RESTRAINING:

Several treatment alternatives exist  for  intervention in assaultive behaviour. Medication, physical restraints and seclusion  rooms may be used  separately or  in combination, according  to protocols in given treatment settings. The 1982 Supreme Court decision in Youngberg V. Romeo held that professional decision to seclude or restrain a patient is presumptively valid and that liability for secluding or restraining a patient may be imposed only when the professional's decision is a substantial departure  from accepted professional judgement, practice or standard. 

The purpose of restraining: 

Containment of  injurious actions. 

To reduce difficult interpersonal relationship. 

To  decrease sensory input  to  reduce sensory  overload. 

Uncontrolled and unsafe behaviour of  the patient. 

Nurse's  Role 

One  staff member should act  as a  team  leader  and direct the actions  of everyone according to established and practiced routines. The leader will tell the patient what is occurring and why, keeping verbalizations concise and matter of fact in  tone. Other members of the team will be assigned to hold  the limbs  to hold and transport the patient  to the seclusion  room or  to apply restraints. Restrictive therapies must have clear guidelines and Physician's  guidelines.  

Termination of  Restraining:

Restraining must depend  on objective criteria rather than arbitrary  feeling states of  the nursing staff.