How to Care for the Insane: A Manual for Nurses — John Shaqi
How to Care for the Insane: A Manual for NursesGranger, William D.
Science
How to Care for the Insane: A Manual for Nurses
Granger, William D.
Psychiatric nursing
_Care of the Destructive Patients._--Besides the violently destructive
patients, there are some who are maliciously destructive, and who exercise
all their ingenuity to escape the watchfulness of the attendants; who
glory in their wrong-doing; who openly say they cannot be punished, and
exultantly tell the physician how they have outwitted the attendant, or
proclaim before him his shortcomings and neglect. Such patients will
destroy their own or others clothing, they will steal and hide, or throw
it out the window or down the water-closet, or erase the name by which it
is marked. They will destroy bedding, windows, crockery, pictures, or
furniture. With a pin, a nail, or a bit of glass or wood, they will mar
and deface their room or the ward, and often do damage that cannot be
repaired. The only way to meet such cases is by watchfulness. They should
be kept, if possible, at work, or at least with a company of workers, and
therefore under constant observation. When put to bed their clothing,
mouth, hair, and person should be thoroughly searched. Kindness often has
but little effect, but a threat is apt to make them more determined to
destroy.
_The Care of Patients by Mechanical Restraint and Seclusion._--All the
restriction of an asylum is restraint. The locking of bedroom doors at
night is very restricted restraint. Most patients in an asylum have a
feeling that they are under great compulsion and restraint, in being
deprived of their liberty. It has already been taught that patients are to
be given all the liberty possible, that restraint over their freedom is to
be exercised no more than is absolutely necessary, and that the greatest
good of the patients alone is to be thought of.
These teachings are equally true of special forms of restraint. If used at
all they are to be used for the good of the patient alone, and an
attendant should be able to care for any case without restraint.
Restraining apparatus should never be kept on the ward. An attendant
should never ask that it be used, nor say he cannot get along without it.
If ordered by the physician it is the attendant's duty to see that it is
so applied as to do no injury, that it does not bind or tie the patient
down, that it does not irritate and make the skin sore, nor restrict the
free movement of the limbs.
Patients who are restrained are not to be further confined to a chair
without specific order. Restraint used during the day is not, unless so
ordered, to be continued at night nor reapplied the next day. Patients are
to be taken frequently to the closet. Restraint should be taken off
several times a day, and kept off long enough to give relief to any
feeling of discomfort, and free movement should be allowed. When patients
are restrained they need unusual care and watching, and should never be
left alone.
Public-domain text, read in full here on John Shaqi.
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