1st June 2016.
Hi, I’m Kat. I’m a Peer Health Care Assistant with lived experience of Mental Health Services. I was recently appointed on Ward Rowan 2. This is an acute female ward at Highbury Hospital, Bulwell. I completed my MVA training at the end of April 2016. I heard of colleagues participating in up to 20 restraints a day as I chatted to people I met on my training. So many questions were running through my mind as we learnt and practiced the restraint techniques.
Here are my thoughts about restraint. Do certain patients become known for needing restraint?
Are patients in a cycle of learnt behaviour?
Do they react and we respond and the pattern repeats?
When the need for restraint arises, is it carefully planned for individual people? What about people’s history, past abuse, claustrophobia or ethical issues around different genders being involved in a possible restraint.
Do we give patients the time to calm down and regain control of themselves before we move in to physically holding them? Do we use our words enough or have we already decided they won’t be effective with this patient as it hasn’t worked for them in the past? Could we be preventing them from moving forward in their recovery? Are patients being given a full debrief? My job role has made me fully aware of a busy ward and the demands to manage the everyday pressures of working in a clinical environment.
So often we don’t have the hours in the day to provide the individual care patients need to feel valued and cared for. Would an increase in one to one time reduce the need for restraint? Can we focus more on managing distress before it turns into violence and aggression?
Could physical activity where appropriate, reduce the build-up of tension and restlessness to reduce the need for restraint?
Are side effects of medication being monitored carefully? Individuals all respond differently, could some side effects be increasing irritation and restlessness, leading to people losing control of themselves? Is living in a restrictive environment contributing to patients not having the space to release frustrations and emotions?
I’m a big believer in the power of words and quality time; talking, listening, giving people time, attention, understanding, compassion, support, distraction techniques, opportunities for achievement and praise recognising people’s strengths and abilities. Could this all help patients to regulate their emotions and try and keep in control of their behaviour? I feel we need to support people to work towards taking responsibility for managing their own violence and aggression.
As a Peer, I feel very uneasy about being involved in restraint. How can I be an advocate and a voice for patients and then be holding them against their will? The thought of holding anyone against their will fills me with dread. I would like to make a positive difference in my work place and I now have a clearer understanding of restraint and the need to maintain a safe working environment. I have a duty of care for patients, staff and myself and to be equipped to fully provide the nurture, protection and safety to the precious people I am here to care for. I feel I will need to face my own fears around managing violence and aggression.
Who knows how I will react when I see or am involved in my first restraint but I feel confident I will not be on my own and I have a very supportive team around me.
My MVA training was a very interesting week and it raised many questions and emotions for me as a Peer Support Worker. I would like to learn more about verbal de-escalation techniques to support somebody to calm down and re-gain control for themselves.
This poem describes how I felt about my MVA Training.
The Power of Words. 18.5.16
Who am I to hold you still?
To bring you down against your will.
Can I take your freedom away?
To walk. To run. To move through the day.
Can words not be enough to give?
To help you find peace to live.
To put my hands onto you.
Who am I to do this to you?
I’ll sit with you till you feel safe.
To listen. To care. To help you face.
Emotions. Fears. Uncertainties.
A longing to be free.
I see. I feeI. I hear your cry.
From deep within.
I see in your eyes.
To fight this battle. To step on through.
The strength you have.
I see in you.
A hand I will not lay on you.
For only you can find in you.
All the answers.
All you need.
I’ll be right here.
You will walk free.
We stand together.
Lift your head high.
Nothing to hind.
We share. We cry.
Safe. Secure. I’ll give to you.
Time to heal. Time to renew.
Nurture. Care. A gentle hand.
To steady your step.
To help you stand.
Growing. Moving. Reach for the sky.
There’s life to take.
Learning to fly.