Ethical Dilemma

Ethical Dilemma

Introduction

The nursing profession requires to face an ethical dilemma on a daily basis, regardless of where one practice. No matter what function they work in their varied roles, nurses have to make ethical decisions that have an impact on them, as well as, their patients. One ethical dilemma for nurses in the psychiatric and mental health services is the use of restraints and seclusion, which concludes as the most controversial practice. Using restraints and seclusion is a topic of long going debate over the legal, professional, ethical, attitude, and safety of using the restraints and seclusion methods (Wynaden, et al., 2002, pp. 260-8).

The practice of seclusion and restraint in psychiatry is an intervention aiming to treat and manage people suffering from disruptive and violent behaviors. These restraints and seclusions, used in emergency situations, serve to be the final response for managing situation where a critical assessment of patients should be done prior. If the assessment demonstrate a considerable risk for the patient themselves, or to any of the staff members, and no other less restrictive method is available, on the intervention becomes essential (Groves, 2008).

Even though, the use of restraints and seclusion interventions in patients with behavior problem seems to be beneficial, current researches suggest several side effects. Most significant of these negative effects is seen on the nursing staff. The decision to use the intervention may be considerate for the rights of patients to receive least restrictive care. On the contrary, the rights of other patients in the unit, as well as, the staff working to have a safe environment cannot be ignored (Groves, 2008). There is a wide range of literature available suggesting how the controversial use of restraints and seclusion leads to emotional distress and dilemma for the nursing staff.

Discussion

The American Nursing Association (ANA) provides standards for the use of restraints in psychiatry ward. According to ANA, the inadequacy of personnel to monitor patients and using less restrictive approaches to behavior management is likely to increase violation of patients' rights and place them at high risk of harming themselves. Dilemma, such as these, in patient care is an inevitable component of nursing responsibility. Nurses consistently struggle to an appropriate balance their responsibilities in protecting the rights of the patients' freedom with their obligation in preventing harm to patients and staff. Family and peers, in many cases, pressurizes the nursing staff to use restraints for their patients. On the contrary, ANA believes on the employment of restraints only when there is no other viable option. For instance, an acute psychotic episode jeopardizing the safety of the patient or staff via aggression or assault, justifies the use of temporary restraints. Furthermore, restraints are also justifiable in cases of dementia or delirium, in which the elderly patients may fall and fracture hips or other bones (Center for Ethics and Human Rights, 2012).

The decision-making process

The recent encounter of ethical dilemma involved the use of restraints and seclusion in the ...