RPNs Use of Seclusion: Navigating ethical practice, clinical judgment, and the code of ethics by Isabelle Jarrin, RPN
Practicing ethically as a registered psychiatric nurse requires attention to standards of practice, the code of ethics, and evidence regarding quality care. Drawing on the findings from a study exploring the place of ethics in mental health nurses' clinical judgments regarding seclusion use, the work of navigating ethically challenging situations will be considered in this presentation. In particular, two themes from the study are explored. The first theme, the complexity of promoting safety and preventing harm highlights the responsibilities nurses saw themselves as having to keep people safe. Often this was done in the presence of power differentials and patient vulnerability while recognizing the various types of harms that can arise with seclusion. The second theme, the importance of knowing for ethical action with seclusion use, demonstrates the role of knowing oneself, the patient, other team members, and the unit in judgments to seclude. In addition, nurses' narratives will be examined to illustrate how they thought about notions of safety, harm, privacy, dignity, and well-being.