Running head: RESTRAINTS AGAINST PSYCHIATRIC PATIENTS
The use of Physical and Chemical Restraints against Psychiatric Patients
Ashley Couturier
Ferris State University
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Abstract
Psychiatric facilities have been around for centuries treating patients with mental health
problems. It was considered ethical to apply restraints to patients that had behavioral problems.
Today physical and chemical restraints have been used unethically and have led to multiple
safety issues. Betty Neuman’s Theory about how the change in environment can be a stressor
and how the impact of restraints can affect psychiatric patients.
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The use of Physical and Chemical Restraints against Psychiatric Patients
Restraints have been used for many centuries in psychiatric facilities in hopes to keep
mental health patients and their nurses “safe” during treatment. Unfortunately there is only a
small margin of orders are truly justified many have become known as abuse. Physical and
chemical restraints have had many safety and ethical issues and have been drastically reduced in
the psychiatric facilities. Multiple people view this type of treatment a violation of a patient’s
basic human right and are considered cruel and harsh punishment. As a nurse it is their
responsibility to not only to follow proper safety protocols and just reasons for restraints but also
treat each mental health patient with dignity and respect.
Physical Restraints
“Physical appliance that inhibits free physical movement and cannot be removed by the
person to whom they are applied, such as jacket or hand restraints” (Mossa & Jeenah, 2009, 7275).
“Psychiatric facilities often use medical interventions in the form of restraint or seclusion
to reduce safety risks posed by violent patients and to prevent patients from harming
themselves and others. In fact, there are approximately 47 situations a month, per
psychiatric treatment facility, in which restraints or seclusion is used” (Luna, 2001).
The use of physical restraints can help in emergency situations, but can also make a patient
worse when they feel they have no control over their bodies. Physical restraints need to be
closely monitored and clearly documented to ensure patient safety.
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Chemical Restraints
Chemical restraints are beginning to be used more to control a person’s behavior.
Psychiatric patients are becoming medicated zombies due to the shortage of nurses which are
necessitating the use of chemical restraints. “Restraint and seclusion can only be used to ensure
the patient’s safety or the safety of others during an emergency safety situation” (Luna, 2001).
“Chemical restraint is a means of medication given primarily to control a person’s behavior, not
to treat a mental illness or physical condition. Chemical restraint occurs when medication is
intentionally given to exert control over a patient’s movement or behavior” (Lambeth, 2013).
Nursing Theory
It is crucial to establish a stable environment for psychiatric patients, because they are
already struggling mentally trying to become stable in their own mind. When stresses, such as
restraints, are introduced it throws the patient’s environment into a traumatic chaos. Theorist
Betty Neuman defined nursing as “Action which assist individual, families, and groups to
maintain a maximum level of wellness, and the primary aim is stability of the patient / client
system, through nursing interventions to reduce stressors” (Betty Neuman’s System Model,
2013). Betty Neuman defines a person as “as a client system and the person is a
multidimensional being”. One of which is psychological, which encompasses the mental and
emotional process (Betty Neuman’s System Model, 2013). Neuman also reflects on the
environment aspect stating that “the totality of the internal and external forces (intrapersonal,
interpersonal, and extrapersonal stressors) which surround a person with which they interact at
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any given time”. Neumans prevention technique is focusing on keeping things that stress the
body and how the body response from having an impact on the body. (Betty Neuman’s System
Model, 2013)
Conclusion
“Reports of patient death and injury while in restraints and studies of patients’
experiences in restraints and seclusion have prompted psychiatric-mental health nurses to
question the benefit of secluding and restraining psychiatric patients”(American Psychiatric
Nurses Association, 2007). There have been many attempts to regulate the use of restraints in
mental health facilities. “Legislation that would regulate the use of restraints and seclusion in
mental health facilities was introduced in both the house of Congress in late march of 1999”
(Psychiatric Services, 1999). In conclusion, the American Psychiatric Association states that in
order to use restraints properly, the staff has to be trained how to use restraints safely. Until all
psychiatric medical staff have proper training in regards to using physical and chemical restraints
the same ethical and safety issues will continue.
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References
American Psychiatric Nurses Association. (2007, May 26). 2007 Position Statement on the Use
of Seclusion and Restraint. Retrieved from www.apna.org/files/public/apna_sr_position_
statement_final.pdf
Betty Neuman’s System Model. (2013). In Current Nursing. Retrieved from
currentnursing.com/nursing-theory./neuman.html
Lambeth, L. (2013). Chemical Restraint. In Mental Health Act.
http://www.dhhs.tas.gov.au/__data/assets/pdf_file/0004/148261/24_CFP_Clinical_Guidelin
e_10_-_Chemical_Restraint.pdf
Luna, J. (2001, August 29). Limiting the Use of Restraint and Seclusion in Psychiatric Treatment
Facilities for Patients under 21. In limiting the use of Restraints and Seclusion, Health
Law and Policy Institute. Retrieved from http://www.law.uh.edu/healthlaw/perspectives
/Mental/010829Limiting.html
Moosa, M., and Jeenah, F. (2009, October). The use of restraints in psychiatric patients
[Electronic version]. , 15 (3), 72-75.
Psychiatric Services. (1999, May). Legislation to Regulate Use of Restraints and Seclusion in
Mental Health Facilities Introduced in Congress. Pubmed.
http://www.ncbi.nlm.nih.gov/pubmed/10332916
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APA Rubric (150 Points)
Points
Points
Possible
Earned
10
Peer Review Checklist
Submits peer review checklist and signature
10
25
Proper APA format: Title page, Typeface, Running head & page
numbers, Margins, Indents, & Spacing, Headings, Abbreviations
Subject matter and Body of Paper
Evidence of scholarly writing and research. Paper is written
concisely and coherently. Critical thinking is evident. Key elements
of assignments covered
Content is comprehensive/accurate/persuasive
Displays an understanding of relevant theory
Major points supported by specific details/examples
Research is adequate/timely
25
35
32
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28
In text Citations and Quotes
25
21
Proper APA format per APA 6th ed.
References (minimum of 3 appropriate APA scholarly resources;
25
24
Nursing Theory
Addresses, defines and relates at least one pertinent Nursing
Theory to the safety/quality topic of the paper
Writer compares/contrasts/integrates theory/subject matter with work
environment/experience
At an appropriate level, the writer analyzes and synthesizes
theory/practice to develop new ideas and ways of conceptualizing
and performing
at least one must be a scholarly journal article)
Reference page cited in proper APA format
Total
140