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Integrating Nursing Concepts

Mental health has been a concerning issue in Australia in recent times (Landstedt, 2017). There has been a rise in the number of incidences reported pertaining to various mental health related issues. The issue to mental health is not restricted to any particular age group. The healthcare professionals face challenges on managing care for these patients on a daily basis. Each individual have their own limitations and their own medical concerns. The healthcare system that can be found to be closely associated with these patients is generally mental health nurses. It is the primary role of the healthcare professional to enable care to these individuals, all the while keeping a close consideration for the policy framework and regulatory bodies that are engaged in this process (Delaney, 2018). There is a dire need for innovative measures to be taken in replacement to old and orthodox methods. This can only be attained through a collaborative approach of taskforce, in enabling care and aiming to safeguard the human rights of the patient and their families involved in the process (Prasad, 2016). This methodical approach will also be helpful in analyzing the mental health related issues pattern, in a larger group of population or community. This will thus, enable drafting of interventions in accordance with the individualized healthcare needs and requirement. Thus, overall having a greater impact in enabling improved and sustainable healthcare outcomes from a patient suffering from mental health related issue. The use of restrains should however, be not encourage din treating mentally ill patients. the essay will help in highlighting the concerns as to why use of restrains can cause patient harm and increase the underlying risk as well.

As per Mental Health Act, 2016, retrain is an instrument that might help in preventing the full functioning of a person in terms of physical capacity (Mental Health Act, 2016). Physical restrain can also be observed as a loss of freedom of expression of an individual (Ye, 2019). Generally, in a mental health setting, various instruments can be opted as a restrain. These instruments include straps, harnesses, handcuffs, cufflinks etc. (Duxbury, 2019). The patients suffering from mental health are also often contained with the help of chemical constrains. These constrains are administered in the form of medications that are generally in the form of a sedative to control the patient’s physical activity (Korczak, 2016). Under restrain the mentally challenged patients might lose their confidence in their respective healthcare providers. Patients upon losing their independence might have an added fear of the unknown and might express their remorse with violence as well. These patients can bring about harm to their healthcare providers as well as to themselves. With an underlying fear of increased chances of unpredictable behavior expressed by these individuals having mental health concerns, it sometimes becomes imperative to restrict them with restrains (Cheesmond, 2019). With recent trends and advancements made in the field of mental health, the technique of chemical restrains has been almost evacuated from the system. Chemical restrains are generally not considered as a part of common intervention techniques, used under the broader spectrum of various mental health related modalities. Chemical restrains are also found to have depreciating effects on the person treated with the same.

The concept of restrains is not favored by either the patients as well as by the mental healthcare nurses. The nurses are generally against advocating the use of restrains for mental health patients as they don’t see any benefit of the same for the patients (Wyder, 2017). Patients suffering from mental health issues are generally found to develop the condition, due to being subjected to any form of trauma. In majority of conditions, person has gone through a certain form of abuse or trauma in their childhood that leads to the development of underlying mental health concerns in the patient (Cross, 2017). The nurses can ensure smooth facilitation of care delivery to these patients, by building a robust bond with the patient. The movement the patients are contained in such restrictions, the chances of blooming a mutual and cooperative bond with the patients reduces to nil. Building a trustworthy environment with the patient not only help in smooth transition of healthcare delivery to the patient, but also provides them with a safe and secure niche to express themselves completely. In a contained and secure environment, better care can be delivered to these patients. This process can also be beneficial in reducing overall harm (Slemon, 2017) to the patient and having an autonomous status of expression in their own health related decision-making process (Karanikola, 2018). This process can also be deemed to deliver effective and positive healthcare outcomes in the patient. With the deliverance of improved quality of care, enhanced healthcare outcomes can be attained. With highlighting the primary focus on the patient, it can be assured that the patient will participate with full interest and thus, providing a more detailed and reliable information. This data can be useful for reporting purposes and providing an inter-relatable comparison for making use of best possible healthcare intervention for the patient. These conventional methods can also formulate the foundational grounds for new and improved reforms that can help in lowering the overall psychological impact on the patients suffering from mental health related issues (Riahi, 2016). The reforms will enable healthcare nurses to deliver care with a personal approach and thus, ensuring cooperation of the patient and reduced harm to both nurses as well as the patients.

Role of nurses in the process of delivering care to the patient can be ascertained as one of the most crucial and vital one. They are the frontline managers for the patients who work in close niche with the other healthcare professionals, making sure that patient gets the required holistic care. Being the advocators for the patient’s rights the nurses can also play a pivotal role in formulating healthcare policies that can be best used to promote and ensure patient’s benefit and quality of care. Methods such as restraining the mental health patients can be considered as redundant and should be obsoleted from the system. Mental health nurses can be helpful in providing an insight on the pertaining harms on the patient that are incurred from such interventions. The accountability of the nurses is also crucial in ensuring the overall impact of harm on the patient is marginalized and also dully reported to the concerning authorities (Lundström, 2020). The role of experienced nurses can also be highlighted as of vital importance in this process. Having spent multiple years of service in this field of expertise, senior nurses can be a fruitful resource in helping in identifying the limitations of the process. Role of concerned authorities to be notified can also be deemed as quite vital and helpful in the process. With proper structural bodies working in place, gaps and red flags can be dully identified and worked on. Nurses can also help in removing these orthodox methods of treatment, by helping with evidence-based research into the subject matter, through the lens of their own individualized clinical and practical experiences. As restrains can be considered of nor therapeutic value in the treatment of the mentally challenged patients, they should be erased from being a part of the fundamental treatment process (Mwebe, 2017). Use and inclusion of high proficiency clinical skills as an integral part of fundamental nursing practices, can ensure marginalizing the harms caused to the patient. Thus, making sure that the process is able to meet with the desired clinical standards of nursing practice to be used in the best possible interest of the patient. Nurses can also help in developing healthy communication channels between the patient and their families. With a known person involved in the process, not only advocation of rights will be easier for these patients, but they will feel safe in expressing themselves as well. Role of multidisciplinary approach can also be opted for educating the patient and their families about their health rights. This will be helpful in developing an overall supportive environment for the patient and reducing the stress involved in treating and managing medical care for mentally challenged patients (Quinn, 2018). This will also enable easy solutions and fixes for tackling with complex mental health concerns and issues.

Despite acknowledging the harmful effects of using restrains on patients suffering from mental health issues, the use of same in clinical settings in a constant affair. Despite constant efforts in place, with string policies, their use is an ongoing process for managing challenging and complex case scenarios. Nurses have a crucial role to play in ensuring delivery of safe clinical practice to the patients. The evidence-based practice should be revolving around identifying the barriers in smooth facilitation of these care services to the patient (Gerace, 2019). By narrowing down these pointers and eliminating the unethical practices, more reformed approach can be adopted and ensured for patient care.

The uses of constrains should be removed from the system of treating patients suffering from mental health issues. These techniques are not found to have any therapeutic advantage for the patient. These methods however, restrict the fair chances of developing therapeutic relationships with the patients. Collaborative approach along with a strong and advancing leadership can make sure that use of valid resources is considered in this process. This will help in ensuring full functioning of the healthcare professionals working at various hierarchical stages and ensuring positive reinforcement for enabling required change in the overall functioning of the system. Thus, making it more profound and effective system than the one existing before in place. A strong collaborative approach with the help of effective communication channels can ensure visibly positive outcomes from the process.

References for Use of Restrains in Mental Health

Cheesmond, N. E., Davies, K., & Inder, K. J. (2019). Exploring the role of rurality and rural identity in mental health help-seeking behavior: A systematic qualitative review. Journal of Rural Mental Health43(1), 45. https://psycnet.apa.org/doi/10.1037/rmh0000109

Cross, D., Fani, N., Powers, A., & Bradley, B. (2017). Neurobiological development in the context of childhood trauma. Clinical Psychology: Science and Practice24(2), 111-124. https://doi.org/10.1111/cpsp.12198

Delaney, K. R., Naegle, M. A., Valentine, N. M., Antai-Otong, D., Groh, C. J., & Brennaman, L. (2018). The effective use of psychiatric mental health nurses in integrated care: Policy implications for increasing quality and access to care. The Journal of Behavioral Health Services & Research45(2), 300-309. https://doi.org/10.1007/s11414-017-9555-x

Duxbury, J., Thomson, G., Scholes, A., Jones, F., Baker, J., Downe, S., ... & McKeown, M. (2019). Staff experiences and understandings of the RE s TRAIN yourself initiative to minimize the use of physical restraint on mental health wards. International Journal of Mental health Nursing28(4), 845-856. https://doi.org/10.1111/inm.12577

 Gerace, A., & Muir‐Cochrane, E. (2019). Perceptions of nurses working with psychiatric consumers regarding the elimination of seclusion and restraint in psychiatric inpatient settings and emergency departments: An Australian survey. International Journal of Mental Health Nursing28(1), 209-225. https://doi.org/10.1111/inm.12522.

Karanikola, M., Kaikoushi, K., Doulougeri, K., Koutrouba, A., & Papathanassoglou, E. D. E. (2018). Perceptions of professional role in community mental health nurses: The interplay of power relations between nurses and mentally ill individuals. Archives of Psychiatric Nursing32(5), 677-687. https://doi.org/10.1016/j.apnu.2018.03.007

Korczak, V., Kirby, A., & Gunja, N. (2016). Chemical agents for the sedation of agitated patients in the ED: A systematic review. The American Journal of Emergency Medicine34(12), 2426-2431. https://doi.org/10.1016/j.ajem.2016.09.025

Landstedt, E., Coffey, J., Wyn, J., Cuervo, H., & Woodman, D. (2017). The complex relationship between mental health and social conditions in the lives of young Australians mixing work and study. Young25(4), 339-358. https://doi.org/10.1177%2F1103308816649486

Lundström, S., Jormfeldt, H., Hedman Ahlström, B., & Skärsäter, I. (2020). Mental health nurses’ experience of physical health care and health promotion initiatives for people with severe mental illness. International Journal of Mental Health Nursing29(2), 244-253. https://doi.org/10.1111/inm.12669

Mental Health Act, 2016. Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0027/465174/cpp-physical-restraint.pdf

Mwebe, H. (2017). Physical health monitoring in mental health settings: A study exploring mental health nurses’ views of their role. Journal of Clinical Nursing26(19-20), 3067-3078. DOI https://doi.org/10.1111/jocn.13653

Prasad, M. N., & Theodore, D. D. (2016). Knowledge of nursing students regarding human rights of mentally ill. Asian Journal of Nursing Education and Research6(2), 151-155. http://dx.doi.org/10.5958/2349-2996.2016.00028.8

Quinn, C., Platania‐Phung, C., Bale, C., Happell, B., & Hughes, E. (2018). Understanding the current sexual health service provision for mental health consumers by nurses in mental health settings: Findings from a survey in Australia and England. International Journal of Mental Health Nursing27(5), 1522-1534. https://doi.org/10.1111/inm.12452

Riahi, S., Thomson, G., & Duxbury, J. (2016). An integrative review exploring decision‐making factors influencing mental health nurses in the use of restraint. Journal of Psychiatric and Mental Health Nursing23(2), 116-128. https://doi.org/10.1111/jpm.12285

Slemon, A., Jenkins, E., & Bungay, V. (2017). Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice. Nursing Inquiry24(4), 12-99. https://doi.org/10.1111/nin.12199

Wyder, M., Ehrlich, C., Crompton, D., McArthur, L., Delaforce, C., Dziopa, F., ... & Powell, E. (2017). Nurses experiences of delivering care in acute inpatient mental health settings: A narrative synthesis of the literature. International Journal of Mental Health Nursing26(6), 527-540. https://doi.org/10.1111/inm.12315

Ye, J., Wang, C., Xiao, A., Xia, Z., Yu, L., Lin, J., ... & Zhang, Y. (2019). Physical restraint in mental health nursing: A concept analysis. International Journal of Nursing Sciences6(3), 343-348. https://dx.doi.org/10.1016%2Fj.ijnss.2019.04.002

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