Running head: Attitudes, Opinions, Behaviors, and Emotions toward Patient Restraint

Attitudes, Opinions, Behaviors, and Emotions toward Patient Restraint

Anzhela Fedoronchuk
Student ID: N00989267
Instructor: Mary McGrory (Monday)
NURS 150-0NC
March 5, 2015
Humber College

Running head: Attitudes, Opinions, Behaviors, and Emotions toward Patient Restraint

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Attitudes, Opinions, Behaviors, and Emotions toward Patient Restraint

The main idea of using any form of restraint is to manage client behavior in therapeutic
manner. Sometimes it is hard to cooperate with the client for better curative treatment. For that
reason, nurses have to be well educated on how to deal with clients and know their personal
needs. I choose the article Attitudes, opinions, behaviors, and emotions of the nursing staff
toward patient restraint by Gelkopf, Roffe, &Behrbalk, because I think that every nurse at least
once had an experience of performing restraint, but not always it really needs to be done.
Difficult situations that seems have no solution without restraint may not be always the case of
performing it. The authors of the article discuss the main idea about why nurses use the restraint
in their practice, and what the statistics look like toward the patient restraint. In addition, the
authors mentioned that Physical restraints are used as a psychiatric intervention to protect
psychiatric inpatients from self-harm or harm to others, by securing a safe environment
(Gelkopf et al., 2009, p. 758). Lev Hasharon Mental Health Centre decided to test one hospital,
especially nurse and the results of the questionnaire were very interesting. The results of
emotional test on how nurses think that the restrained patients feel; it shows that actually the
higher percentage of patients feel anger and fear during the procedure of aphysical restraint. The
other test was about what are the nurses` beliefs related to emotional influence of the restraint.
Most of them consider that the manner of restraint may calm down patients` attitude. Similar, the
results of the questionnaire about environmental conditions that may influence restraint shows
that the highest percentage why nurses use restraint is because of appropriate medical drug
treatment. Moreover, the environment around the patient may not always be pleasant. For
example, Lev Hasharon Mental Health Centre may influence on the patients behavior, negative
emotions, cognitive development that leads to violations and next the least possible restraint.

Running head: Attitudes, Opinions, Behaviors, and Emotions toward Patient Restraint

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Restraints are commonly used in geriatric health care settings. The main idea of
performing restrain is to promote safety on the first plan. According to CNO Practice Standards,
Least restraint means all possible alternative interventions are exhausted before deciding to use
a restraint (2009). I agree with the author of the article Karlsson,Bucht, Eriksson, &Sandman
(2001) Factors relating to the use of physical restraints in geriatric care settings that the
conflict between patients and nurses may happen because of different factors as a result a
restraint will be an active form to control behavior and movement of residents. The use of
physical restraint on elder people most of the time influence on their health. It is very interesting
how emotionally and physically an elder person may change during a restraint procedure. There
are three important factors why nurses may decide to provide physical restraint on patients, such
as risk for fall and physical dependent on assistant, refusing of medication administration and
refusing of treatment, violation of behavior and cognitive impaired residents.
The reasonable purpose of implementation of a restraint is because the resident is at risk
for fall. People who live in geriatric health care facilities have to be assess for risk for fall and
level of dependency. The primary concept of doing that is because some of them may need more
attention and help from nurses. In the article about factor relating to restraint, the author explains
that In the present study, a physical restraint is defined as a mechanical device inhibiting free
physical movement, including chair belts, geriatric chairs with fixed tray table, and locked room
doors(Karlsson, 2001, p.1723). I think that the importance of using these devices is valuable
and could be used for safety reasons. Moreover, patients who are dependent on nurses and need
help in decision making for their health should be under control to make sure that the patient is
safe. For example, the resident who has Dementia, Alzheimers, cognitive impaired needs extra
attention and could be at risk for fall because of medication adverse effect and may be restrained

Running head: Attitudes, Opinions, Behaviors, and Emotions toward Patient Restraint

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by doctors order. These people cannot decide for themselves; POA will take care of them; nurses
should observe the patient and prevent risk fall. Sometimes patients may refuse to take
medication. Ensuring that patients know they have a right to refuse the drug being administrated
and informing them properly of the potential consequences of refusal (Lilley, Harrington,
Snyder, 2011, p.13). There is an exception if the patient has a trachea, IV, G-tube, and wants to
remove it, because he is cognitive impaired or has other issues related to mental health. The
nursing intervention will be to prevent the patient from self-harm and life threatening.
Nurses have to use their therapeutic relationship with the client in order to maintain his
well-being. According to CNO Practice of Standards, Promoting client well-being means
facilitating the client`s health and welfare, and preventing, or removing harm (2009). Nurse
must understand and use all possible interventions that to reduce patients` violated behavior.
They should teach, listen, use therapeutic methods and plan in advance their actions for patients`
positive attitude. It is hard to manage the patients` negative behavior, but to prevent and to
predict clients` violation is better way to avoid restraint. People usually feel aggressive, agitated,
and sad when they are restrained. Most often they just have lack of understanding. Nurse should
find individual care plan and therapeutic relationship with the client.
I agree with the authors` point of view about factors that influence on patient restraint
that cognitive impaired older people may be restrained for their well-being and safety reasons.
Nurses, who have lack of knowledge on how to cooperate with patients, mostly prefer to use
restraint. Older people with mental issues need extra attention and time for their positive
behavior. It is not easy to manage stressed situations in mental health settings, geriatric care
settings, hospitals, but the more experience the nurse professional has, the more problem solving
and decision making processes are successful.

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To conclude, I think that education regarding restraint is important and needed in many
health care settings. Nurses have to be creative, kind, and develop therapeutic relationship with
the client that to understand, help the patient to relax, and feel better. Physical restraint is the
least thing that the nurse can do. Person might feel agitated at one time but maybe he just need
attention, but not the restraint that can increase his feeling in more negative way. It would be
better to assess the patient and discover main reasons why the patient violates or behaves in not a
proper mood. There should be a logical reason for client`s expressions and actions. The two
articles that I have read were similar in the way of understanding the problem before actually act
for restraint. The first article explained more about difference in nurses` mood and patients`
mood during restraint in the hospital. The second article was concentrated on factors that related
to the use of restraint. To my mind, the education about physical restraint have to be reviewed by
nurses, and prevention of violation must be done in advance by assessing the patient.

Running head: Attitudes, Opinions, Behaviors, and Emotions toward Patient Restraint

References

CNO. (2009). Ethics. Standards & Guidelines. Retrieved from

http://www.cno.org/Global/docs/prac/41034_Ethics.pdf
CNO. (2009). Restraint. Standards & Guidelines. Retrieved from
http://www.cno.org/Global/docs/prac/41043_Restraints.pdf
Gelkopf, M., Roffe, Z., Werbloff, N., &Bleich, A. (2009). Attitudes, Opinions, Behaviors, and
Emotions of the nursing staff toward patient restraint. Issues in Mental Health Nursing,
30(12), 758-763.
Karlsson, S., Bucht, G., Eriksson, S., & Sandman, P. (2001). Factors Relating to the Use of
Physical Restraints in Geriatric Care Settings. Journal of the American Geriatrics
Society, 49(12), 1722-1728.
Lilley, L.L., Harrington, S., & Snyder, J.S. (2011, p.13). Rights of Medication Administration:
The Five, Seven, or Ten Rights. Pharmacology for Canadian Health Care Practice.
Second Edition. Toronto, ON: Elsevier Canada