Essay on Use of Restraints on the Psych/Mental Health Unit

Introduction

The people with a mental health condition are at times unstable to the point that they require restriction since they may cause harm to themselves and others around them. Restraining the patients has been done using chemical and physical means. At times, it is considered as something to protect the mentally-sick patients while at times, it is seen as an abuse of power by the medical providers. In the recent years, the topic of the use of restraints has increased to be sensitive due to the physicians abusing their power in the name of protecting the patients. The number of the patients being admitted in the psych wards are increasing over time, thus causing an issue in taking care of the patients since the number of nurses is limited, there are fewer beds for the inpatient services and as well, no enough medication. Restricting is thus used to reduce the burden of taking care of the psychic ward. The following work will help investigate the use of retrains, the reasons behind it and impacts on patients using the system theory.

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Most of the families take their patients for patients in the mental hospitals and abandon them there. They pay for only the initial fee and leave the burden to the hospitals. The more the number of abandoned patients, the more they will be neglected. The hospital management may consider that such people do not have rights and they end up being deprived of liberty. The patients who are being paid for are given the advantage of medical attention while the rest are restricted to avoid causing chaos or making it hard for the nurses to operate. Some are given chemicals so that they can sleep for days which reduce their dietary needs or being given medication (Murphy and Bennington-Davis, Maggie, 2005).

The mental hospitals are increasingly becoming a dangerous place, and both healthcare providers and patients require protection. The patients are now more aggressive considering that the highest number is admitted due to previous substance use and they are not able to control their behavior. The mentally-ill people are a danger to the society, and when taken to the psychic wards, they threaten the existing people. There have been cases of female nurses being harassed and sexually abused by people with a mental health condition. Some even physically beat the nurses and fellow patients. Such people make it hard for the operations to be carried out and they have to be restrained till when they can control their violent behavior. In this case, the restraints may be justifiable as it is for the protection of all the people in the mental institution. There are studies which show that some mental institutions restrict their patients as a norm and not the characteristics of the patient. Some hospitals believe that the recuperation of the patients is based on being restrained using either chemicals or physical measures so that they can learn to control their behavior.

The studies done on using of retrains in the mental institutions indicate that there are adverse effects. Death is one of the side effects, for example, where continuous chemicals are used on a patient to keep them less active, they interfere with the normal functioning of the body. Eventually, the patients will die due to overdose or even the chemicals poisoning the body of the patient (Shives, 2007). In the United States, research shows that about fifty to one hundred and fifty deaths occur annually due to retraining the patients. Holding the patients against their will may even worsen their mental condition instead of helping them to recuperate. The more they struggle to get free, the worse they get and do not even respond to medication and thus taking longer to get healed and released from the hospitals.

The issues associated with retraining the patients resulted in the introduction of Health Care Financing Administration (HCFA). The policy was to ensure that mental facilities would receive Medicaid and Medicare payments to fund the hospital running such as purchasing medical supplies and requirements such as beds. There are also rules which outline the rights of the patients in the psychiatric hospitals and addressed the use of restraints and seclusion, and under the conditions, they should be used (Johnson, Miller and Horowitz, 2008). These are rules meant to make sure that the patients and their family members are aware of the rights of the mentally-ill patients in regards to how they should be treated and handles. The funding approaches are also meant to create equality for the patients to avoid denying some medical treatments because their families have not been paying for the medical requirements.

In defense to the use of restraints, most mental institutions indicate that putting the patients in seclusion or being retrained is necessary on immediate arrival to the hospital for several reasons. To begin with, the nurses are not aware of the extent of the mental health status of the patients and how they will be reacting after learning that they will be hospitalized against their will and forced to take medication. It is thus necessary to seclude them for a period to determine how they respond to different situations before letting them interact with the rest of the patients. Permissive medical rules are guiding every hospital though they tend to be ignored depending on factors such as payment of hospital bill and the number of nurses that are available to handle the mentally-ill patients. The HCFA standards indicate that no medical provider has the power to order a restriction except a face-to-face with a doctor which is required to last for one hour. The period under which the restriction should be done is also indicated which is four hours for adult patients, from 9-17 years, they should be restricted for 2 hours and one hour for under nine years old children (Meyer and O'Brien-Pallas, 2010).

Conclusion

In conclusion, since the effects of seclusion or retraining the people with a mental health condition have adverse effects, it would be wise to have training mission for the nurses and doctors dealing with the people with a mental health condition. When these care providers are trained, they can be able to handle even the violent patients without restricting them, unless they are more energetic or pose a threat to themselves such as a suicidal case or terrorizing the rest of the patients. The government should also take the responsibility of financing the mental institutions. It will make sure that patients are given equal treatment, and some are not retrained to create space for the patients who can afford to pay. Seclusion and restricting policies should be implemented in every mental hospital and punishment also applied for the medical providers who will be using either physical or chemical restrictions.

References

Johnson, J. K., Miller, S. H., & Horowitz, S. D. (2008). Systems-based practice: Improving the safety and quality of patient care by recognizing and improving the systems in which we work. Retrieved from http://www.ahrq.gov/downloads/pub/advances2/vol2/Advances-Johnson_90.pdf

Meyer, R. M., & O'Brien-Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828-2838.

Murphy, T., Murphy, Tim., & Bennington-Davis, Maggie. (2005). Restraint and seclusion: The model of eliminating their use in healthcare. Marblehead, MA: HCPro, Inc.

Shives, L. R. (2007). Basic concepts of psychiatric - mental health nursing. Philadelphia: Lippincott Williams & Wilkins.