Physical And Chemical Restraints

The subject of how to ethically treat prisoners is a contentious one, and when the struggles of mental illness are added to the equation, it becomes even more complex. In attempt to manage difficult or dangerous prisoners, solitary confinement has increasingly became the punishment of choice by prison officials. Solitary confinement can intensify or aggravate detrimental occurrences in behavior in prisoners when they are exposed to this isolation for extended amounts of time. The article “Solitary Confinement and Mental Illness in U.S. Prisons: A Challenge for Medical Ethics,” was written by Jeffery L. Metzner M.D., a Clinical Professor of Psychiatry along with Senior Counsel of Human Rights Watch, Jamie

Physical/manual restraint by a team, mechanical restraint and seclusion should only be used for people detained in a mental health facility under the NSW Mental Health Act 2007 or the Mental Health (Forensic Provisions) Act 1990. If one of these interventions is applied to a voluntary patient, a Medical Officer (M.O.) must assess them as soon as possible after the event to review their status under the Mental Health Act.

As we all strive to encourage the use of verbal de-escalation and reduce the occurrence of physical restraint, I would like to request that all programs ensure they’re entering every student restraint or student disturbance into the Risk Management reporting site. This will allow team members to identify common barriers staff members face as well as identify best practices across programs. I believe that the most programs are entering these incidents and I would like to thank you for doing so! For programs that have not been entering student restraint or student disturbance incidents into the reporting site, please begin doing so immediately. Documenting every incident provides the student, staff, and AMIkids as a whole the ability to revisit any event in detail should any injuries or allegations occur from the incident; I cannot stress how important highly detailed documentation is.

Having poor heath care within the prison system is something that is very dangerous. It can lead to things such as accidental deaths, worsening pre-existing conditions, and conditions occurring that could have been prevented if the proper care was

The American Medical Association has described it as "a barbaric practice that needlessly inflicts excruciating pain and humiliation." The practice contravenes the United Nations convention against torture. Along with AMA, the Federal Bureau of Prisons, the U.S. Marshals Service, the American Correctional Association, the American College of Obstetricians and Gynecologists (ACOG), the American Civil Liberties Union (ACLU) and the American Public Health Association all oppose shackling women during labor, delivery, and postpartum recovery because it is unnecessary and dangerous to a woman's health and well-being. Shackling risks include increased duration and painfulness of labor as women who are shackled to a hospital bed cannot walk or change position. In fact, the vast majority of female prisoners or detainees incarcerated are non-violent offenders and restraining these prisoners and detainees increases their potential for physical harm from an accidental trip or fall ("Act to prohibit the shackling of pregnant prisoners"). Additional risks include delays if emergency operations are needed and increased risk of postpartum hemorrhaging as restraints on a pregnant woman can interfere with the medical staff's ability to appropriately assist in childbirth ("Act to prohibit the shackling of pregnant prisoners"). Especially for incarcerated women who lack adequate

and there is a gradual shift from injudicious use to patients being freed from restraints. "Decision-making related to physical restraint use is also influenced by nurse-related factors such as nurses’ perception of patient

In behavioral health nursing, using physical restraints is a very integral aspect to the overall health and well-being of patients and staff. Although this is still a very prominent and sensitive subject amongst healthcare professionals, I deemed it important that my facility implement and utilize physical restraints on our behavioral health unit. Nurses need to be educated on the use of restraints, which lead to my self-education on this topic. Nurses need to be aware of the benefits and the consequences that restraints can have on a patient.

Argument from health professional is that the use restraint is very vital to their security especially in situations where a patient poses the risk of being a menace to himself or others around them (Psychiatric Times, 2015).A study has showed that the act of violence and aggression against patients and nursing staff is unbelievably rising, with about ' more than half of NHS staff nurses 'being violently assaulted by patients in ‘2013-14’ (Nice, 2015). Even though, most of these attacks do not normally result in major injuries, they have caused staff to experience severe anxiety, emotional traumas and in some case ‘post-traumatic stress disorder’ (City University, London, 2009). Against these facts, it is believed that the use of restraint, especially in an Acute setting, is essential and ethical (Psychiatric Times, 2015). However, research has shown that there is a correlation between staffs reaction towards mental health patients and the violent and aggressive behaviour exhibited towards them. This typically occurs when patients feel they are being patronized, not made aware of what is going on around them and not treated well( Glover, 2005). With recent records of excessive and abusive use of restraint, there have being

not only harms the patient and places them sometimes in life and death situations but also it can

Incapacitation Theory is described to be the theory of Locking Up The Wicked. The Incapacitation Theory assumes that if we lock up every person that commits a crime and throw away the key, then it would be a better world with less criminals on the streets. But would it be better to lock up all the predators out there? Or would it cost America more to keep them locked up? Within the Incapacitation Theory there are two main points which are Selective Incapacitation and Collective Incapacitation. Selective Incapacitation is when the court system makes an attempt to determine which criminals are going to continue to commit crimes and to keep them locked up. Collective Incapacitation is used to describe locking up all criminals who commit certain

Although, it may seem self explanatory, it is important to evaluate why preventing restraints is important. Restraints are traumatic for the entire unit. What I mean by the unit is the entire secure area where patients are staying for their care, this includes, the staff, and any other patients who are there. When a restraint happens,

I strongly believe physical restraints are used to increase the patient’s safety but often has an effect opposite of the intended purpose, which is to protect the patient from injury. Under the review of literature that I have gone through, in my opinion restraints should be used according to the Least Restraint Policy ( J. Williams et al, 2010). The first rule as a nurse is to understand your patient that you are taking care and only then you will be able to figure out the reasons for a patients behaviour and can act accordingly by taking into account the alternative measures. As nurses we should consider the risk of using a restraint and must use our clinical judgment and decision making power to make the best choice for the patient.

The first step in identifying concerns that impede patient care is to educate staff, enhancing their understanding of nursing-sensitive indicators, and how to improve quality of care through recognition of those indicators (ANA, 1999). In the scenario regarding Mr. J, many concerns are identified which makes me question the organizations awareness of nursing-sensitive indicators, hence the lack of staff education. A significant nursing-sensitive indicator acknowledged in this scenario is the use of restraints. What is the reasoning for the use of restraints on Mr. J? What knowledge do the nurses have regarding the use of restraints on patients? Do the nurses understand state and federal regulations and potential risks for both patient and staff associated with the use of physical restraints? What alternatives were recognized and utilized before initiating restraint’s on Mr. J? There appears to be a lack of education amongst the nursing staff relevant to the use

The use of physical restraint is quite common among caregivers in health facilities when dealing with geriatric patients. Yet this topic is one of the most debated issues in healthcare and medicine. The purpose of medical restraints is to prevent patients from harming themselves or those around them. It seems to be a simple solution and panacea for unruly patients who needs to be treated. However, ethical implications surround its usage as the practice of physically restricting people strips them of their autonomy as well as other psychological factors, such as agitation and trauma. Therein lies the dilemma on how to approach such an issue.

Restraints of any kinds are administered by a protocol that ensures that it is properly and correctly applied. Though patients are not independent at the time when a decision to restraint is taken, explaining to them why the restraints are needed to protects their right to self determination. By doing this, autonomy will be considered, and they do not feel restraints used as a punishment. If a patient is unconscious or not competent enough to consent for restraint, then substitute decision maker should be involved to get consent on behalf of a patient. Nurses should closely monitor the patient with restraints to ensure safety, look for the earliest and safest time to remove the restraints, and frequently offer help to a person with restraints