Inclusion Criteria:  Mechanically ventilated (with or without tracheostomy) Receiving analgesic-sedating medications Wearing soft wrist restraints Glasgow Coma Scale score > 8 Participants must be between ages 18-89 years old English-speaking English speaking legalized authorized representative (LAR) Participants must be admitted under one of the following physician groups: Trauma services or critical care physician group.  Exclusion Criteria:  Children (under age 18) Pregnant women Cognitively impaired adults (must be able to follow commands) Prisoners Combative patients