After the tough decision to use restraints has been thoughtfully made, follow these steps to ensure the safety of you and your resident.
Do not try and restrain a patient or resident on your own.
Create a clear plan of action with a team of colleagues, as well as communicating to the patient or resident.
Remove any objects from the area that may present a potential danger.
If the concern is a patient pulling out tubes or IVs, consider only restraining their wrists and or forearms.
Ensure the restraint is tight enough to restrict movement, but not so tight it constricts blood flow or creates trouble breathing.
Regularly check back in on the patient or resident to ensure the restraints are not cutting off circulation or causing harm, and remove restraints as soon as they become unnecessary.
Entirely unpleasant, but unfortunately necessary in certain circumstances, physical institutional restraints serve a critical purpose in institutional environments such as jails, prisons, psychiatric centers, and juvenile detention centers. Restraint furniture in particular is often found in these institutions.
According to a study conducted by Junrong Ye and Chen Wang, among others, titled “Physical restraint in mental health nursing: A concept analysis” and published in the July 10, 2019 edition of the International Journal of Nursing Sciences, physical restraint is not an ideal solution but does become useful once alternative methods break down.
The study states, “Patients with mental illness may pose critical risks to themselves and others. Patients with severe mental disorders have a high possibility of autolesion and agitation.”
“Medical practitioners generally apply alternative approaches, such as de-escalation techniques and crisis management, to alleviate critical risks posed by an acute mental illness patient. Nevertheless, compulsory intervention is implemented when alternatives fail to resolve the conflict,” the study continued.
Despite its effectiveness in unbearably tough situations, the use of restraint and restraint furniture can be harmful if used incorrectly or without caution. For example, a situation that didn’t require restraint will likely escalate the situation and can quickly spiral out of control, if restraints are used.
According to Penal Reform International, an international nongovernmental organization dedicated to penal and criminal justice reform worldwide, some restraint devices have even been prohibited in the past due to their use being regarded as degrading or painful.
As such, it is important to set and follow laws and standards designed to eliminate or limit the negative externalities associated with restraints. Following this mindset, Penal Reform International suggests in its “Instruments of Restraint” Factsheet following the mandate outlined in Article 5 of the UN Code of Conduct for Law Enforcement Officials, which writes that the term ‘cruel, inhuman or degrading treatment or punishment’ should be interpreted as to cover the widest possible protection against abuses.
Therefore, Penal Reform International states, “The use of restraints should be prescribed by law, and be restricted by the principles of necessity and proportionality. International standards require that restraints are used restrictively, only in exceptional cases, where other methods have been exhausted and failed.”
Further, restraint instruments, such as mechanical restraints that are used in conjunction with prison beds, should never be used as punishment. They are designed solely to ensure the safety of residents and institutional employees and should be used as such.
If the role of an institutional rehabilitation center is to rehab and reintroduce its residents to society, shielding them from unnecessary trauma should be considered a top priority.
Patients and residents deserve to have their constitutional rights of life, liberty, and freedom from cruel and unusual punishment honored. According to The Journal of the American Academy of Psychiatry and the Law, the use of restraint to control a patient who does not pose a risk to their own or others’ health can result in serious legal sanctions.
With all of this in mind, it is important to remember that physical and mechanical restraint is still necessary under certain circumstances. Proper caution and safe methods are being taught around the states now, reducing the amount of trauma our correctional and psychiatric residents and staff go through when restraint furniture and institutional restraints must be used.
Restraint furniture such as Max-Secure’s Multi Point Restraint Bed and the Endura Series 8 Point Restraint Bed are designed with safety, comfort, and rehabilitation in mind. These restraint beds can be used as both jail beds, psychiatric restraint beds, or even beds for institutional centers such as juvenile detention centers. They also feature industry-standard restraint options that can be used in conjunction with most common mechanical restraints.
Prioritizing residents’ safety and health is a noble goal that can produce many tangible benefits, and small steps such as practicing caution and safe restraint methods can make all the difference in the world.
