Seclusion Practice in Psychiatric Nursing: Assessing Nurses' Attitudes

Abstract

Background: Seclusion is the physical isolation of a patient for the purpose of protecting the patient from harming self or others. It is often nurses who place a patient in seclusion, especially in the psychiatric setting. Seclusion is a very common practice in a psychiatric setting. To date, there is limited evidence describing nurses' attitudes towards seclusion in the psychiatric setting. Purpose: This paper describes nurses' attitudes towards the use of seclusion in the inpatient psychiatric setting. Method and Sampling: A qualitative design was used to assess nurses' attitudes towards the use of seclusion. Participants were recruited through snowball sampling. Two focus group discussions were used to obtain descriptions of nurses' attitudes to the use of seclusion for patients in psychiatric settings. Twelve nurses with current and/or previous work experience in the inpatient psychiatric setting, ages 21-62, participated in the study. Results: Factors guiding nurses' attitudes included feelings and beliefs, the patient's behavior, and the participant's knowledge of seclusion. Behaviors such as violence, agitation, and/or elopement were perceived as threats to the patient's safety and the safety of others. Seclusion was used to eliminate such behaviors and was perceived as therapeutic for both the patient and the individual unit. While participants reported an overall positive attitude towards seclusion, they reported a lack of knowledge in regards to policies governing seclusion. Conclusion: Attitudes were found to influence the use of seclusion. Participants in this project felt seclusion was useful to reduce violent behaviors and agitation. Seclusion was also seen as therapeutic. Educating nurses is necessary to change their attitudes towards seclusion and to reduce the practice of seclusion in the inpatient psychiatric setting.