A "restraint" is defined as a chemical or physical device or means that restrict the freedom of the client and the ability to move about and easily removed or eliminated by the client. The physical restraint is such that the mechanical device, equipment, or material to attached restraint individual which restricts the movement of the body from normal. The chemical restraint is the discipline that uses the drug to treat medical symptoms. The topic here will discuss the arguments on physical or chemical restraints used in confused people. The discussion will include the support of ICN codes, standards, and guidelines for the respective topic.
Physical or chemical restraint is not formed of medication. They are administered to the patient to control the behavior and not the physical or mental condition. They are given to reduce the symptoms of physical conditions to identify the side effects (Suliman, 2018). The sedation is also one way to give chemical or physical restraint. Sometimes more dose is given to the patient than the usual doses of medicine to a person diagnosed with mental illness. The clinical factors according to which clinical factors are taken into account are the nature of the patient's condition, diagnosis of mental illness, and a series of medications. Although the restraints provide safety and containment at a time to patients but also it is a source of distress for representatives, staff, visitors, Support persons, and visitors (O’Connor et al., 2019).
Mental healthcare is provided to the patients to provide safety and wellbeing to patients. The activities are done to improve the overall experience of staff as well as patients with the strategies aiming at inclusion, sense of acceptance, and building connectedness. Restraints are given to the patient to keep them in proper condition and prevent them from falling. The patients in the hospital need restraints so that they do not develop scratches on the skin, harm others, get out of bed, or to give fluids and medicines. They should not be given because they harm the rights of the patient and are used as a source of punishment.
The ethical judgments of physical restraints in the ICN code of ethics state that they harm the ability of a person to make their decision on a personal level. Undoubtedly, they contravene the principle of autonomy because it breaches the freedom of the patient. In certain conditions, the informed consent is not possible majorly when the patient behaves involuntarily at the time of admission. This act is not considered as lawful for registered nurses as medical staff judges as a violation of patient rights (Mott, Poole & Kenrick, 2015).
In recent times, personal autonomy has important value and it should be respected and not disregarded according to mental health professional guidelines. It is because, the patients are administered to the patients with mental illness (Gowda et al., 2018). Moreover, mentally ill patients should be treated with the least involuntary treatment to ensure health and safety to others. Any type of medical intervention should be stopped to minimize the aggressive behavior of patients due to mental disorders. However, in terms of safety, mental health guardianship relates that the implementation of physical restraints guarantees the interest of people and the prevention of staff from getting harm. The alternative methods should be adopted by the staff to deal with mentally ill patients in using physical restraints (Currier & Allen 2016).
The registered nurse standards of practice dealing with the principle of justice and principle of beneficence for implementing the measures to address the needs of mentally ill patients. The physical restraint is blamed by the person because justice is ignored in this. However, physical restraint is unavoidable in nursing practice to manage violence created by the patients. The complaint relates to the basic needs of humans that are not fulfilled and are treated with harmful restraints. Although, the principles are meant to ensure that patients are benefited from the café provided to them.
Especially, some procedures are conducted to ensure beneficence in the way that protective intervention is designed to prevent the patient from physical injury. In the code of ethics and guidelines, the nursing staff is provided an obligation to provide appropriate care for the promotion of health as it is an important means of nursing care. The behavior risks associated with this are self-injury, aggression, and suicide. Hence, the main focus of restraint is to control the movement of a patient with mental disorders (Teece, Baker & Smith, 2020).
Although, the ICN code of ethics, nursing practices according to registered nurse standards and mental health guardianship act must be followed and physical or chemical restraint should be reduced. The principles, guidelines, codes, and standards should be taken into consideration. However, protection and safety should be ensured in the provision of care.
Currier, G. W., & Allen, M. H. (2016). Emergency psychiatry: physical and chemical restraint in the psychiatric emergency service. Psychiatric Services, 51(6), 717-719.
Gowda, G. S., Lepping, P., Noorthoorn, E. O., Ali, S. F., Kumar, C. N., Raveesh, B. N., & Math, S. B. (2018). Restraint prevalence and perceived coercion among psychiatric inpatients from South India: A prospective study. Asian journal of psychiatry, 36, 10-16.
Mott, S., Poole, J., & Kenrick, M. (2015). Physical and chemical restraints in acute care: Their potential impact on the rehabilitation of older people. International Journal of Nursing Practice, 11(3), 95-101.
O’Connor, L., Rebesco, M., Robinson, C., Gross, K., Castellana, A., O’Connor, M. J., & Restuccia, M. (2019). Outcomes of prehospital chemical sedation with ketamine versus haloperidol and benzodiazepine or physical restraint only. Prehospital Emergency Care, 23(2), 201-209.
Suliman, M. (2018). Prevalence of physical restraint among ventilated intensive care unit patients. Journal of clinical nursing, 27(19-20), 3490-3496.
Teece, A., Baker, J., & Smith, H. (2020). Identifying determinants for the application of physical or chemical restraint in the management of psychomotor agitation on the critical care unit. Journal of clinical nursing, 29(1-2), 5-19.
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