_________________________________________________________________ Managing Disruptive Patients
INDEPENDENT HEALTHCARE PROFESSIONAL INTERVENTIONS AND THEIR RATIONALE FOR PATIENTS WHO EXHIBIT AGGRESSIVE BEHAVIORS Independent Healthcare Professional Interventions Rationale Use good interpersonal skills. Be nonconfrontational. Establishing rapport can help decrease the likelihood of aggression. Assess for potentially violent occurrences. Maintaining alertness to possibilities of violence allows the healthcare professional to be prepared. Acknowledge the patient's feelings (e.g., "You seem angry"). Listen actively. Providing an opening for verbal discussion can decrease possible violent episodes. Anticipate a potential problem. It is important to stay aware of environmental cues for escalating violence. If a patient's anger is escalating, communicate verbally with then in a soft but firm voice. Attempt to foster a therapeutic relationship by conveying empathy, acknowledging the patient's feelings. Encourage patients to express anger verbally rather than by "acting out" their feelings. Dealing with anger in this way will create a safe environment and help the patient learn more effective coping skills. Be respectful of a patient's personal space. Allowing a patient plenty of room sometimes keeps anger at a lower level. Teach stress reduction techniques (e.g., deep breathing). Providing alternative outlets for anger is good patient education. Continuously observe patients who are potentially dangerous to themselves or to others. Evaluation is part of the healthcare professional process. Assess the patient's coping skills and ability. Crisis intervention techniques may work to prevent violent eruption. Help the patient maintain control by offering choices, talking, or walking. Physical activity can sometimes defuse angry outbursts. Initiate or collaborate on a plan that includes a team approach to restraining a patient. Prepare ahead of time for potential violence. Alert others of the potential problem. Do not approach an aggressive patient alone. Use of a team to demonstrate a show of force is often all that is needed to defuse a potentially violent situation. Monitor the situation for the safety of others and the staff. Ask those who can to leave the area if violence is erupting. Source: [13; 33] Table 2
That evening, Erik speaks in an agitated manner, in Swedish, to another patient. Jackie, his evening healthcare professional, goes to Erik’s bedside to calm him down and see what is wrong. He is gesturing and muttering to himself, quite loudly at times. Jackie notifies the physician on call. When the physician examines Erik, he still appears agitated but somewhat calmer. The attending practitioner orders a sedative and informs Jackie that he will check with her again in an hour. Erik falls asleep in a short while. The rest of the evening shift progresses unremarkably.
Self-Assessment Quiz Question 2
Based on the information presented, what healthcare profes- sional actions should Jackie take at this point? A) Arrange for security to send someone to stay right outside Erik’s room. B) Locate some restraints and place them in Erik’s room. C) Check on Erik at frequent intervals throughout the night. D) Treat the patient the same as any other patient. The correct answer is C. Rationale : Even though Erik is sleeping now, it does not eliminate the possibility that he might become agitated.
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