Restraining Order

Just another Tuesday at the office. What did I do at work?
Ya know, went in, checked my e-mail, got strapped to a mattress frame by 18 other employees.

Okay, it was not just another day at the office, it was the mandatory safety and restraint hospital training for anyone who works directly with patients. Restraints are a technique that were used much more frequently in psychiatric hospitals up until about 20 years ago. I know when people picture someone who's "crazy," the image of someone in a solitary padded room or strapped to a bed often comes to mind because that is what has been shown in so many movies. However, this is really an uncommon practice now, and that is mainly because so much paperwork has to be filed for insurance purposes when any kind of restraint (could be just as simple holding someone's arms down and walking them to their room) is performed.


So it is Tuesday around 1:00 and everyone is sleepy from lunch and tired and bored and we have to get up and learn how to use the 4 point (wrists and ankles) cuff restraints and of course they need a body to do this on so after waiting 3 or 4 seconds while everyone avoids eye contact with the instructors, I volunteer. I have to lie down on this "mattress" which is more like a gym mat and the other 18 people in the room alternate holding me down, cuffing me and tying the leather cuffs to the mattress frame with what are basically leather belts. I was listening to them as they all did this and a few comments were "this is so creepy," and "this is like a nightmare." I have to say, as someone who was fully conscious and aware of what was happening and in a training environment that was not remotely high stress, it was freakin creepy. Having people you don't know, hold you down and realizing how little you can do in that situation and being unable to really keep up with who is doing what and where, it made me a little anxious. From that, it's still very hard for me to imagine what it would be like if I was not fully able to understand what was happening and if everyone was totally serious and the tension was high.

There is a lot of negativity towards the mental health practitioners for doing these restraints. They are usually portrayed as cruel and unnecessary and even torturous. Let me just say, as someone who has had to perform a variety of different kinds of holding restraints (not using any sort of stretcher/cuffs) that they can be necessary. For example, when you have a patient who is psychotic and clawing at her face and completely out of touch with reality, if you don't intervene that patient can seriously hurt herself. Usually restraints are done (at least from what I have seen and from how I personally believe they should be used) to intervene when the patient is a harm to him/herself, and on occasion when a patient is a serious threat to another patient or staff. As much as I like to paint a picture that mental health is not as scary as it is made out to be, those movies don't come from nothing and these situations do happen, usually on more acute units. Note: they do NOT happen at every hospital and they do not happen on every unit at every hospital and this should in no way be the predominant image in your mind of what mental illness looks like, I cannot say that enough. Where I work, they are performed on some units and so all staff have to learn them. First, we learn about a million different ways to try to verbally distract the patient or calm him/her down without any kind of touch. But on the occasion that does not work we learn the restraints.

If I had my way I would order everyone who potentially has to do a restraint get restrained. I don't think you can be as good surgeon if you don't know what it is like to go under the knife. I don't think you can be as good a doctor if you don't know what it's like to be really sick. Of course we can't all share the same experiences, and I think for some reason people find mental health issues the hardest to relate to. Actually I believe the reason is because these issues are actually the easiest to relate to and that threatens the idea that people have, that they are in complete control of their bodies, minds and emotions. So convince themselves that mental illness is something bigger and scarier and more overblown that it really is so that they can believe that it could never ever possibly develop within them. I think people have less empathy with mental health and illness than with physical health and illness because of this and so I think as practitioners we have to go the extra mile to try and empathize that much more.

So go ahead and question my sanity, I do often enough, but I was glad I had that experience.