The study looked at the impact of nurse assignments on the use of restraints among the inpatient child/adolescent psychiatric population and found that the milieu-client tasks were all-encompassing and significantly lowered the monthly rates of restraint use compared with the individual-client assignments that had no regard for patient acuity. This finding is intended to drive a change from the individual-client duties used by many facilities to the evidenced-based, milieu focused assignments effective in the early de-escalation of aggressive behaviors.
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Having had my daughter admitted to a psychiatric unit for a small mental breakdown, I find it heartbreaking that restraints are being used regularly. Kids have a hard enough time expressing what it is they are trying to do or say and then adding something so forceful to them would surely only make matters worse. I had never heard of a Milieu nurse until your poster, but I feel that having someone to help provide that structure would be much more beneficial!
I really like your poster. Your graphics are good. I feel stressed just looking at it and your dissonance and uncertainties is easy to follow and see the path they take. I have not heard of milieu nure before either. I looked up your article and then had to look up the meaning of milieu. Do the nurses get this training on the job or is their extra training with cerification. It hard to think of children having to be restrained and hopefully the milieu will be more the norm and restraints rare.
Thanks for sharing your poster,
Gayle
Very interesting topic! In my 20+ years of nursing I have never had to care for a child in restraints. I have however cared for adults in restraint and can only imagine the negative affects this may have on a child. I agree that the use of de-escalation techniques would be a better alternative when appropriate. Good work!
This is a very sensitive topic especially when it concerns a child. I observed a child in restraint during my nursing clinical time at a mental care facility for children. It was hard to watch, but the kid was too aggressive to hurt himself, other children, and caregivers. To protect him and others, the facility uses restraints as a protective measure. It has to be timed and the nurse needs to assess the kid within a certain amount of minutes. Good job on your topic!
Thanks for all your responses. It is indeed traumatic to have a child in restraint but sometimes necessary to keep everyone safe. The use of controls can be avoided by milieu presence, which helps catch the situation before it escalates. It is heart-wrenching when I see 14-year-olds brought in by 4-5 hefty security men in restraints…..how did we get to that point and what can be done differently?