Aggression and violence sometimes occur in mental health settings, and nurses need to know how to de-escalate these situations. If de-escalation techniques are unsuccessful, the patient may need to be physically restrained or placed in seclusion. It may also be necessary to administer medication to calm the individual. This article explores the nurse’s role in relation to the use of rapid tranquillisation as part of the management of aggression and violence. The procedure is outlined and the importance of patient monitoring to observe for possible adverse effects is discussed. The legal and ethical issues are examined, along with guidance on the use of advance directives.