Using restraint with restraint: a reflection

A peer support worker responded to my query about what nurses could do to improve care with people who were acutely mentally unwell and exhibiting disturbed behaviour. ‘Use restraint with restraint’ was his response, a sage response to a complex, disturbing, distressing practice for all concerned but containment that is necessary as a last resort in care, to maintain safety for nurses, consumers, visitors, and health professionals alike. We know that the international literature tells us that seclusion and restraint are not therapeutic in any way, and there are many reports of adverse outcomes (World Health Organization (WHO) 2017). It is also known that all forms of restraint are associated with physical and psychological deleterious effects on consumers leaving them traumatized, worthless, punished, trapped, and bored (Van der Merwe et al. 2013). The mission to reduce all forms of restraint is, however, complicated, particularly given the incidence of aggression and violence in the workplace.