Week 2 Discussion
Ethical and Legal consideration of constraints
Restraints is a clinical treatment method used in hospitals for many reasons, such as protecting manic patients from harming themselves or others and preventing demented patients from pulling out their tubes. There are three types of restraints: physical restraints, chemical restraints, and environmental restraints. It is usually the last resort for healthcare providers after all other interventions such as verbal de-escalation failed.
Ethical Consideration of Restraints for Adult Patients
Restraints usually happen in emergencies, healthcare providers will apply them against the patient’s will, which caused considerable ethical dilemmas in clinical. Considering the patient’s safety and autonomy, providers have to weigh the outcome of its use against the outcomes of not using it. Healthcare providers have to receive professional training about the protocols of restraints, familiar with evidence-based guidelines, and legal problems associated with restraints. When restraints are used, they should only limit the movements that may cause harm to the patients or others. Restraints should never be used for the caregiver’s convenience or threatening. If all other less restrictive treatments are failed, restraints are inevitable, providers will make sure that the patients still have their rights during the restraints. Also, the further need for restraints should be assessed continually by healthcare authorities, so, the restraints can be discontinued as soon as possible (Salehi, & others, 2019).
Legal Consideration for Restraints for Adult Patients
Restraint should be used as a last choice and only be imposed when necessary to protect the patient from harming themselves or others. Patients’ rights should be always protected and promoted during the restraint period. Such as privacy, safety, and the right to be free from all forms of abuse or harassment. The attending physician must be consulted as soon as possible. Providers should debrief with the patient and family to discuss the previous interventions and alternatives to restraints. Each restraint order may only be renewed 4 hours later for adults, and it will expire within 24 hours. The restraint order must be discontinued at the earliest possible time (Public Health, 2018). The Code of Regulation also listed many other legal considerations related to restraints and seclusions.
Ethical Consideration of Restraints on Children/Adolescents
Physical restraint used for children and adolescents in mental health facilities requires particular ethical and legal consideration, it is often used as a reactive behavior management strategy for aggressive behaviors. We all realize that restraints limit the patient’s physical movement, and may cause some physical injuries if it is not used appropriately, but we can’t ignore that they could cause severe and long-term psychological consequences for children or adolescents who experienced restraints and seclusions (Nielson, 2021) ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE.
Providers need to understand the consequences of physical restraint on a child’s physical and mental well-being. Children and adolescents are mentally immature, they may feel defended, and they will experience anger, fear, anxiety, and many other negative emotions. According to some patients’ retrospect reviews, being physically restrained is a severely traumatic experience, it caused physical injury as well as psychological damage. Also, reports suggested that the use of restraint within mental health facilities can damage the therapeutic relationship between patients and healthcare providers.
Legal Consideration to Restraints on Children/Adolescents
Due to the tension between the patient’s right to freedom and the healthcare provider’s duty, healthcare providers may face potential claims of improperly detaining patients, false imprisonment, or harming children when restraints are applied. The use of restraints is among the most controversial practices in mental health care, especially for children and adolescents. Children and adolescents are considered the most vulnerable population among mental health patients. Federal and state law shared a desire to provide minor patients with the greatest protections regarding the usage of restraints and seclusion. Providers are mandated to notify the parents and legal guardians of the use of restraints as soon as possible, they will supply a copy of the restraint policy and obtain a written acknowledgment of the policy from the parents. (Neiman, Pelkey, & Holloway, 2016).
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