Forced Grooming Found to Constitute Patient Abuse and to Be Grounds for Removal of Psychiatric Nurse from Her Position
Hafemeister, Thomas L., Developments in Mental Health Law
The level of grooming and personal hygiene can be a source of ongoing tension and conflict between residents and staff in a facility for individuals with a mental disorder. A failure to attend to grooming and hygiene may antagonize staff and other residents, and taken to extremes can pose a health risk. At the same time, principles of autonomy and privacy encourage respect for a person's right to make these decisions for themselves, a right that is now widely acknowledged to be generally retained by individuals even when their placement in the facility is the result of court-ordered civil commitment.
A federal court of appeals ruled that a staff member who engages in forceful behavior to impose grooming on a resident without adequate justification may be found to have engaged in patient abuse and can lose his or her position as a result.
A licensed practical nurse had worked as a psychiatric nurse at a Veterans Administration hospital for seventeen years with no prior record of discipline. One evening while making rounds dispensing medication to patients, the psychiatric nurse told a patient who had been diagnosed with paranoid schizophrenia that he needed a haircut and she was going to cut his hair. The patient responded that he did not want a haircut. The nurse nonetheless proceeded to cut his hair.
The nurse then began to shave the patient's beard. The patient again objected and attempted to "roll off' in his wheelchair. The patient's hand and the wheel of his wheelchair were held to prevent him from leaving. The patient became more agitated, physically resisting and cursing. The patient's wrists were held, at which point the patient continued to repeat his objections and started kicking. At this point the nurse ceased her efforts to shave the patient's beard. …