When faced with an aggressive patient You may be able to defuse the situation by remaining calm and clearly demonstrating a willingness to help the patient. Try to avoid raising your voice or adopting confrontational body language, such as crossed arms or entering the patient’s space.
Full Answer
How do nurses deal with aggressive patients?
Our first reaction as nurses is to move towards patients, offering a comforting touch. However, respect for personal space is vital when dealing with aggressive behavior as the invasion of this space can increase the level of anxiety.
What do the correct and incorrect responses to aggressive patients indicate?
The correct response indicates impaired circulation and necessitates the nurse's immediate attention. The incorrect responses indicate the patient has continued aggressiveness and agitation. 11. Which is an effective nursing intervention to assist an angry patient learn to manage anger without violence? a.
Should hospitals change their approach to managing aggressive behavior?
Changing hospitals’ approach to managing aggressive behavior can be difficult because it requires a change in mindset that any patient can pose a risk. “We weren’t trained that way; we were trained to care give,” said Plamann.
What is CentraCare doing about aggressive behavior in the hospital?
CentraCare also made several process changes to help staff better identify patients who might be at risk of aggressive behavior. It can be difficult to identify all risks as some patients display aggressive behavior in the hospital when they otherwise would not.
How do nurses deal with aggressive patients?
Since most patients that arrive at the hospital are fearful or anxious, it is not uncommon for some patients to utilize anger or aggression as a coping mechanism. Therefore, nurses should utilize active listening as a tool to help comfort and reassure patients that they are invested in their safety and recovery.
How do you handle a patient with aggressive behavior?
Dealing with an aggressive patient takes care, judgement and self-control.Remain calm, listen to what they are saying, ask open-ended questions.Reassure them and acknowledge their grievances.Provide them with an opportunity to explain what has angered them. ... Maintain eye contact, but not prolonged.More items...•
How do you de escalate an aggressive patient?
Tips for de-escalating angry patientsMove to a private area. ... Be empathetic and non-judgmental. ... Respect personal space. ... Keep your tone and body language neutral. ... Avoid over-reacting. ... Focus on the thoughts behind the feelings. ... Ignore challenging questions. ... Set boundaries.More items...•
How do you diffuse an aggressive patient?
Key Things to remember when dealing with aggressive behaviourBe self-aware. Try to avoid any physical contact unless absolutely necessary as this may cause provocation. ... Remain objective. ... Non-verbal communication. ... Active listening. ... Provide solutions.
How do you deal with aggressive clients in aged care?
Speak to them using whatever name they like to be called by and don't argue or disagree with them. Show empathy by making it clear that you understand that they are upset and ask if you can help them. Be sure to listen closely to their reply and follow up any accusations or claims.
How do you treat agitated patients?
Surprise agitated patients with kindness to help them get better.Start by being respectful and understanding.Show you want to help, not jail them.Repeat yourself. ... Offer a quiet place for the patient to be alone to calm down. ... Respect the patient's personal space.Identify the patient's wants and feelings.Listen.More items...•
How does violence affect emergency departments?
Aggression and violence have increased in the nation's emergency departments and other areas of hospitals. Aggression is internal to an external continuum of pressure that causes behavior and attitude changes leading to potential harm. Violence is the actual event with the intent to cause injury and even death.
What is the difference between violence and aggression?
Violence is a destructive force causing injury or even death using any means the person may have to inflict destruction. Aggression is a continuum of behavior leading to violence.
How to deal with aggressive behavior in nursing?
Our first reaction as nurses is to move towards patients, offering a comforting touch. However, respect for personal space is vital when dealing with aggressive behavior as the invasion of this space can increase the level of anxiety. Stay at least two arms’ lengths away from the person. This also puts you out of reach of assault by either hitting or kicking and gives you space to evade or ward off an actual attack.
How to respond to challenges in healthcare?
Ignore challenges against the health care institution or you personally, such as “Who do you think you are to tell me that”. Responding defensively to challenges will only lead to arguments. Lead the conversation back to the central issue at hand.
Why are nurses the most likely to be first in line?
ADVERTISEMENTS. Nurses are the most likely to be first in line when patients or their relatives become aggressive and possibly violent. Because anger is usually an expression of loss of control over one’s circumstances, potentially violent behavior happens mostly where patients are mentally unstable and in ER Departments where ...
What is the instinctive response to violence?
When faced with potential violence the instinctive human response is fight or flight, but neither of these two actions is suitable for the healthcare setting where nurses have a duty to care . Using the following techniques to deal with aggressive behavior can usually turn the situation around and reduce the need for a crisis team. Learning and practicing these skills will also give you self-confidence in handling any crisis.
How to avoid confrontation?
Avoid facing of the person in a full frontal position because this is an aggressive stance and might be interpreted as confrontation. Stand slightly to the side and at an angle. Adopt a relaxed posture, arms at your sides with hands open and facing the person. 3. Be calm and respectful.
How long should a nurse de-escalate?
When in the firing line there is not always time to call a trained responder. A 5-minute de-escalation is also far preferable to the use of physical restraint, where staff members are also at greater risk of being injured in the process.
Is the nursing profession a dangerous profession?
Workplace violence is seen by the American Nurses’ Association as the most significant occupational hazard faced by nurses and an issue that should be addressed as a priority with adequate workplace policy as well as skills training for all nurses. Nursing is one of the most dangerous professions.
Why is it so hard to change hospitals' approach to managing aggressive behavior?
Changing hospitals’ approach to managing aggressive behavior can be difficult because it requires a change in mindset that any patient can pose a risk. “We weren’t trained that way; we were trained to care give,” said Plamann. “We just haven’t been trained to think of hot coffee as a potential risk or weapon.”.
Why is CentraCare placed outside the patient's room?
It may be caused by a reaction to medication or stress of their condition, for example. However, if a patient is known to have a past history of multiple aggressive behaviors or the nurse determines they may have a current potential risk for aggressive behaviors, a spiral-shaped magnet is placed outside the patient’s room, similar to how many hospitals identify patients at risk of falling with a “falling star.” This common symbol replaced other signs such as “check with nurse before entering” that staff didn’t always think applied to them. “This reminds staff to be thoughtful about every move they make; to knock first, be aware of their position in the room and so forth,” said Plamann. In addition, an alert can be added to the patient’s record in the electronic health record so all staff can be informed of the risk.
Does Centracare have a safety culture?
CentraCare is working to change that mindset and has made a long-term commitment to involve staff at the bedside to try to mitigate the risks of this issue. As with many safety and performance improvement efforts, a strong safety culture is at the foundation. Staff must recognize that aggressive and violent behavior by patients does not have to be tolerated, and they must feel that the hospital will support them in putting their own safety first.
Why do older people use anger?
Recent study suggests that, older people may use anger as a strategy for maintaining some sense of power over their own lives because as long as they remain angry or resistant, people will notice them . Walker et al (2004), as people get older, they are exposed to a wider variety of situations and are therefore less likely to find new situation stressful, though some older people may be resistant to change. The patient was in severe pain, so i would think he used anger and aggression as a pain coping strategy. Cowan (2000), anger is therapeutic in relieving stress. Hyland and Donaldson (year please) say, health care professional can reduce patient anger by providing the information the patients wants about his condition. So communication plays a very important part in diffusing tense situations.
How to be more effective as a student radiographer?
To be more effective, as a student radiographers should attempt to understand the extent and expression of the anger, the specific problems resulting from the anger, the function the anger serves and the underlying source of the anger.
Can anger be used as a cover for fear?
This experience taught me that, anger and aggression could be used as cover for deeper problems. Anger could be a cover up for fear, being used as a shield to keep other people at a distance so they are unable to see one’s insecurities and weaknesses, Booth (2003).
What is ED aggression?
Aggression in the Emergency Department (ED) remains an ongoing issue, described as reaching epidemic proportions, with an impact on staff recruitment, retention, and ability to provide quality care. Most literature has focused on the definition (or lack of) core concepts, efforts to quantify the phenomenon or provide an epidemiological profile. Relatively little offers evidence-based interventions or evaluations of the same.
What is the lack of evidence based intervention strategies?
The lack of evidence-based intervention strategies leaves clinicians in a difficult situation, often enacting practices based on anecdote rather than evidence. Local solutions to local problems are occurring in a pragmatic manner, but there needs to be clarification and integration of workable processes for evaluating and disseminating best practice.
Where is the 2Centre for Postgraduate Nursing Studies?
2Centre for Postgraduate Nursing Studies, University of Canterbury, Christchurch, New Zealand
Is violence a problem in emergency care?
Violence continues to be problematic in the emergency health-care setting. It has been variously described as alarming, 1 escalating, 2 at crisis level, 3 and even at epidemic proportions. 4, 5 Evidence continues to emerge demonstrating that health-care violence and aggression occur in a range of countries, across varied geographical settings, socio-economic levels and within services offering varying technological capacity. 6 – 8 While the presence of violent outbursts and associated aggression may not be a new phenomenon, the ability to identify and share information rapidly has increased recognition of the extremes that present, and highlighted the issue in ways not possible before. This international awareness has benefits – not only is it raising the awareness of the extent and seriousness of the issue, but it also provides the opportunity to share learning and responses and to identify potentially transferrable or adaptable options from other services or countries.
Is there a one size fits all approach to ED violence?
There is no simple, “one size fits all” remedy to the management of violence and aggression in the emergency department (ED). Reports identifying and describing violence and aggression in EDs have been produced for as long as EDs have existed. Emergency Medicine as a specialty typically dates from the 1960s in the UK 9 and USA, 10 and from the 1980s–1990s in parts of Asia and Europe. 11, 12 In other regions it is even more recently recognized as a specialty (India, parts of the Middle East and Africa) 13 – 15 and so remains a relatively new field. Therefore, it is appropriate to look at the wider health-care arena for effective approaches to management of the aggressive patient. It is important to acknowledge that the ED environment has specific challenges, and has been identified as one of the areas of highest risk within the health sector. 16 – 18 Within the ED setting, the workforce is not equally targeted – various studies have highlighted the rates and types of violence amongst different groups working in the ED. What is apparent is that nurses and health-care assistants, whether because of their higher levels of patient contact and potentially their perceived position in the hierarchy of the health system, are at risk of greater exposure to violence and aggression. 18 – 21 Predictors of violence and aggression have been suggested, including patient behavior, background and condition (including organic derangements and presence of alcohol or drugs) 22, 23 as well as environmental and social stressors including prolonged waiting times, overcrowding, stress, anxiety, and pain. 24 – 26 Additional consideration has been given to the individual skills of the practitioner with regard to communication, interpersonal interactions, clinical expertise, and individual personality traits and attitudes (such as self-confidence, resilience, and reflection). 27, 28 As well as being potential contributory factors, there is uncertainty whether certain character traits or clinician behaviors exist prior to exposure to violence or develop as a secondary, traumatic response. 29 – 32 Thus, any efforts to manage the aggressive patient must be mindful of the available breadth of resources (from outside the ED setting as well as within) and awareness of the potentially targeted nature and necessary focus for at-risk groups amongst staff. This enables the opportunity to draw on and adapt from generic approaches while building tailored programs and evidence-based responses.
When are patients more aggressive?
Patients are more likely to become aggressive at admission, at shift change, at mealtimes, during visiting hours, during the evening, when being transported, and during periods of change
What is held after staff restrained a patient's aggressive behavior?
After staff restrained a patient's aggressive behavior, a debriefing is held. Which topics should be the focal points of discussion?
What is rehospitalization related to?
A patient is rehospitalized related to psychotic symptoms and medication noncompliance. During prior hospitalizations, the patient was verbally and physically offensive for several days until the medication took effect.
What should the priority action be before leaving the patient in the room?
Before leaving the patient in the room, the priority action should be:remove potentially harmful objects from patient.
What does a patient say when they are diagnosed with depression?
A patient diagnosed with depression says, "I'm so stupid. I can't say 'no,' so other people always take advantage of me." Select the best goal. The patient will express anger assertively.
What is the crisis phase?
The crisis phase is characterized by a patient's loss of self-control with fighting, hitting, kicking, scratching, biting, and throwing things.
What is the triggering phase?
The triggering phase is characterized by increased tension, readiness to retaliate, pacing, irritability, suspiciousness, glaring, breathing changes, and diaphoresis
How does a nurse help a patient with control?
A patient gains feelings of security if he or she sees others are present to help with control. The nurse gives a simple direction, honestly states what is going to happen, and reassures the patient that the intervention will be helpful. This positive approach assumes the patient can act responsibly and will maintain control. Physical control measures are used only as a last resort.
What is the purpose of the expectation that the patient will maintain control of behavior?
Stating the expectation that the patient will maintain control of behavior reinforces positive, healthy behavior and avoids challenging the patient. Offering as-needed medication provides support for the patient trying to maintain control. A firm but calm voice will likely comfort and calm the patient.
What should a nurse do when a patient is a widow?
The nurse should make eye contact and assure the patient of safety. Once the nurse has the patient's attention, gently touching the patient, asking what he or she needs, or directing the patient to discontinue the behavior may be appropriate. 16. A cognitively impaired patient has been a widow for 30 years.
Why is it important to make sure space is present between the nurse and the patient?
Making sure space is present between the nurse and the patient avoids invading the patient's personal space. Personal space needs increase when a patient feels anxious and threatened. Allowing the patient to block the nurse's exit from the room may result in injury to the nurse.
What is confused patient?
Confused patients are not always able to evaluate the actions of others accurately. This patient behaved as though provoked by the intrusive actions of the staff.
What is aggressive behavior?
Aggression is harsh physical or verbal action that reflects rage, hostility, and potential for physical or verbal destructiveness. Aggressive behavior violates the rights of others. Refusing medication is a patient's right and may be appropriate. The other incorrect options do not feature violation of another's rights.
What does "aggressive" mean?
ANS: A. Aggression is harsh physical or verbal action that reflects rage, hostility, and potential for physical or verbal destructiveness. Aggressive behavior violates the rights of others. Refusing medication is a patient's right and may be appropriate.
Aggression and Violence
Evaluation of Aggressive/Violent Patients
- Assessment of the patient who has the potential to cause harm is crucial to help reduce the possibilities of a violent episode. Darla's patient underwent a triage assessment and ongoing assessments looking for a sign of physical or mental distress throughout his visit. Evaluating these patients takes a keen eye and the ability to address issues quickly so as not to intensify th…
Nursing Treatment Options
- First and foremost, the environment must be safe for staff and patients. If aggression or violence is suspected, it's imperative to secure the room of any sharp or movable objects that could be used as a weapon. 1. Safe scene, check the environment 2. Communication of progress during the visit 3. Clear goals for the patient encounter 4. Recognize p...