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'Restraint is by far the worst thing about working in mental health'

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As student nurses, we aren’t involved in restraint. But if you’ve had an inpatient placement or work as a support worker on a ward, chances are you’ve probably seen it happen.

Last week, Mind called for a end to face-down (also known as prone) restraint, along with accredited training for restraint and for national guidelines to be established. 

They found that in 2011-2012 there were 39,883 physical incidents in mental health trusts which resulted in 949 injuries to patients. 3,439 patients were restrained in a face-down position.

There is no denying the potentially life-threatening risks that being restrained face-down carries, just look at the case of Rocky Bennett who died after being restrained by four nurses in 1998 and Geoffrey Hodgkins in 2004.

Pinning people to the ground is not what I came into nursing for, but neither is letting vulnerable people be unsafe in an environment that is supposed to be safe

Restraint is by far the worst thing about working in mental health.  It can be traumatic and humiliating for vulnerable adults who are unwell. Staff find it upsetting as well. It should be an absolute last resort and it should only be done by those who have training. 

Face-down restraint is particularly dangerous but if it is used for the purpose of rapid tranquilisation or because that is the position that they just ended up in, they should be transferred to supine as soon as possible.

The issue of restraint makes me question practice in mental health nursing as at first glance it seems completely paradoxical to what nursing care should be about. However, the restraints that I have seen and been involved in have never been used as the first option and have always been necessary to protect the patient from harming themselves or others. 

Pinning people to the ground is not what I came in to nursing for, but neither is letting vulnerable people be unsafe in an environment that is supposed to be safe.

I asked student nurses on Twitter what they thought on the use of physical restraint. @kizandcorez said she was “pro restraint as long as it is care planned/risk assessed and only used as a last resort” whilst @heleigh42 said that “if used appropriately after all other de-esculation techniques than it can be very effective.”

Mind raise extremely important points about the concerns surrounding physical restraint and their website contains stories frm patients who have experienced it. Whilst restraint may be used inappropriately in some places, I think it is important to remember that restraint is not intended to be a punishment for patients but ultimately is there to maintain the safety of themselves, other patients, and staff as well.

Natalie Moore is the mental health student nurse editor for Student Nursing Times.

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Readers' comments (1)

  • I as well work within in patient services as a learning disability student nurse. Im positive that if i was in the position of the paitent iw ould rather be retrained than be allowed to assault someone. The repercussions of assaulting someone could potentially mean an appearance in court or visit to a prison. Restraint is essential to keep patients safe and as we all know, should be used as a last resort.

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