Overview
Why Restraint Decisions Demand Judgment
A patient pulling at an airway, trying to climb from bed, or striking another person may create a genuine safety emergency.
A patient pulling at an airway, trying to climb from bed, or striking another person may create a genuine safety emergency. The nurse's first question is not, "Which restraint should I use?" It is, "What danger is occurring, what is causing the behaviour, and can it be reduced without restricting movement?" Restraint removes liberty and can itself cause injury, so it requires a defensible clinical reason, the least restrictive effective response, ongoing reassessment, and a clear endpoint. A confused patient may be responding to pain, hypoxia, urinary retention, medication toxicity, fear, or an unfamiliar environment. Treating that driver often removes the apparent need for restraint.
