Effectiveness of Restraints

Miss Use of Restraints within The Health Care system

Jaspreet Kaur
822 297 909
Humber College-North Campus
Nursing Theory-260
Franklin Gorospe
Febuary 24th, 2014

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While health care providers in the hospitals focus their primary concerns on helping their
patients recover from various medical conditions, the lack of research is unforgettable. In order to assist
with a hospital visit, there are numerous factors involved in making sure adequate care is provided to
the patient. The article I chose is Attitudes, Opinions, Behaviours and Emotions of the Nursing Staff
Toward Patient Restraint by Marc Gelkopf. In this article, different aspects of nursing and restraints are
discussed; allowing the reader to understand the opinions of nurses towards restraints. On the contrary,
I decided to compare the article Canadian Critical Care Nurses and Physical Restraints by Beverly
Leith in order to recognize specific similarities and differences that may be relevant in comparing
nurses and their every day work. The article by Marc Gelkopf relates to the article written by Leith B,
because they both discuss the unnecessary punishment of restraints on vulnerable patients. Both of
these articles state and explain the abuse that goes on in a hospital due to the lack of informal education
of the patients and staff (Gelkopf, 2009; Leith, 1999). Furthermore, it expresses the multiple ways
critical situations are handled by males and females, concluding that males are at a decreased chance of
coming to a conclusion to use restraints whereas females jump directly into using a restraint Finally, it
goes on to explain the trials and tribulations that patients experience with the use of restraints, which
also negatively affects their health in the long term. The reason why I selected this certain topic was
because initially I thought this article would explain a positive side to why restraints are good
alternatives to use at hospitals but while reading it, it clearly changed my mind. These techniques
should be considered a last resort for hospitals, as I did not know that hospitals already take undue
advantage for these medications. As I further progress my thesis into a series of arguments, I will
examine the critical disadvantages of the use of restraints and supply the reader with different
suggestions on how the nursing practice in a hospital can change into a positive environment while
using restraints simultaneously.

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Both the authors from these articles discuss the negative use of restraints where the surveys that
were taken by many different health care providers that proved the neglect that patients feel by nurses
as they are being tied down to their bed. Studies in both these articles have proven that the lack of
knowledge that nurses have about holding a patient down is interfering with the care provided by them
drastically. However these problems can be solved in several different ways, which will make a great
positive impact on nursing practises in many situations. Gelkopf (2009) expresses her findings by
explaining frustration that nurses feel when prompt education is given about those certain restraints. If
more education were given to nurses on how to deal with angry patients then nurses would not jump
to the conclusion of restraining a patient so fast. According to both studies, approximately 38% percent
of nurses said that they use a restraining tool when they feel fear or when they are annoyed (Gelkopf,
2009; Leith, 1999).. Another suggestion that can be taken in consideration is that if there was an equal
amount of males and females present on the unit, things may turn for the better. As proven in the study
of Marc Gelkopf (2009), more males present on the unit decreases the percent of restrains used on
patients. At most times, they are able to show authority and able to make the unit a safe environment
whereas female nurses tend to restrain the patient so that they can continue with their day at work.
Lastly, if more restrictions were put against when restrains can be used, this would minimize the use of
them on many patients ultimately affecting their treatment in a positive manner. For example, 3
warnings could be given to allow the patient to know if they are doing something wrong. What I learnt
from reading both these articles is that education is very important when it comes to understanding
your patient and their needs and wants. Both of the articles talk about how gender plays a key role in
how health care providers deal with restraining patients. In my opinion, if health care providers were
forced to take continuing education classes where they were taught how to deal with mental patients,
then the percentage of restraints used each year would decrease drastically. One way an organization
could do this is by reinforcing both new and senior nurses to take a two-day class every three to four

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years. This would be a good way to refresh their memory. This would also influence the care provided
in a positive manner because patients that are not mentally stable would feel more comfortable and
would be easily taken care of in order to ensure quality care was given.
After reading both articles and reviewing the standards of guidelines for nursing, I agree with
the terms outlined in CNO (Practice Standards Restraints, 2009) in comparison to the point of views
of both authors. Under the outlines of restraints in CNO, it discusses the importance of nurses to be
educated with restraints (Practice Standards Restraints, 2009, p. 5). Another important guideline that
is outlined in the CNO that needs to be a measurement tool to help indicate if effective restraining
guidelines are being followed and if nurses are being well educated in these categories, ultimately
proving to be very effective. If more awareness was published into hospitals in forms of paper media
and continuing education, on how to deal with different patients and different methods of approaching
patients, then nurses would not have to jump straight into applying force in order to get control on a
patient. Another CNO (Practice Standards Therapeutic, 2009) guideline that relates to the articles
listed about is therapeutic responses with a client and their patient, when talking about respect in a
definite manner. It emphasizes on the importance of presences of respect that each individual is entitled
to. This relates to the articles mentioned previously because Marc Gelkopf elaborates on the lack of
respect that patients feel. Overall, reading both the articles has helped me clarify my understanding
about restraints and what they should actually be used for. After reading thoroughly, I realized that
although hospital settings are supposed to be considered safe environments, a lot of miss use with
equipment goes on where patients suffer ultimately banishing the idea of safe in terms of patient care.
In my point-of-view, these can be interpreted as a type of abuse because ultimately the patient is not
getting the best medical care for their health. I am now more aware of the different types of changes
that are required in order to make a hospital setting more safe and applicable to patients.

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As a future nurse, this article definitely affects me and shines light in a positive manner because
once I graduate and become a nurse; I will be a part of this team. As a future healthcare provider, I
believe that it is our job to ensure a positive outlook for patients and visitors that will positively affect
the stature of the nursing staff and hospital itself. Ultimately, this will guarantee that the best quality of
care is being provided to the community. Over the course of this semester and during my clinical
placement, I have learnt that nursing is a teamwork-orientated facility that requires utmost dedication
and compassion. This helps me understand the importance of providing our patients with the best care
possible. In order to make a change and improve the health care system, these mistakes have to be
recognized and corrected. The articles listed above (Gelkopf, 2009; Leith, 1999) have helped me
deviate the areas of improvement. If we as a community work together and try to achieve these goals as
a whole, the outlook of care provided at hospitals will drastically change in a positive direction.
Overall, with some moderate changes done to the healthcare system, great improvement can be
achieved. Both Authors Marc Gelkopf and Beverly Leith emphasize a great deal, on how the use of
restraints can be improved in order to ensure adequate quality of care is provided. The consistency of
knowledge that is not required for nurses is putting the patients of these nurses in great misery. This
contradicts with the CNO standards and guidelines, as patients feel a lack of respect and privacy taken
away by their nurses. While I am just a student and many may feel that a change will not occur, if we as
a community can come together to guarantee a change is made, we can then help the hospitalization of
a patient a pleasant recovery.

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Bibliography
Gelkopf, M. (2009). Attitudes, Opinions, Behaviours, and Emotions of the Nursing Staff
Toward Patient Restraint. Informa Healthcare. Retrieved February 18, 2014, from
http://www.ncbi.nlm.nih.gov/pubmed/19916810
Leith, B. (1999). Canadian Association of Critical Care Nurses. NCBI, 10, 10-14. Retrieved
February 18, 2014, from http://www.ncbi.nlm.nih.gov/pubmed/10347502
Practice Standard Restraints (p. 5). (2009). Quality Practice Settings. Toronto: College of
Nurses of Ontario.
Practice Standard Therapeutics. (2009).Toronto: College of Nurses of Ontario.