Essay On Patient Restraints

Restraints are defined as, “a measure or condition that keeps someone or something under control or within limits” (Google 1). How would someone feel if he or she were restrained from natural movement or thinking? In the medical field, restraints are meant to be used to prevent harm of the patient and others with a doctor's order, yet this is not always the case. Restraints in today's time hold a negative connotation although are necessary for patient safety.
In an article written by Samantha P. Ziglar, BSN, RN, she describes the main purpose of restraints through her eyes in the medical field. Ziglar states that at least one in every four patients will be restrained at least once, that’s 79.715 million people in the United States (Population). “Specific reasons include fall prevention, limiting wandering behavior and preventing dislodging or interference of therapeutic devices, and controlling violent or agitated behavior” (Ziglar 1). Ziglar emphasises the growing problem among restraints; improper use among nurses. “Patient safety should be every nurse’s top priority; therefore, nurses need to have a thorough knowledge base of the risks and benefits of using physical restraints” (1). As a result of what a nurse needs, restraints are required to succeed in his or her profession, making their patient as safe and comfortable as possible. The purpose of restraints as a whole is to provide patient protection. Ziglar lists the pros and cons of the use of restraints. Some major

negative effects listed included death by strangulation, fall injuries, deconditioning, skin breakdown, incontinence, constipation and psychological effects such as agitation and emotional distress (1). While there are negative effects of restraints to the patient, she also describes the negative effects towards the caregiver after the injury has occurred. To resolve these negative effects, nurses can begin by furthering their education on how to use the restraint as well as the individual's needs using the restraint, this can be accomplished through classes or observations (1). Physical restraints are well known, however, there are other forms of restraining an individual such as chemical restraints.
According to, “Nursing Home Abuse Guide” presented by Paul & Perkins PA, a “Chemical restraint is defined as the use of any type of drug to restrict an individual’s movement or freedom”, they are used to sedate individuals. Chemical restraints may also be referred to as psycho-pharmacological drugs, or replacing the word sedative with anti-anxiety medications (Hughes 1). The use of these medications is not the problem, it is the over and misuse of the medications. It is illegal to give these medications to patients who do not need the drug, but have given it by the nurse to sedate the patient. If not used correctly, these drugs could lead to death due to their side effects (1). There are laws for the use of chemical restraints,”chemical restraints may only be used to ensure the physical safety of residents and other individuals” (1). Additionally, as a standard, a doctor's order must be signed before restraints can be applied. The resident or resident’s representative has the right to refuse the use of a chemical restraint, even when recommended by a physician”(1). Patient’s rights are not to be neglected, when going against a patient's rights is when malpractice among the caregiver starts.
To view one's ample, a caregiver who experienced the use of restraints first hand is a nurse by the name of Chad. Chad tells his story including experiences with restraints and a former patient, an eleven year old boy (Jack) with a history of abuse, neglect, self harm and aggressive behaviors (Chad 1). With Jack's background in mind Chad knew he had to keep his guard up. Chad had to break bad news to Jack, he would not be going home, instead he would be joining a secure facility for further treatment (1). Chad did not know what to expect as an outcome from Jack while delivering this news. Jack was out ragged and through a headset at Chad before storming out of the room and slamming the door into another (1). Chad, following procedure, watched over the video monitor to observe Jack ripping a stuffed animal apart (1). In confusion Chad went to see what Jacks purpose in ripping the stuffed animal was, only to walk in on him cutting himself with a broken compact disc he hid inside the stuffed animal (1). Chad as the care-provider used instinct to foreshadow Jack’s behavior. Immediately Chad yelled for assistance to take the sharp object away, multiple people holding Jack down in this process, as they waited for the restraint order to go through. Holding Jack down was a form of physical restraint, caregivers have to careful during the time period between ordering a restraint and receiving it. Finally the order was approved and Jack was put in a restraint for his own good, eventually jack calmed down and went to sleep (1). Restraints are necessary and very useful if used in the correct way. Chad’s experience just indicates restraints can be a positive tool to use if used correctly with the right approval.

According to an article by C Gastmans and K Milisen,
“Use of physical restraints in nursing homes:clinical ethical consideration”, physical restraints are defined as,”any device, material or equipment attached to or near a person’s body and which cannot be controlled or easily removed by the person and which deliberately prevents or is deliberately intended to prevent a person’s free body movement to a position of choice and/or a person’s normal access to their body”(Gastmans

1).