"The purpose of this phenomenological study was to explore nursing assistants’ experiences of administering manual restraint for CNF of young persons with AN. The findings paint a physically and emotionally distressing picture of the participants’ experiences and provide valuable insight into the experience of applying manual restraint for CNF of patients with AN. It is clear from the analysis that administering manual restraint for CNF of young persons with AN was a distressing practice for nursing assistants. The practice elicited numerous unpleasant emotions including anxiety, guilt and anger, and a small number of participants described becoming emotionally sensitised to the practice over time. Although the majority of participants expressed becoming emotionally desensitised to the manual restraint procedure, their accounts were often contradictory, suggesting that they had not necessarily become desensitised to the practice. These findings are in line with that of previous studies of staff’s manual restraint experiences in both child and adolescent, and adult consumer settings, which have also highlighted the experience of distress and numerous unpleasant emotions as a result of administering manual restraint (e.g., Bigwood & Crowe, 2008; Bonner et al., 2002; Chapman et al., 2016; Lombart et al., 2019; Sequeira & Halstead, 2004; Steckley & Kendrick, 2008; Svendsen et al., 2017; Wilson et al., 2017). It is not surprising that the theme “Importance of coping” was extracted from the analysis, given the illustrated adverse physical and psychological staff consequences that could result from applying manual restraint for CNF of young persons. The majority of nursing assistants described consciously detaching themselves from manual restraint incidents as a means of coping with the distress it elicited. Detaching oneself appeared to serve a protective function for participants, somewhat safeguarding them against the experience of distressing emotions; this is in line with the findings of previous studies in both child and adolescent, and adult consumer settings which have highlighted how some staff “switch off” their feelings or “temporarily suspend” their ability to empathise with patients during manual restraint incidents (Lombart et al., 2019; Sequeira & Halstead, 2004). Talking with colleagues and young persons who were further in their recovery were also cited by nursing assistants as coping strategies. These strategies appeared to help nursing assistants regulate their emotions through humour (e.g., “banter”), and through cathartic processes (e.g., “venting out”). Staff participants from previous studies of manual restraint within adult mental health settings have similarly highlighted the importance of colleague support in coping with restraint use (Bigwood & Crowe, 2008; Bonner et al., 2002; Sequeira & Halstead, 2004). However, this finding has not been explicitly reflected in studies within child and adolescent settings (e.g., Lombart et al., 2019; Steckley & Kendrick, 2008; Svendsen et al., 2017)."
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