Violence Flashcards
If you are a nurse and go against a mentally impaired person you become a
Felon
Acting out
expresses feelings behaviorally rather than verbally
Acting out
Causes
inability to communicate
sense of desperation
to prevent acting out the nurse (4)
(1)helps patient communicate
(2)reduces desperation
(3)prevents secondary gains
(4)helps coping with responses
Interventions to promote communication
teach skills
observe desperation signs
convey empathy
ID and convey
make staff avalibile
avoid overloading
stay objective
Interventions to reduce desperation
monitor for desperation and address
promote communication by interacting with patient
provide alt outlet
anticipate frustration and process
decrease demands on the pt in general
Restrains on a patient acting out can:
increase desperation and be seen as punitive
If staff shames the patient during an acting out episode:
the patient can become overwhelmed with guilt and embarrasement
INCREASED RISK OF SUICIDE
Interventions to responses to acting out:
process events/pt’s feelings
convey empathy
manage own emotions and stay objective
correct/undo punishment
Causes of aggression in patient care:
threat or fear
frustration
delirium
learned response
conflict about rule/limit
Factors affecting one tendency to violence includes:
HC:
staff who are unduly fearful
institutional ridgity
Unmet expectations: Pain
anxiety, impaired coping, ability to communication, impulsiveness, psychosis, PAIN
Goals for beh crisis
safety
de-escalate
likelyhood reoccurance is reduced
STATE, SEEK, DO
I see that you are upset you do not have permission to leave the unit, I would like to see everyone stay safe.
How do you see things?
What do you think would help?
“fair trade approach”
pt threatening staff with chair
nurse states goal
“we don’t want you to go to jail”
Dislocation of expectations
pt wants nurse to be fearful
nurse remains calm to maintain control
