Gallagher A(1). “When and How to Use Restraints.” American Nurse Today 10, no. Fundamental principles to guide future action on the issue of seclusion and restraint … Nonetheless, the restraints perhaps hold different significance for the patient himself, the family members, and the staff. 1 (2015). This article examines some of the ethical issues associated with the use of physical restraint in psychiatry and neurology. Restraint and seclusion: A distressing treatment option? Loneliness has been defined as “the aversive state experienced when a disagreement exists between the interpersonal relationships one wishes to have, and those that one perceives they at present have “(Peplau& Perlman, 1982). At this juncture also the principle of beneficence and non maleficence is applied. 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. Lai & Wong (2008) found that the use of restraints has a negative impact on the patients and their families. Physical restraints provoke patients to become anxious and worried, lose their autonomy, freedom of choice, and dignity. 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. The family was involved in this decision making. Hine, K. (2007). While dealing with the situation in respect to Mr. A.C., who was left unrestrained, the actions resulted in positive outcomes. Many families are unaware of their rights to refuse the use of restraints and to ask for alternatives (Lai & Wong, 2008). Obrele and Bouchal (2009) explain the laws in accordance with the situation. The PEG tube was already halfway out of the stomach; meaning that harm had already been done. There are certain things that need to be considered in regards to the use of physical restraints and the ethics of the circumstances. Nursing in Critical Care, 12(1), 6-    11. 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. Ethical Dilemma Factor in Regarding Physical Restraints to Elderly of Female Nurses with the Living Together Experience 330 . Nurses still fail to do proper risk assessments because they lack education and are unaware of Facebook Depression! 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. I did an assessment of the choices and compared the benefits versus the tribulations involved in the situation. 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. Often applied in intensive care units with patients experiencing agitation and insufficient sedation, physical restraint techniques are advised for prevention of self-harm and unplanned extubations. 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. (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 father noticed …, Copyrights: Journal of Pioneering Medical Sciences, http://www.rehabnurse.org/uploads/files/pdf/GeriatricsRestraints.pdf, https://www.cno.org/Global/docs/prac/41043_Restraints.pdf, http://www.americannursetoday.com/wp-content/uploads/2014/12/ant1-Restraints-1218_RESTRAINT.pdf, In Perspective: Implications of Using Physical Restraints in Clinical Settings. Nursing profession is self regulatory, where every nurse is obligated to follow the standards of practice set by College of Nurses Ontario (CNO), Canadian Nurses Association (CNA) Codes of ethics, laws, and institutional policies (Obrele & Bouchal, 2009). Nurses’ personal moral values play a significant role in dealing with ethical dilemmas in their practice. This would also make communication with the client much easier, and ultimately the patient’s wellbeing would be enhanced. Nurses’ competency for handling agitated and aggressive patients depends upon their continuous education. 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). However, I thought about the consequences of leaving him unrestrained. 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). Ethics in Canadian Nursing Practice. 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. Definition of Ethical Dilemma . These include the right to autonomy, dignity, respect, justice and equality. A discussion of the ethical, legal, practical, and professional issues follows, to help nurses understand the difference between unacceptable or … js.src = 'https://connect.facebook.net/en_US/sdk.js#xfbml=1&version=v3.0&appId=160541900690768&autoLogAppEvents=1'; These considerations include why physical restraints are used, what is the importance of using physical restraints, and who is affected the most, the patient, family, or nursing staff. 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. 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