"Physical exhaustion. All nursing assistants described the physical exhaustion they felt in relation to applying manual restraint for CNF, especially in circumstance where the young person was highly resistive. There were multiple manual restraints to perform per shift, and reports of sweating during restraints were not uncommon. At times, the manual restraint continued even after nasogastric feeding had been completed because the young person was either trying to self-harm or purge the liquid supplement they had just been given. This made the whole restraint even more tiring for participants: Once you’ve been in a restraint in a feed you just want to be done with it because it’s a physical thing, your body’s tired, you’re hot and sweaty, you’re covered in their sweat as well . . . and if someone continues it by trying to purge, it’s more tiring than anything else. (Participant 5) Despite the physical exhaustiveness of using manual restraint, all nursing assistants also reported that the restraint of some young persons involved minimal physical exertion because of their increased compliance and preference to be fed under restraint: I was restraining her arm and one of her legs, and it wasn’t very intense. The patient was going through this process for a very long time, so she was at that stage where she wanted this holding let’s say, but she wasn’t aggressive or very resistive. (Participant 1) Once you’ve been in a restraint in a feed you just want to be done with it because it’s a physical thing, your body’s tired, you’re hot and sweaty, you’re covered in their sweat as well . . . and if someone continues it by trying to purge, it’s more tiring than anything else. (Participant 5)"
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Force-feeding
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