Mental health articles

Our responsibility in relation to restraint

The nurse has a duty of care to the older person, The Nursing and Midwifery Councils Code of Professional Conduct states that in the care of a professional nurse, ‘clients should be safe and respected as individuals whose interest and dignity are respected’. The use of restraint should be used within this duty of care.

It should be planned, and any restraint used should be recorded, monitored and reviewed regularly, and so only used for the minimum of time needed. If nurses are confronted with the dilemma of using restraint, they will need to decide how to act, using their professional knowledge and expertise to problem-solve ways forward. This offers an opportunity for us to work more closely with older persons and those significant in their life, along with the multi-disciplinary team and colleagues in mental health and social care to share perspectives that create a supportive plan of care. This calls for the nurse to make decisions and judgements as part of the assessment process using both rational thinking and their intuition, a useful skill when working with older people experiencing mental health problems who may try to communicate with us on many levels, and who will continue to want information and advocacy which keeps their sense of independence throughout any difficult times.

While outlining plans, the nurse should be aware that the employer as well as our professional body governs the decisions made. This means we have to be aware of, and act in line with, local policies and procedures that relate to restraint. Do you know what these are? It is worth checking good practice and policies where you work. To continue improving our practice, we can review care, reflect, carry out audits that compare our practice to others and keep ourselves in touch with the evidence base to make sure we respond in the best way we can for older people.

Tags: responsibility, restraint