Managing Patient Aggression

Question 1

What conditions does can potentially cause a patient to become violent

Answer 1

• TBI
• PTSD
• neurocognitive impairment
• confusion
• infection
• fatigue
• fustration

Question 2

What are some ways to approach a conflict situation

Answer 2

think about these questions as you apprach a conflict situation

• what is happening?
• who is involved
• what do I know about them? triggers/issues
• are the parties in close proximity
• might the patient think that I am an adversary, an enemy etc

Question 3

How can you prepare to approach a potentially violent patient

Answer 3

• turn the stones of rings inward
• tuck necklaces and ties
• remove dangling ear rings
• for some fighters these actions is fight preparation activity

Question 4

how can you try to defuse the situation

what Attitude should you take

Answer 4

• no losers
• dignity left intact for all
• no injury

Question 5

How can you tell the patient why it is better to resolve verbally

Answer 5

• ask patient to give you a quick opportunity to try to defuse things now
• restate expectations for a positive outcome
• remain persistent and stay focused on a peaceful ending

Question 6

how can you present a non-threatening appearance

Answer 6

• sitting if they are
• actively listening to asking questions
• if safe move patient to a more private location
• remain calm and do not argue

Question 7

How can you show active listening and empathy to help with patient aggression

Answer 7

• listen sympathetically
• leaning forward
• using eye contact
• nodding in recognition of what’s said

Question 8

Active listening with restatement for patient aggression

Answer 8

• let the patient vent
• use short verbal acknowledgments (uh-huh, hmm)
• write down or repeat what is said (if this is okay with the patient)
• it shows importantce but could be perceived as documenting the case against them

Question 9

Active listening with clarification

Answer 9

• ask the patient to explain vague/confusing complaints
• exhust the list of complaints
• let them talk out all the issues and emotions
• show or repeate the list to the patient and ask if it is complete

Question 10

Analyzing a conflict situation: functional behavior assessment

Answer 10

• where and when did it happen?
• who was present
• what events preceded the action
• what behavioral signals did the patient show before the outburst
• what actions were taken to prevent the crisis and were they effective
• what factors influenced/supported this behavior?