Is this restraint issue a dilemma that can go to the ethical committee?

Nurses General Nursing

Published

I'll keep it brief.

Situation: Pt is A + O x 4. He is able to understand. However, he constantly pulls IV, kicks, pulls O2 off, tries to pull foley, etc. This is after acknowledging that this can hurt him...3x times in a row. IV's re-inserted again and so on. RN finally decides to assign a LVN to be a sitter. LVN is unable to keep her from pulling and calming her down. Finally, LVN decides to call in mechanical restraints. Family is also at bedside but said they disagreed with putting restraints on and said he isn't doing any harm and needs to be calmed down. Argument ensues. Mechanical restraints are finally put on. Within 30 minutes, an MD order for restraints is obtained. Pt is no longer able to pick at IV. Family is angry. Nurses are stressed.

Added to the mess was also all 4 guardrails being up, which means safety and false imprisonment.

The above was a moment in my first semester. For my part, I did not put restraints on the other side because it was against the family's wishes and at the time, i thought we can somehow calm the pt down in another way. At the same time, I realized safety was an issue and the pt can't keep picking at IV's etc.

Is this a dilemma that can potentially go to the ethical committee? This is for a research project and there must be more than 2 correct options to go about in this situation. What do you guys think?

Sometimes I have put pt's on their stomachs. It is not always a way of doing this but I do understand your frustration. I have been in predicaments and I always call the "Alpha-Dog" on the unit be it supervisor, old timer, or just the person who can give you good advise. I do not know how your facility might choose to interpret your action but CYA ...most important thing as well as pt care. If this pt needed this treatment and was able to sign themselves in ...I would hope things would go in favor of his care. GOD BLESS!

Specializes in Hospital Education Coordinator.

foro the purpose of your paper you want to include what "rights" the family has in this case, if any at all. I wonder why the MD did not order a sedative or tranquilizer. Sounds to me like the assessment was not very inclusive.

And for the purpose of your paper, talk about A&Ox4. That is usually not descriptive of a patient who is continually pulling things out. Alert, oriented to self and place, exhibiting inappropriate behaviors, unable and/or unwilling to follow plan of care. As the above poster pointed out, there is something amiss with the assessment. Or the assessment was spot on, and now there's a HUGE change in MS.

I'm going to take all this into consideration. Didn't think I would get these many responses. Thanks all!

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