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Original Question
Watch the following video clip then answer the reflection questions. Refer to the video as needed. https://www.youtube.com/watch?v=k3uOLNS5rK0 How should nurses respond when someone has lost touch with reality as his psychosis worsens and he is deeply disturbed? What lies behind that disturbance? The first part of this film shows ‘poor practice’, as the nurses both fail to proactively intervene and actually exacerbate the situation by their use of language, tone and nonverbal communication. 1.Identify what you see as unhelpful? In the second part of the film, the nurses take a very different approach. They attempt to intervene early and, despite Don’s anxiety, frustration and anger, are consistent, calm and compassionate as they help Don become less aroused, using a seated de-escalation. When they need to escalate their response, it is done carefully and thoughtfully, with attention to detail as they plan who will do what. A full de-escalation then takes place, allowing the team and Don to remain safe and medication to be administered. 2.Look for what you think is helpful and anything you think could be done differently in such a challenging and potentially distressing situation when staff were trying to de-escalate Don. Describe 3. Considering what you have learned about restraints in theory class describe how Don met criteria for restraints, was he aware what needed to happen to discontinue and if you were the nurse in the scenario what are your responsibilities? Did patient debrief take place at any time did staff debrief? If so, what was discussed in the debrief that would be helpful in working with Don in the future? Important note: the guidance and practice for the physical intervention with patients has been changed since the making of this film, when this type of restraint was regarded as best practice. That has now changed and the form of intervention that is safest involves supine restraint i.e. guiding the person onto their back. This is because the risk with the form of intervention demonstrated here i.e. prone restraint, is that the person can have serious limitations placed upon their ability to breathe. However, the key principles i.e.the seated de-escalation, holds used, careful planning, trying everything possible to de-escalate the situation, acting decisively and communicating with the person as clearly and compassionately as possible remain applicable. Watch the following video clip then answer the reflection question. Refer to the video as needed. https://www.youtube.com/watch?v=Q4T-x1za6lg Compare and contrast the differences between the way the” nurse” interacted in the video clip with the patient in this clip. If you were the nurse in this situation how would you respond. Be very specific .
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