'It's part of the job, but it spoils the job': a phenomenological study of physical restraint

Int J Ment Health Nurs. 2008 Jun;17(3):215-22. doi: 10.1111/j.1447-0349.2008.00526.x.

Abstract

This paper examines mental health nurses' experiences of physical restraint in an acute inpatient psychiatric setting using Van Manen's descriptive hermeneutic phenomenological methodology. The aim was to understand the nurses' experiences of physical restraint. One overarching theme emerged from the analysis: It's part of the job. This theme had a subtheme of Control which was constituted by the Conflicted Nurse and the Scared Nurse. The findings suggest that mental health nurses are very uncomfortable with physical restraint despite it being taken-for-granted as integral to their role. The nurses experienced conflict and fear associated with the procedure and would prefer to utilize other de-escalation skills if it was possible. The main source of conflict related to the imperative to maintain control and the professional values of the therapeutic relationship. While the nurses could see no viable alternative in some situations, the paper concludes that while environmental issues impact on the practice of physical restraint mental health nurses need to practice it with as much care and humanity as possible.

MeSH terms

  • Adaptation, Psychological
  • Attitude of Health Personnel*
  • Burnout, Professional / etiology
  • Burnout, Professional / psychology
  • Conflict, Psychological
  • Fear
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Needs and Demand
  • Humans
  • Internal-External Control
  • Job Satisfaction*
  • Male
  • Narration
  • Negotiating / methods
  • Negotiating / psychology
  • New Zealand
  • Nurse's Role / psychology*
  • Nurse-Patient Relations
  • Nursing Methodology Research
  • Nursing Staff, Hospital / psychology*
  • Occupational Health
  • Professional Competence
  • Psychiatric Nursing / methods
  • Qualitative Research
  • Restraint, Physical* / adverse effects
  • Restraint, Physical* / psychology
  • Surveys and Questionnaires
  • Violence / prevention & control
  • Violence / psychology