Abstract
IntroductionForensic mental health nurses working at the forefront of services can intermittently face enduring and somewhat harrowing or stressful situations. Enclosed is an example of the use of mechanical restraints (Soft Restraint Kit) for a two month period. Staff experience of working under such circumstances is an under reported area.MethodsThe experience of nursing a patient under extreme conditions was captured through use of a qualitative study, using semi structured interviews with a purposive sample of (n = 10) staff nurses and nursing assistants in a high-security hospital.ResultsThematic analysis was undertaken generating four themes: sense of responsibility, aptitude, enablers/inhibitors, and consequence. Conclusions suggest that Soft Restraint Kits provide a useful method of containment, although prolonged use presents considerable challenges for staff. The importance of preparation and training cannot be underestimated and continued support and supervision are absolutely essential.
Highlights
Forensic mental health nurses working at the forefront of services can intermittently face enduring and somewhat harrowing or stressful situations
The aim of this study is to explore the perceptions of staff nursing a patient in Soft Restraint Kits over a sustained period of time
This study offered an excellent opportunity to capture the perspectives of nurses working under extremely difficult circumstances, necessitating the use of mechanical restraints with a very disturbed and distressed patient
Summary
Forensic mental health nurses working at the forefront of services can intermittently face enduring and somewhat harrowing or stressful situations. Nurses need to ensure they are actively involved in discussions relating to the management of violence, because staff safety is a primary concern in forensic mental health facilities [1]. For example, seclusion and manual restraint are important matters for hospital management and nursing practice [6]. Extreme measures, such as those highlighted, are most commonly used when there is a risk of harm to others [7]. It is the increasing emphasis on the use of restrictive practices that is a concern and seclusion is becoming a contentious practice [8]. The challenge to clinicians, especially nurses, is to provide a safe environment while dealing with volatile patients and they may have little alternative to seclusion, having exhausted all other
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