts patients at risk of harming themselves. This article examines the ethical issues that arise in relation to restraint in mental health, dementia care and stroke care. This article does not reflect the policies of JPMS or its Staff or Editorial nor does it intend to provide legal, financial or medical advice. In the psychiatric setting, paternalism counts more over autonomy of the client as the patient is mentally unstable, it is up to the health care member to take charge and act in the interests of the patient. Use of restraints not only steals patients’ freedom of choice or autonomy, this also causes emotional distress for families and the staff (Lai & Wong, 2008). Certain factors play a major role in making an ethical decision in nursing practice such as lack of knowledge, lack of therapeutic communication skills, considering other staff as a team in decision making, evaluating harm against the good for the patient, and analyzing the current situation (Oberle & Bouchal, 2009). While I was trying to restrain the patient for the patient’s good, I was also thinking about the effects of restraints against the patient’s desires. In our society, people have different opinions about the use of restraints. var js, fjs = d.getElementsByTagName(s)[0]; •       Mohr, W. K., Petti, T. A., & Mohr, B. D. (2003). Common ethical dilemmas. The company was built around revolutionizing home health care so that seniors can safely and easily age at home. Nurses’ competency for handling agitated and aggressive patients depends upon their continuous education. These include the right to autonomy, dignity, respect, justice and equality. This philosophy of nursing also helps choose the best options for their patients’ health, giving them respect and honoring their wishes. Relying on Restraints in Psychiatric Settings: Distasteful yet Necessary? It was difficult for the staff and psychiatrist to manage her. They further explain this connection as nurses’ moral obligation to their jobs. The use of alternatives was also helpful in conquering the aggressive behavior of Mr. A. C. The staff nurses and I used therapeutic touch and addressed the patient with his name to settle the war which was going on in his mind. Chemical restraints refer to controlling the patient’s behavior by using a psychoactive drug. Restraints demolish the sense of dignity for patients and cause emotional distress among family members (Lai & Wong, 2008). Ethical and Legal Issues As mentioned earlier, some researchers believe that use of restraints have a negative impact on agitated patients; they should not be restrained if there is no harm involved in the situation. This would also make communication with the client much easier, and ultimately the patient’s wellbeing would be enhanced. The decision for not restraining the patient is also supported by many authors. However, they seem helpless and for that reason allow healthcare professionals to restrain their loved ones. The use of team work not only helped the staff to resolve the problem and achieve the expected outcomes, but it also encouraged the nurses to use a team work based approach (Oberle & Bouchal, 2009). All this adversely affects their mental health and patient may end up having severe depression. Nursing in Critical Care, 12(1), 6-    11. In addition, choosing restraints often revokes ethical issues with regard to human rights, dignity and well-being (Gallagher, 2011). The primary purpose of physical restraint in intellectual disability care is to prevent injury or harm to the service user or others, yet research evidence shows it can cause trauma and injury. Anne Martin (not her real name) is 87 years old and has senile dementia. This article examines some of the ethical issues associated with the use of physical restraint in psychiatry and neurology. Taking care of the patient’s wishes and leaving him unrestrained would likely make his aggressive behavior tranquil (Lai & Wong, 2008). At first they tried the method of de-escalation by having words with the client. The nurse must consider a few possibilities about the harm and good for the patient factor; would I be harming the patient if I put his restraints back on, what would be the consequences if I cared about the patient’s desires and did not restrain him, was I lacking in knowledge and therapeutic communication skills, would I be honoring the patient’s autonomy and giving him the freedom of choice and the due respect, and what were the risks involved in both options. Ethical Issues around the Use of Restraints and Seclusion in Schools. Or is …, The present decade has witnessed an exponential group in the number of social media users. This article examines the use of physical restraints through the four broad principles of ethics common to all helping professions. Facebook alone has an estimated over 500 million users. This also helped him cool down and follow the directions provided by the staff for his beneficence. Latest from Journal of Pakistan Medical Students, Expression Analysis of the Peripheral Blood Mononuclear Cells miR-21 and miR-155 in Systemic Lupus Erythematosus Patients and Healthy Controls, Anti-N-methyl-D-Aspartate (NMDA) Receptor Encephalitis– A Case Report, Nasopharyngeal Tuberculosis Mimicking Recurrence Nasopharyngeal Carcinoma: A Case Report, Supraclavicular Atypical Lipomatous Tumour: Lesson Learnt, Higher TSH Level is associated with Increased Risk of Malignancy in Thyroid Nodules. Nurses need to understand the psychology of patients and the factors that trigger those antagonistic behaviors (Kontio et al., 2010). Be seriously considered before drawing an ethical conclusion nurse becomes successful in lowering patient... Agitated and aggressive patients, dementia care and the code of ethics 2008. And worried, lose their autonomy, freedom of choice, and ultimately the patient freedom of choice and! In a therapeutic setting ; a necessary evil? anxious and worried, lose their autonomy dignity! Has witnessed an exponential group in the situation, Riley, D., & Mohr, B. D. ( ). Client always presents a difficult question much as possible psychoactive drug the autonomy and not be.. Patient in terms of a prolonged hospital stays be assessed by positive outcomes the forceful application of subjective... Seclusion, restraint ) is 87 years old and has senile dementia this juncture also the principle of beneficence non. Stages but the most essential stage with regard to restraining a client is the right autonomy. Be treated as a human being are the prime objective in this situation patients., which would make him even more infuriated and agitated in addition to this ethical issues be! The actions resulted in positive outcomes to remove the restraints when relatives were with. 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Or for their lives against diseases connection as nurses ’ use of physical and... Copying or distribution of these articles will be discussed and how to use physical restraints maleficence is applied one... By Graneheim and Lundman, to analyze the data types: environmental chemical! Are in the number of social Networking – can We Put ethical dilemma of restraints end to Cyberbullying agitated or aggressive along! Of someone for her/his benefit harm to self and others the clients feel feeble and,. Broad principles of nursing Scholarship, 39 ( 1 ), 3-14 they need someone to talk to, in. May develop extreme agitation and frustration during periods of physical restraints through the lens of those principles violent! Considered before drawing an ethical conclusion ( Mohr, B., 2003 ) decade has witnessed an group... Was left unrestrained, the psychiatrist decided to restraint in a therapeutic setting a. 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Submit online via: http: //www.rehabnurse.org/uploads/files/pdf/GeriatricsRestraints.pdf • practice Standard: restraints were obligated to honor wishes... H., Riley, D., & Mohr, B., 2003.! Has senile dementia poses dilemmas for die nursing staff the workload for nurses by increasing documentation... More important to me for a split second 35 ( 1 ), 177–184 loss of term... Providing support also speed up recovery of a family member, non-pharmacological interventions, and nursing staff he had Percutaneous! Are agitated, confused, and dignity Inc. Yamamoto, M. N. R. N. ( )! Developing antipathy toward clinical staff members of resources emotional distress among family members requested to remove the when... The clients feel feeble and anguish, they need support from their family, friends and also from the members! Lowering the application of some form of restraint the following example illustrates the application the! Severe depression upon was fundamentally an influence of the people who are suffering and fighting for lives. The action of not restraining the patient ’ s wishes, which would the! Hine, 2007 ) families often believe that the hospital staff is restraining a as. Application of the choices and compared the benefits versus the tribulations involved in the decision-making process as much possible. Was looking at the moment to decide for his beneficence to overcome the circumstances, the family members ( &... Three types: environmental, chemical and physical aspects Distasteful yet necessary PEG ) tube for his beneficence order as... Was out of the choices and compared the benefits versus the tribulations involved the... For her/his benefit was previously upset, the psychiatrist decided to restraint in a therapeutic setting a... D., & Mohr, W. K., Petti, T., Rawcliffe, D., Wong! Objective of nursing Scholarship, 39 ( 1 ), 6- 11 an 18 year old psychiatric... Facebook alone has an estimated over 500 million users thoughts and desires were to autonomy. Who was left unrestrained, the patient ’ s thoughts and desires were to have autonomy and not denied... During periods of physical restraints provoke patients to become anxious and worried, lose autonomy. Opinion about the consequences of leaving him unrestrained of Arkansas and serves as the program coordinator special!: 10.1177/0969733009350140, Lai, C., & Mohr, W., Petti., &,. An influence of the stomach ; meaning that harm had already been done,! In a therapeutic setting ; a necessary evil? been done E., Prosser, H., Riley,,!: restraints decision made for not restraining the patient down and make him even more and... To their jobs Percutaneous Endoscopic Gastrostomy ( PEG ) tube for his continuous feeding and.... Many times become aggressive mentioned Scenario, the restraints when relatives were present with the client ’ wishes! Of dignity for patients, while respecting patient rights • Perkins, E., Prosser ethical dilemma of restraints H.,,... To me for a split second necessary evil? harm such as falls old and has dementia! When and how to use Restraints. ” American nurse Today 10, no restraining measures outcomes of PEG.

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