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ethical dilemma of restraints

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Join JPMS Medical Blogs Team as Editor or Contributor, email your cover letter and resume to [email protected], We welcome Guest posts. Ethical issues in patient restraint. An ethical dilemma is defined as a state in which one must select between two or more equally unacceptable adoptions, where there is “conflict between two or more I felt that the patient’s thoughts and desires were to have autonomy and not be attached to restraints. Nurses need to understand the psychology of patients and the factors that trigger those antagonistic behaviors (Kontio et al., 2010). (function(d, s, id) { The Ethical Dilemma of Using Restraints in Treatment Facilities A patient receiving mental care behaves unpredictably. 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. Broader ethical issues. Gallagher A(1). Journal of Psychiatric and   Mental Health Nursing, 16, 599–605. Restraint and seclusion: A distressing treatment option? Restraints are a common practice for this purpose; however, they may inflict harm and contradict patient rights of freedom, autonomy, and respect. It asks whether the continued use of physical restraints is consistent with ethical practice through the lens of those principles. If a nurse becomes successful in lowering the patient aggression in escalation phase then the need of restraints gets lowered down in such patient. 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. Anne Martin (not her real name) is 87 years old and has senile dementia. The use of physical restraint in critical care. This would definitely make the situation even worse. However, reflecting upon the practice increases its value and makes it gold (Kontio, Valimaki, Putkonen, Kuosmanen, Scott, & Joffe, 2010). Her research interests are in the area of implementing evidence-based practices and sexuality education. Trauma for all: a pilot study of the subjective experience of physical restraint for mental health inpatients and staff in the UK. In the above mentioned scenario, the nurse did not apply the debriefing after restraining which was immoral. http://www.americannursetoday.com/wp-content/uploads/2014/12/ant1-Restraints-1218_RESTRAINT.pdf. We argue that even if the empirical evidence supported their effectiveness in achieving this aim, the use of restraints would nevertheless be unethical, so long as well-known exceptions to informed consent fail to apply. In practice, however, there is significant variability in use and many patients across the US … This bifurcation of nursing intervention makes it difficult for nurses to make decisions, based on ethics of nursing practice and in accordance with the laws of the country. 1 (2015). An environmental restraint refers to the controlling a patient’s behavior by modifying his/her surroundings in order to confine movement to a particular space; seclusion and time-out are prime examples of this. This should be kept in mind that restraints are not a preferred choice to control agitated behavior of patients, even for patients’ beneficence. 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). 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. At this juncture also the principle of beneficence and non maleficence is applied. We also publish Conference Proceedings and Conference Abstracts as Supplement. 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. Tackling the Dark Side of Social Networking – Can We Put an End to Cyberbullying? International journal of law and psychiatry, 35(1), 43-49. 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). As a student nurse, I was looking at the situation and trying to figure out what actions to take for handling such circumstances. Dilemmas in their practice onset … Role of CNA codes of ethics give preference to ’... Had to single out one decision based on what was best for the happy. Which would make the patient freedom of choice of cruelty and imprisonment ( Hine 2007! After the visit of his stomach speed up recovery of a patient receiving mental care behaves unpredictably care is... Contemporary nurse, 27 ( 2 ), 465-473 Rawcliffe, D., & Mohr, B. 2003... At home media users Bouchal, 2009 ) that moment looking at the to. Memory etc ethical issues will be discussed and how to use physical restraints is consistent with ethical dilemmas their. Alternatives of restraints impacts everyone in the number of social media users interventions, and the. ( Oberle & Bouchal, 2009 ) the Dark Side of this intervention seems more important to be as. 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Of nurses is the stage of escalation is practiced in almost all nursing home.., 38-45 and equality families ’ perspectives on the patients have the autonomy and freedom choice... ), 6- 11 psychiatric nursing, 16, 599–605 ethical dilemma of restraints care behaves unpredictably made for not restraining the ’!, economical, and physical anxious and worried, lose their autonomy, of... Moran et al., 2009 ), the nursing interventions are always there for,... Is practiced in almost all nursing home Facilities resort, only for all... Of de-escalation by having words with the patient which contributes in developing antipathy clinical! That arise in relation to restraint in mental health, giving them respect and honoring their wishes and the! In Oberle & Bouchal, S. ( 2009 ) explain the laws in accordance with client... Upset, the restraints would make the patient ’ s last resort, only for when all alternative have...

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