Need more inference on ethical dilemma issue regarding restraints.

Hello,

I have an ethical dilemma paper to write about as a requirement. I chose my past experience as a 1st semester nursing student where an LVN gave me restraints to tie down a patient who was acting up. RN was not present and attending to patients elsewhere.

Of course, I chose not to...based on 1) Hearing that you aren't supposed to as a student, especially a 1st semester student, 2) I wondered if there was a order and assumed there wasn't (It turned out there was not one and they had to get a doctor's order) and 3) I didn't want to put my instructor's license on the line if something I did went wrong.

In the end, I helped hold the patient's other side down and calm him with my words. I stupidly texted my instructor that "Is it ok to document the mishap or document the actual restraints on the MAR?" to which he replied "NOOOOOO!!!!!~~"

Can anyone give me more suggestions/ideas/tips to write about? Especially those that won't upset my very, very strict instructor. More minds, the better! lol
I can't give you any suggestions about the ethics of the use of restraints but can offer you examples of real cases I've encountered that have actually gone to ethics committees:Teenage girl with acute mental status changes found to have Anti-NMDA receptor encephalitis. This is a rare disease and is sometimes associated with ovarian teratomas. Parents discovered this through the internet/youtube and elected for a complete oophorectomy. The entire work-up the child had had revealed NO ovarian involvement but the parents were convinced that this would cure her. The child is now infertile and still having problems from her encephalitis. The Ethics Committee at the hospital and the court system sided with the parents because their goal was not to sterilize her but to cure her disease.On that note, there was a very famous case a few years ago about parents' decision to sterilize their severely developmentally delayed daughter: Ashley Treatment - Wikipedia, the free encyclopediaChild with end-stage brain stem tumor whose parents refused to believe that she was dying and requested a permanent tracheostomy and long-term ventilation. Ethics committee sided with the parents. Support was eventually withdrawn on the order of the ICU team after brain death was pronounced. Previously healthy child diagnosed with X-linked adrenoleukodystrophy after presenting with a new seizure. This led to discussions of testing the child's younger brother and, if he was found to have the disease, whether to proceed with experimental treatment despite the presence of no symptoms. Specifically, the question was whether to proceed to stem cell transplant for the brother without knowing when his disease would onset and to risk death from the transplant itself. I do not know what the outcome of this case was. Children with congenital brain malformations who are likely to live but with severe impairments. In rare cases, parents do not want this life for their children and choose not to treat them. What then? Nursing Center - Journal ArticlePediatrics and genetics are FULL of ethical issues, especially when you combine the two.

Thanks. It seems like those cases are rather very complex to have gone to the ethics committee. My situation was in Med-Surg and was not severe enough to have gone to the ethics committee.

If you are looking for an ethical dilema, I seem to remember a case in the news a few years back where there was a child with some form of cancer. It was against the parent's religion or some type of morals (I don't remember where actually the belief system came from) against cancer treatment. With out the treatment the child would have died. So basically it boiled down to do parents have the freedom of religion and autonomy to raise their children in their beliefs or at what point can the state jump in and force the child to recieve the life saving cancer treatment. Another ethical dilema I actually sent up to our ethics committee was a pt had a specific living will that the family was refusing to follow. Pt was actually trached and asking his wife to turn off the vent, problem was he was on a low dose of propofol and ativan for anxiety so he wasn't "of sound mind" to actually make the call. With out the propofol & ativan he was bucking the vent alittle so we couldn't just turn it off. Good luck!

Quote from FLICURNIf you are looking for an ethical dilema, I seem to remember a case in the news a few years back where there was a child with some form of cancer. It was against the parent's religion or some type of morals (I don't remember where actually the belief system came from) against cancer treatment. With out the treatment the child would have died. So basically it boiled down to do parents have the freedom of religion and autonomy to raise their children in their beliefs or at what point can the state jump in and force the child to recieve the life saving cancer treatment. Another ethical dilema I actually sent up to our ethics committee was a pt had a specific living will that the family was refusing to follow. Pt was actually trached and asking his wife to turn off the vent, problem was he was on a low dose of propofol and ativan for anxiety so he wasn't "of sound mind" to actually make the call. With out the propofol & ativan he was bucking the vent alittle so we couldn't just turn it off. Good luck!

There was one patient who I put a sheet around, not because I was told to or because there was an order but because I was afraid she might fall. She had severe arthritis and I did not think her chair was safe for her. There was nothing I could do about it. She was mine and the anxiety was driving me insane. I told a visiting relative that I would rather get in trouble for restraining her without an order than to see her fall. No one argued with me.

Quote from J-Swishan LVN gave me restraints to tie down a patient who was acting up. RN was not present and attending to patients elsewhere. Of course, I chose not to...

All great ideas and this one particularly gave me some more insight as well. Thanks all. You rock.