What Alternative Approaches Can Nurses Use to Avoid the Use of Seclusion and Restraint?
A reader asks, “What do you do when a 220-pound violent patient is throwing furniture or has already assaulted a staff member?” The first thing you should do is clear the area of others, and then remain quietly available at a safe distance until the peak of the crisis has passed. The risk of injury to both patients and staff is high when a direct verbal or physical intervention is attempted at the peak of a crisis. If a staff member has been assaulted, the staff member should be removed from the area and other staff must take the lead in intervening. A patient should not automatically be secluded or restrained following a staff assault, a response often born of fear or the conviction that the person needs “consequences.” Seclusion or restraint should never be used to introduce consequences; instead, other approaches to supporting behavior change may be instituted once the crisis has passed. Early identification of the problem and appropriate assessment of the situation are essential be
