Restraining (restrained) patients have a become popular culture within the hospital settings, from the ICU to residential old age homes(Evans & FitzGerald, 2002). The act of physical restraint is defined as “any device,material or equipment attached to or near a person’s body which can not be controlled or easily removed by the person and which deliberately prevents or is deliberately intended to prevent a person’s normal access to their body”(Evans & FitzGerald, 2002).
The common use of this practice has been categorised into, staff and organisation orientated reasons and patient orientated reasons which include: safety ; agitation; behaviour control; wandering and support(Evans & FitzGerald, 2002).
Restraining patients was never seen as an issue to most students before the discussion arouse in one of our lectures. This was true for myself because I viewed it as making sure the patient was safe due to varies body movement abnormalities e.g impulsive stroke patients who were at risk of falling if they were to mobilise themselves. In a sense, it was a “this cot side should be up / I should tie this patient in bed so that they know, they should not move without the help of someone else” moment. However, retraining was never disclosed. It was always assumed that patients knew it was to their benefit. The issue with restraints arises when human-rights are violated and seen as ‘irrelevant’ to staff because certain duties need to be carried out. During my clinical experience, I have witnessed many accounts of this and much to patient’s discretion. This experience has made me vigilant to always making sure that my patients/clients are aware of what is being done for and/or to them. During the event, I witnessed how a patient was explicitly restrained by nursing staff in order for a wound to be cleaned. The patient refused treatment several times and cried out for help. Many staff members, myself included, sympathised by word as the patient was being retrained.It made me wonder if my intervention to stop the staff would be more detrimental then beneficial as the process was very necessary in order to keep the patient’s wound clean and healthy.
As a South African citizen, one is entitled to certain rights within the constitution of South Africa. According to the national patients rights charter(“Patients’ Rights and Responsibilities”, 2014) every patient has a right to: A healthy and safe environment that ensure their physical and mental well-being, take part in deciding on matters affecting one’s health, friendly health care providers, Refuse treatment verbally/writing(“Patients’ Rights and Responsibilities”, 2014).In contrast Health care workers also have a responsibility according to the Health Professions council of South Africa guideline booklet (HPCSA) section 5 states: health professionals have certain duties towards patients, the first clearly indicates that health professionals should always regard concern for the best interests or well-being of their patients as their primary professional duty (HEALTH PROFESSIONS COUNCIL OF SOUTH AFRICA, 2008).
Considering patent rights according to the constitution and Health professionals responsibilities, it all has an underlying tone of making sure that the patient’s health is put first. With regards to restraint in order for treatment to be carried out effectively and safely, I have to agree to it’s use. However, health professionals should always make sure that their patients have received all necessary information regarding their treatment and the use of restraint (i.e “I am going to assist you to the chair today but the sheet will be used to hold you in the chair for safety”) and are free to have authority over the decisions regarding their health and treatment.
References
Evans, D., & FitzGerald, M. (2002). Reasons for physically restraining patients and residents: a systematic review and content analysis [Ebook]. Elsevier Science Ltd. Retrieved from https://www.sciencedirect.com/science/article/pii/S0020748902000159
HEALTH PROFESSIONS COUNCIL OF SOUTH AFRICA. (2008). [Ebook] (1st ed., p. 7). Pretoria. Retrieved from https://www.hpcsa.co.za/downloads/conduct_ethics/rules/generic_ethical_rules/booklet_1_guidelines_good_prac.pdf
Patients’ Rights and Responsibilities. (2014). Retrieved from https://www.westerncape.gov.za/general-publication/patients-rights-and-responsibilities
3 thoughts on “Role over Restraint: A Human Rights Dilemma”
Hey Chandre, thank you fro sharing your experience with us it reminds me of a similar experience i had. Its something that should be brought to more people’s attention, because its a matter that gets swept under the rug often. Patients still have rights at the end of the day.
Content: i can see the topic you want to convey to us is human rights, more specifically, patients’ rights. Despite the lack of any photos or media, the message you brought is clear. in a sense, i also feel as if i am violating patients because i wouldn’t like to be restrained for treatment.
Argument: From the literature you provided, I can assume what the argument is you’re trying to present. However, I do not know what your personal opinion is on the matter. My advice to you would be to state your argument and supplement it with literature or other sources for more credibility.
References: There aren’t any references cited in your text. When voicing your opinion, it would be wise to make use of credible and reliable sources.
Writing: Your text was grammatically correct with minor spelling errors. It is easy to read and provides valuable insight to what physiotherapist might come across in this line of work.
Keep up the good work.
Good afternoon Chandre.
I thought you shared your clinical experience well and it is a topic that almost all of us have witnessed yet definitely is a difficult topic to discuss as one can understand the reason behind using restraints, yet we also live in a country that is based on human rights that we should always abide by.
I liked how you explained what restraints are and the reasons for their use. I would just suggest you add references for where you found these definitions.
I understand that you have acknowledged that you are basing your argument on the patient’s rights but it is not very clear. I think it would be valuable to describe in more detail how you specifically felt when seeing a patient being restrained and how you feel things should be done differently, or if there is even an alternative.
I think you could make your argument stronger by stating whether you agree or disagree with restraining patients. Or if you cannot pick one, explain what your views of the positives and negatives are of restraining patients.
I would also suggest you find recent articles that discuss restraining patients in order to help substantiate your writing.
I would also suggest proof reading your work and there were a few spelling mistakes, but those can easily be fixed and your writing piece was still easy to follow and flowed in a logical manner.
Halinka.
hi chandre , thank you for sharing your piece of writing
content: your topic is good and relevant, and is something that we see almost every day at the hospitals. this makes me think in a different way about my own clinical practice
Argument: your argument is present just not clear. do you agree or disagree about this, is it something that should be done or not? if yes whats your reasons if not is there a better way that it can be done? how do you feel about? and t is also important that you support your argument with the literature
Reference: you don’t have any reference it is important that you support your writing with reference to make it stronger. and you must also reference your definition at the beginning of your writing
writing: your writing is easy to read and follow, grammatically correct but with some spelling errors
your writing is good, and you’re on the right track. you just have to make your argument clear and also found literature to support your writing