"By far the most prevalent finding in this study concerned the adverse physical outcomes that pervaded nursing assistants’ experiences of administering manual restraint for CNF of young persons with AN. Nursing assistants were subjected to frequent physical aggression by some young persons, they sustained physical injuries from being physically abused and from executing manual restraints, and they were often physically exhausted from applying manual restraint, typically multiple times during each shift. These findings are in line with previous studies of manual restraint within adult consumer settings which have highlighted the commonality of staff injuries during manual restraint use (Chapman et al., 2016; Lancaster et al., 2008; Southcott & Howard, 2007; Wilson et al., 2017), the physical exhaustion associated with administering manual restraint (Hawkins et al., 2005), and the patient physical aggression staff may be subjected to during manual restraint incidents (Wilson et al., 2017). However, with the exception of one study which reported staff physical exhaustion (Lombart et al., 2019), these findings have not been reflected in previous studies of manual restraint within child and adolescent settings. An important finding in this study concerned the interpersonal challenges that the majority of nursing assistants reported experiencing including staff conflict, and feelings of pressure and responsibility. In almost all cases, the former and latter experiences were associated with manual restraint performance, that is, the nursing assistants’ effectiveness at executing their designated manual restraint positions. Although these findings have not been explicitly reflected in previous studies of staff manual restraint experience, two of the participant extracts in one study within an adult mental health setting, were illustrative of the feelings of pressure and responsibility described by participants in this study (e.g., “they were all there watching, and I am thinking Oh God, have I done this right”; Bigwood & Crowe, 2008, p. 219)."