Integrating Nursing Concepts

Mental health is a concerning issue and the incidence of the same have been observed to be on rising trend. The issue of mental health has affected all age group of individuals (Van, 2019). There are multiple healthcare professionals aligned in the care and management of the patient suffering from mental health related issue. These healthcare professionals are subjected to various challenges in managing care for these patients. The most crucial role in this process has been observed to be of the mental health nurses who being the main point of contact bridging the gap between the healthcare professionals and patients. They not only help in delivering care to the patients but also help in drafting a quality policy framework that help in securing rights of the patients (Muir, 2018). However, treating mental health patients still requires use of certain orthodox methods of treatment. These methods include use of restrains. These restrains are either physical or chemical. The role of nurses can also be defined as safeguarding the human rights of these patient and advocate for them, as they are unable to do the same themselves. This essay will help in highlighting some of these factors and implications that alter with the healthcare delivery to the mentally challenged patients. The study will reflect upon the ethical and legal considerations that are aligned with the reflection of this topic. Despite of using an orthodox approach of using restrains for treatment of patients suffering from mental health, there is a need of development of advanced methods through collaborative approach (Read, 2019). The essay will highlight the disapproval of use of restrain methods for treating patients suffering from mental health related issues.

According to the Mental Health Act, 2016, restrain can be defined as an object that brings about a limitation to the person’s ability to express and act (Mental Health Act, 2016). The restrains in mental health treatment can be of two different kinds. One is physical constrain and other is chemical. Physical restrains can be observed in the form of cuffs, harnesses, head harness, straps and so on, that are applied across extremities of the patients to limit their movements. This is generally used for treating patients who might have display of violent behaviour and can be potent to bring about physical harm to themselves or to the person enabling care to them. Chemical restrains are generally delivered in the form of sedative medications that put the patient in an unconscious state of mind and thus, restrict their functioning (Wong, 2019). Patients might find themselves not having a freedom to express themselves and can have an underlying fear of harm from the person aligned in providing care to them. However, there have been few amendments in recent times in the manner of delivery of healthcare services to the patients. These recent changes have been able to evacuate the use of chemical restrains as a treatment modality for these patients. Chemical restrains are also observed to have multiple long-term side effects on the patient and thus, cannot be a positive method for facilitating care (Muir‐Cochrane, 2020).

In a general healthcare setting, the use of restrain is not favoured both by the patient as well as by the healthcare professional. Besides limiting the movement of the person, restrains are found to have no other therapeutic benefit for the patient, in terms of improving their health status. In spite it might bring about an undue trauma to the patient. Instead of using restrains with these patients, a more personal approach can be delivered to the patients. This can be carried out by the help of building a trust worthy bond with the patient, through mutual understating (Strandås, 2018). This method is also useful for restoring the trust of the patient in the medical process implemented for their care. This method helps in providing a protective environment to the patient. Thus, enabling them a support system where they can express themselves freely. Patient is supposed to be the primary focus of care. Thus, the facilities should be provided as per their specific requirements. The nurses also play a vital role in harm minimalization in the process of care delivery to these individuals suffering from mental health concerns. The planning and execution of interventions should be done by keeping a close consideration for promoting psychological well-being of the patient. However, the use of restrains limits that by multiple folds. The use of such restrictive methodologies can although be replaced by conventional methods that can help in care delivery through mutual respect and alliance. Thus, safeguarding the best interest of both of the parties involved in this process.

Nurses can be the foundational point of contact to help develop reforms that can be enabling safe and secure care delivery to these patients. The family of the individuals can also be involved in this process to provide and insight about the changes that should be included. Therapy methods such as retrains should be deemed as redundant and obsolete (Hylén, 2019). Senior healthcare professionals can also provide and insight for the reforms to be used as a part of new system, through their respective experience of working with such patients. Noting the red flags and acting on the same within the stipulated time-frame will help in marginalizing the harm by multiple folds. This will also pave way for developing new advanced methods of therapy. Strong communication channels should be established between the concerning authorities. This will ensure that the right person is provided with the apt information, required to bring about a change. This will also ensure patient safety through clear standards of health defined for the patient. It will also help in safeguarding the ethical and legal concerns of harm to the patient while delivering them care (Askola, 2017). Instead of using retrains the family can be included in the therapy process. This will help the patient adjust well to the system through a supportive environment provide to him. The delivery of care will be based more on evidence-based approach (Heslop, 2016). This will help in reducing the negative impact on patient’s health and will assure delivery of care with advanced method. Will less chances of errors and certainty of more favourable results from the patients, positive and desired healthcare outcomes can be delivered.

References for Use of Retrains in Mental Health

Askola, R., Nikkonen, M., Putkonen, H., Kylmä, J., & Louheranta, O. (2017). The therapeutic approach to a patient's criminal offense in a forensic mental health nurse–patient relationship—The nurses’ perspectives. Perspectives in Psychiatric Care, 53(3), 164-174. https://doi.org/10.1111/ppc.12148

Heslop, B., Wynaden, D., Tohotoa, J., & Heslop, K. (2016). Mental health nurses’ contributions to community mental health care: An Australian study. International Journal of Mental Health Nursing, 25(5), 426-433. https://doi.org/10.1111/inm.12225

Hylén, U., Engström, I., Engström, K., Pelto-Piri, V., & Anderzen-Carlsson, A. (2019). Providing good care in the shadow of violence–an interview study with nursing staff and ward managers in psychiatric inpatient care in Sweden. Issues in Mental Health Nursing, 40(2), 148-157. https://doi.org/10.1080/01612840.2018.1496207

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

Muir‐Cochrane, E., Grimmer, K., Gerace, A., Bastiampillai, T., & Oster, C. (2020). Prevalence of the use of chemical restraint in the management of challenging behaviours associated with adult mental health conditions: A meta‐synthesis. Journal of Psychiatric and Mental Health Nursing, 27(4), 425-445. https://doi.org/10.1111/jpm.12585

Muir‐Cochrane, E., O'Kane, D., & Oster, C. (2018). Fear and blame in mental health nurses’ accounts of restrictive practices: Implications for the elimination of seclusion and restraint. International Journal of Mental Health Nursing, 27(5), 1511-1521. https://doi.org/10.1111/inm.12451

Read, U. M. (2019). Rights as relationships: Collaborating with faith healers in community mental health in Ghana. Culture, Medicine, and Psychiatry, 43(4), 613-635. https://doi.org/10.1007/s11013-019-09648-3

Strandås, M., & Bondas, T. (2018). The nurse–patient relationship as a story of health enhancement in community care: A meta‐ethnography. Journal of Advanced Nursing, 74(1), 11-22. https://doi.org/10.1111/jan.13389

Van Spijker, B. A., Salinas-Perez, J. A., Mendoza, J., Bell, T., Bagheri, N., Furst, M. A., ... & Salvador-Carulla, L. (2019). Service availability and capacity in rural mental health in Australia: Analysing gaps using an Integrated Mental Health Atlas. Australian & New Zealand Journal of Psychiatry, 53(10), 1000-1012. https://doi.org/10.1177%2F0004867419857809

Wong, A. H., Crispino, L., Parker, J. B., McVaney, C., Rosenberg, A., Ray, J. M., ... & Bernstein, S. L. (2019). Characteristics and severity of agitation associated with use of sedatives and restraints in the emergency department. The Journal of Emergency Medicine, 57(5), 611-619. https://doi.org/10.1016/j.jemermed.2019.07.019

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