‘We are not trained to do clinical work’: security staff providing physical restraint for NGT feeding in English paediatric wards—a qualitative multi-informant study

Abstract

ObjectiveTo gain insights into the experience, and impact, of using security staff to facilitate physical restraints for nasogastric tube feeding.DesignA cross-sectional design using 39 individual interviews, three online focus groups and three written submissions involving young people with lived experience (PWLE), parents/carers, paediatric staff and security staff involved in nasogastric feeding under restraint in paediatric settings in England. Qualitative semistructured interviews were transcribed and thematically analysed.Participants53 individuals participated: seven security staff (all men); nine PWLE who experienced the intervention between the ages of 9 and 17 (all female); 20 parents (15 mothers, 5 fathers) and 20 paediatric staff (5 men, 15 women).ResultsRegarding the involvement of security staff, participants spoke in relation to two primary themes (1) short-term impact and (2) long-term impact. Short-term themes included that the intervention felt inappropriate and traumatic while also recognising its lifesaving nature and the fact that involving security guards preserved positive relationships with nursing staff. Longer-term themes included the development of trauma symptoms, while also acknowledging the skill development and improved professional relationships that could result from delivering the intervention.ConclusionsThis lifesaving clinical intervention can negatively impact security staff as much as the patient, parents/carers and paediatric staff. A prebrief and debrief should be seen as part of the ‘process’. Further research is needed to better understand what else can mitigate negative impacts.