Healthcare Administration Case Study: Analyzing Patient Restraint

This case study analyzes a scenario where Mr. Nathan, a patient hospitalized for prostatic surgery, attempts to leave the hospital and injures a nurse in the process. The study addresses the hospital's responsibilities in caring for Mr. Nathan, actions regarding the nurse's injuries, and the justification for the physician's decision to administer a sedative and order physical restraints. It also evaluates the potential success of Mr. Nathan's lawsuit against the hospital for false imprisonment and aggravated assault, considering patient rights and the legal implications of detaining a patient against their will. The analysis references relevant literature on patient rights, hospital responsibilities, and workplace violence in healthcare settings.

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Case study
The hospital has no excuse to have detained Mr. Nathan whether in an office or hospital against
his will even if Nathan was sick. Expert agree that the patients have the right to opt not for
treatment and forcing them to accept the treatment against their will the physicians will be
interfering with their rights(Chlan et al., 2013). Patients and doctors should always operate under
the assumption that it is against the law to hold Mr. Nathan against his will (Kowalenko et al.,
2012). But also there are exceptions where Mr. Nathan would have been denied his right to
refuse the treatment according to Allan Meisel a Bioethics and professor of law at the University
Of Pittsburgh School Of Law (Kowalenko et al., 2012). He states that it is unreasonable holding
a patients against their will and says this is civil wrong of false imprisonment.
The physician or the hospital in such scenario will be forced to show that there was a legitimate
reason for doing so. For instance, according to Meisel if Mr. Nathan pose a danger to himself or
those around him, or he is mentally incompetent or have no capacity to make his own decision as
a result of intoxication by either alcohol or drugs the hospital has the right to detain him(Speroni,
Fitch, Dawson, Dugan & Atherton, 2014). Meisel add that, the physical may be used to Mr.
Nathan in cases where there is extreme circumstances but should not amount to injuring someone
as Mr. Nathan claims.
Also, simply coercing, or delaying, or blocking a doorway to make the patient stay with no
justification can be termed as false imprisonment when it comes to competent patient. Experts
states that, If the hospital was unsuccessful in persuading Mr. Nathan to stay for treatment to
convince him to talk to a Champlain or counselor they should have the protocol to call on states’
authorities to help(Waddington, Badger & Bull, 2012). If this does not work the hospital can
follow the states’ guidelines which allow emergency admissions of patients without their
consent. Expert recommends that, to protect against legal risks physicians should document in
the hospital administrative and medical records the patients’ discharge request (Speroni, Fitch,
Dawson, Dugan & Atherton, 2014). This can be asking patients to sign a release form that
indicate they are refusing treatment or leaving despite contrary medical advice (Chlan et al.,
2013). This is for the purposes of getting informed consent and if the case of this case study Mr.
Nathan fails to sign it is even safer for the physician and the hospital.

Healthcare administration
i. Case study analysis
The facts in the case are that Mr. Nathan is admitted for prostatic Surgery. Prostratitis is an
infection caused by bacteria in the prostate and results to inflammation. Some signs and
symptoms of prostatitis includes difficulty urinating, body aches, burning pain while urinating,
blood in urine or semen, fever or chills, frequent urinating, vomiting among others(Speroni,
Fitch, Dawson, Dugan & Atherton, 2014). Mr. Nathan is not willing to stay in the hospital and
tries to escape from the hospital. Mr. Nathan has pushed the RN as she tries to confront him
leaving her injured in the head and sustaining concussion. The physician has ordered that Nathan
be given intramuscular sedative.
2. Responsibilities of the hospital in caring for Mr. Nathan
There are 5% emergency admissions in United States which is estimated to be caused by
behavioral disturbances. A big number of those cases aggressiveness and agitation are the
motivators of admissions. Nurses should have the experiences required to handle patients with
those behavioral disturbances (Speroni, Fitch, Dawson, Dugan & Atherton, 2014). If in any case
Mr. Nathan’s health is at risk, the hospital has the responsibility of ensuring that a good patient-
physician relationship is created where trust and respect prevail so that patient can feel
acceptance and believe that their illness is recognized (Waddington, Badger & Bull, 2012). This
will control Nathans’ aggressiveness .The hospital has also the responsibilities to encourage the
patient to try putting their feelings into words while assuring the patient that the physician as
good intentions of helping him to control their feelings.
3. Action of the hospital against nurse injuries
Incidences of nurses finding themselves kicked, severely beaten, pushed against walls, pinched,
sexually assaulted, and down flights of stairs are common. Nurses have also been murdered in
few cases (Thomas & Moore, 2013). According to the American Association of Care, patients
contribute 48% of time perpetrators. In November 2011, a survey by Emergency Nurses
Association found that in a one week period nearly 1 out of ten nurses in emergency room got
injured through some form of physical violence (Thomas & Moore, 2013). Some of the
incidences has been equated to delays in hospitals due to increased number of patients and few
staff(Waddington, Badger & Bull,2012). Some of the challenges like bites, beatings, pushed

Healthcare administration
against walls posed by patients to nurses will make nurses patients making it difficult to handle
their duties as they seek care(Phillips, 2016). Response to the incidence always depends on the
nature of the employer and the available resources to utilize the interventions available. The
hospital should help the injured nurse by ensuring they record statement by the employer and the
police on the account that transpired (Speroni, Fitch, Dawson, Dugan & Atherton, 2014)..
However there are no specified laws that specifically state how the hospitals can help the injured
nurses.
ii. Executive decision
4. Was the physician justified in giving the patient a sedative and ordering physical restraints?
Provide a rationale for your position.
As discussed above, nor hospital or physician should detain a patient for, bill or any other reason
against their wish. There are no justifications that the physician was right to give Mr. Nathan
sedative as well as ordering physical restraint (Chlan et al., 2013). Mr. Nathan needed to be
involved in his admission and if he was not for it he should have been allowed to leave. Unless in
cases where Nathans’ condition both mental and physical was so much severe
5. Do you think his suit will hold up in court? Why or why not?
Nathans’ suit is likely to hold water because as a patient he has the right to make decision on his
own. Being falsely imprisoned is against the law and the hospital could be in for it. They can if
caught with the offence be highly fined for interfering with the patient right (Lamont, Jeon &
Chiarella, 2013). Unless the hospital would provide with the patient signed document stating that
they refused to be treated even as the condition was confirmed dangerous

Healthcare administration
References
Chlan, L. L., Weinert, C. R., Heiderscheit, A., Tracy, M. F., Skaar, D. J., Guttormson, J. L., &
Savik, K. (2013). Effects of patient-directed music intervention on anxiety and sedative
exposure in critically ill patients receiving mechanical ventilatory support: a randomized
clinical trial. Jama, 309(22), 2335-2344.
Kowalenko, T., Cunningham, R., Sachs, C. J., Gore, R., Barata, I. A., Gates, D., ... & McClain,
A. (2012). Workplace violence in emergency medicine: current knowledge and future
directions. The Journal of emergency medicine, 43(3), 523-531.
Lamont, S., Jeon, Y. H., & Chiarella, M. (2013). Health-care professionals’ knowledge, attitudes
and behaviours relating to patient capacity to consent to treatment: An integrative
review. Nursing ethics, 20(6), 684-707.
Phillips, J. P. (2016). Workplace violence against health care workers in the United States. New
England journal of medicine, 374(17), 1661-1669.
Speroni, K. G., Fitch, T., Dawson, E., Dugan, L., & Atherton, M. (2014). Incidence and cost of
nurse workplace violence perpetrated by hospital patients or patient visitors. Journal of
emergency nursing, 40(3), 218-228.
Thomas, J., & Moore, G. (2013). Medical-legal Issues in the agitated patient: cases and caveats.
Western Journal of Emergency Medicine, 14(5), 559.
Waddington, P. A., Badger, D., & Bull, R. (2012). The violent workplace. Willan.