An inmate was diagnosed with posttraumatic stress disorder (PTSD) caused by severe sexual abuse. One day this inmate sees a person with similar characteristics to the perpetrator, has a flashback, and then attacks the person
Correctional officers place the inmate in restraint. Which action by the correctional nurse is most appropriate?
a. Plan to meet with the inmate for debriefing after release from the required period of restraint.
b. Support use of restraints as needed to control violent outbursts and assure the safety of all inmates.
c. Contact a supervisor authorized to make an exception to the restraint policy and explain why an alternate response is needed.
d. Confront the correctional officers who initiated the restraint, explain the inappropriateness of this action, and request the inmate's release.
ANS: C
Nurses have advocacy responsibilities, regardless of the setting. The optimum outcome in this situation would be to minimize the duration of the restraint episode. The inmate and others are at risk of injury until the inmate is calm. The restraints will likely worsen and extend the inmate's distress and agitation. Supporting the use of restraints ignores the need of select inmates for alternate responses that do not paradoxically worsen the situation instead of help it. Meeting with the patient to calm her after her release would be the second most helpful response, but it does not shorten the duration of the patient's restraint. Confronting the officers is unlikely to be successful, since they are following proper procedures; accusing them of improper actions will likely increase defensiveness rather than expedite the inmate's release from restraint.
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