Many terms are used to describe restricting a child’s movement, depending on the perceived degree of force used; for example, restrictive physical intervention, restraint, immobilization, clinical holding, therapeutic holding and holding. These terms are based on presumptions of force, and suggest that nurses have a common understanding of what constitutes the use of force in the clinical setting. Children, parents and children’s nurses find many types of procedures stressful and sometimes traumatic, and often have questions around why, when and how restriction happens.

Restricting a child’s movement for routine clinical procedures is distressing for the child and may have an impact on their later psychological development. Parents have also expressed feelings of helplessness and powerlessness when their child was restricted for a clinical procedure. They are in a very vulnerable position, often unable to adequately comfort or care for their child, and not questioning practice because they feel disempowered in an unfamiliar environment.

There are a number of considerations for the nurse when caring for a child that needs to be held still for a clinical procedure, relating to the care of the child, care of the parents and self-care for the nurse. There are three main phases: the lead in to the procedure, care during the procedure and the post-holding phase.