The nurse's holding power: patterns of use in mental health.

Implementation of the nurse's holding power (Section 5(4) of the Mental Health Act 1983) is an important, yet poorly researched aspect of mental health nursing practice. Data collected from the Mental Health Act records of all patients detained under Section 5(4) in one trust from 1983 to 1997 suggest that detainees generally came from the acute mental health services, were female, were detained by male registered mental nurses and were held for an average of 2 hours and 24 minutes before being placed on another section of the Mental Health Act. The use of Section 5(4) seems to be influenced by the time of day, but not the day of the week, or month of the year. Peaks of Section 5(4) usage corresponded to such factors as the changeover of shifts, the absence of medical staff, visiting time and medicine rounds. The importance of these findings for clinical practice is discussed.