Restraints: Essential or Debilitating? The use of restraints for medical purposes have been in effect for many years. Whether it be in a nursing home setting, mental health, ICU, emergency department, or even a possible school setting. The effectiveness and/or overall harm essentially caused by restraints is an issue that has been argued and studied by many health care professionals throughout time. Restraints are oftentimes used to either protect a patient from harming themselves, or even harming the nurses or other medical personnel that is assisting with their care. Even with the current research and studies whether or not the services provided by restraints will continue to be utilized is still unknown. Although there are a lot of questions …show more content…
I was taught the basics such as: make sure the patient is not in pain when restrained, make sure they can still reach the call bell, check and make sure they don’t need anything before leaving them, make sure they are not in a position where they can get hurt. I was taught that if the patient was restrained with something more constricting such as the wrist restraints it was necessary to check on the individual at least once every two hours and loosen, if not remove, the restraints for 15 minutes at those intervals to ensure proper circulation. During my research one article supported this teaching with, “After the restraint is applied, initial monitoring is done whenever necessary but at least every 15 minutes for the first hour by a qualified registered nurse. When the patient or resident is stable and without significant changes, the monitoring and correlating documentation is then done at least every 4 hours for adults, every 2 hours for children from 9 to 17 years of age, and at least every hour for those less than 9 years of age” (Androus). Another thing discussed in the CNA program is the severity of needing a doctor’s orders before applying any form of restraint. Of course with us only being CNA’s we do not have as many privileges as possibly an RN or more so a doctor. If a CNA was …show more content…
It is essential for a nurse, or any medical professional, to not feel threatened so that way they are able to administer their best care possible. Every case and instance is different, no two patients or hospitals are the same. This is why individuals are stressing the act of becoming more personable with patients and the public because a treatment option that may be ideal and work perfectly for one case, may be extremely harmful for another. The goal of a nurse, or even the entire hospital/facility is to create a safe and welcoming environment in which they can provide essential care for each individual. Our intricate health system may be filled with varying degrees of controversy, but the public would be in dire situations without
Nurses are required to protect and support their patients if they are to be an efficient patient advocate. Ethically questionable situations are quite common for nurses that conflict with their professionals and personal morals. At times, the patient necessitates the nurse to speak out for them demonstrating
Nurses are central to patient care and patient safety in hospitals. Their ability to speak up and be heard greatly impacts their own work satisfaction and patient outcomes. Open communication should have been encouraged within the healthcare team caring for Tyrell. Open communication cultures lead to better patient care, improved outcomes, and better staff satisfaction (Okuyama, 2014). Promoting autonomy for all members of the healthcare team, including the patient and his parents, may have caused the outcome to have been completely different. A focus on what is best for the patient rather than on risks clinicians may face when speaking up about potential patient harm is needed to achieve safe care in everyday clinical practice (Okuyama,
Seclusion and restraint started out in psychiatric hospitals and have now evolved into many schools. Restraint started out in England in the mid 19th century after having a history of poor conditions. Since Americans did not open up their first state- run mental hospital until 1822, they were unaware of the negative history that happened during the British reformation ("Human Side of Hospitals"). The American physicians thought that the restraints were keeping their patients safe when it was actually mistreatment of their patients. Anything that can be used to restrict the movements of a patient is a form of restraint. Things used as restraints can be leather or velcro wristlets or anklets that are used to hold the patient or attach them to their bed, lock them in their room, or by using sedating chemicals.
Physical restraint, according to Health Care Financing Administration, can be defined as any handling, physical and mechanical methods applied to a patient with the aim of denying him or her the freedom of movement or access to his or her own body (Di Lorenzo et al., 2011). It may involve use of belts or ties that restrain movement of an individual such as seclusion. Seclusion refers to isolation from others, often done in a room that’s I avoid of any furniture and has a small observable window as the only connection to the outside world (Chandler, 2012). The use of physical restraint in handling patients has been on debate for several years now. In most countries such Italy, it
Frequently, nurses are confronted with the task of finding the balance between advocating for the patient, and remaining loyal to their hospital or institution (Hanks, 2007). Risks that are associated with patient advocacy are more on the institutional level (Bu & Jezewski, 2007). Risks such as accusations of insubordination, reputation slander, hostile work environment, and loss of job security are among some of the top reasons nurses tend to shy away for patient advocacy (Bu & Jezewski, 2007). Another problem with advocacy is that there isn’t a universal definition as to what being an advocate means, along with inconsistency of interpretations (Bu & Jezewski,
According to the American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the health, safety and rights of the patient” (p. 6). Nursing responsibilities should be acted upon at the highest standard and must be based on legal and ethical obligations. Healthcare provider’s perception and judgment of the patient’s well being, as well as taking into account the rights of the patient in every action, is one of the key elements in nursing practice. International Council of Nurses (ICN) (2006) states “The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence” (p. 3).
Another factor that influences being a safe and professional nurse is having the right attitude. This will help you develop your nursing skills better if you have a positive attitude, because you may work with a team of registered nurses but you must recognize that each of you have your strengths and weaknesses. You must value each nurse for their expertise and skills, and always be willing to learn and accept feedback to help improve yourself. As a nurse, you may be great at starting IVs, while another nurse may be great at talking to patients, another nurse may be great at wound care, etc. Overall, recognizing when to ask for help is a good quality in nursing, this isn’t as a disfavor to yourself but actually a service to your patient, because
The way we react or treat patients is dependent on what we learned in training and schooling, provided by nursing educators. In the American Journal of Nursing, Rosemary Taylor stated “…the future of the nursing profession depends on the support imparted by educators in their formation of a professional identity” (Taylor, 2017, p.11). I think that how we teach our nurses with the resources and experiences given to them, will determine how patient care is given. Many facilities are requiring that we at least get out bachelors degree before they even consider you, which is why I plan on getting my doctorate. Furthering our education and schooling will be beneficial for patient care and
Nursing surrounds the concept of patient care physically, mentally and ethically. The therapeutic relationship that is created is built on the knowledge and skills of the nurse and relies on patient and nurse trusting one another. The use of nursing skills can ensure these boundaries are maintained, it allows for safe patient care. Professional boundaries are the line that nurses cannot cross, involving aspects such as patient confidentiality and privacy, ensuring legal aspects of nursing and the boundaries put in place are not breached. However, nurses accepting financial or personal gain from patient can also cross these professional boundaries. It is only through education in this area that the rights of patients can be preserved, as well as the nursing standards. Through education in areas such as confidentiality, boundaries can remain in tact and the patient care can remain within the zone of helpfulness.
When dealing with masses of people on a daily basis, who need a nurse constantly, and who have complaints and needs, there will be major stress to deal with. Difficulties will come and go, but not always with ease. A nurse may deal with a lot of drama, procedure problems, and time limitations. Not all patients are kind, patient,
The goal was chosen, background obtained, literature review done, methods established, and implications for nursing practice reviewed. They wanted to implement one-on-one discussions with bedside nurses related to behavioral justification for restraint use, use of least restrictive restraint, and prompt removal when clinically justified, along with coordination of information-sharing with nursing leadership to promote a data driven approach to reduction in restraint usage. Outcomes were that as a result of monthly discussions, there was a sustainability of reduction in usage of restraints in the adult ICU’s. Another initiative was the nurse driven urinary catheter removal protocol. The goals were to reduce catheter associated urinary tract infections through early removal of indwelling urinary catheters and increase compliance to the Surgical Care Improvement Measure Urinary Catheter Removal through a nurse driven protocol that standardizes care and sanctions catheter removal based on approved criteria. A pilot was conducted at two hospitals to assess efficacy of implementing the plan system wide. A plan was developed with interventions, a urinary catheter removal algorithm, and documentation compliance parameters. Outcomes were lower catheter days and reinsertion rates, decreased catheter utilization ratio, and infection rates
It is important for health care organisations to have policies and guidelines on the safe management of vulnerable patients in the community and hospital for health care professionals, including more specifically the perioperative environment for operating department practitioners (ODPs). This awareness of these patients, policies and guidelines is needed in order to act in a manner to protect and safeguard. Health care professionals must also have the appropriate training in caring for these vulnerable patients, for example professionals caring for children should have up to date qualifications in paediatric care and be able to communicate efficiently with the child and parent/carer. The Royal College of Nursing, RCN (2011) consider that this should a...
Nursing revolves around a commitment to helping others in need, to become the healthiest they can possibly in all aspects of their being. A nurse needs to know how to care, that means to realize what it is that matters to the patient and how to help them get it, and the basis of my philosophy is that caring is the body of nursing, and nursing is not possible without caring. Caring in a professional sense is to prevent future harm, treat those who are ill, a commitment to learning how to provide the best possible care, and to maintain the patients dignity through all aspects of the care that is being provided. Patient care should always have a holistic root, this opens the door for the patient and nurse to interact in a way that can give the nurse insight into that patients values. Patients who are comfortable in their environment heal better and faster, and one of the best ways to make a person feel comfortable in an unfamiliar place is to establish a therapeutic relationship. A therapeutic relationship is one built with trust on both sides, I think for a nurse to be able to see the situation for the patient’s point of view there needs to be a certain amount of openness in the relationship which will not develop without trust. Nursing should always be focused on what is helping the patient in the most ways, a nurse should always
As a result, it is important to communicate properly respectfully with the public. There are two types of communication, verbal and non-verbal. “Verbal communication is an exchange of information using words, while nonverbal communication is information without the use of words”(Taylor et al. 2015). A professional nurse should use proper grammar and spelling while verbal communication. Nonverbal communication indicates facial expression, touch, eye contact, and posture. Patients are always observing, for example, if a nurse enters the room and makes no eye contact and negative body language, the patient would feel as if he/she is bothering the nurse or the nurse just doesn’t like caring for him/her. Further more, it is important for the nurse to communicate with the families or the patient. For example, if the patient were a 5-year-old boy, his parents would probably do most the communication. They want the best nurse and the best team assisting their son. Further more, nurses should maintain privacy and never communicate the patients name, address, age, diagnosis etc. with the public. The patient has the right to privacy and a professional nurse needs to respect patient’s
Nursing may be seen as very independent work even though there will be situations that will require others. Friendships may be formed; however, to have professional interactions is something that is not always followed. In terms of patient confidentiality, we may not realize that a HIPPA violation has occurred due to friendly conversation with coworkers. If a patient were to overhear their nurse discussing their information in an unprofessional manner then it may cause issues with a patient’s dignity and their rights. If a patient’s right is violated then it can lead to a patient’s mistrust in their caregiver, leading to mistrust in the facilities, and can end with a patient’s health being compromised. The patient is the reason for this career; if the needs of the patient are being unmet or violated then the purpose of our occupation will be unsuccessful and