Episodes of violence and aggression against healthcare professionals are a sad and worrying fact.
10 Tips for dealing with an agitated and aggressive patient.
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The acquisition of awareness of the existence of such phenomena and of the need to adopt related ” zero tolerance ” policies by political institutions, company top management and operators themselves seem to proceed slowly and with difficulty. And every day the news offers us the story of situations, similar to each other in the dynamics, suffered by doctors and nurses, really intolerable .
What can a nurse do to defend against the aggressive patient?
What can a healthcare professional on the front line do to defend themselves, to avoid being in an extreme situation and still be sure that they have been assisted in the best possible way?
In the face of the patient or an upset family member there are ultimately the operators, often without physical or tangible defenses and in possession only of those that may derive from their relational and communication skills. To be played in advance, however, to block the escalation of aggression of that patient who has been waiting for 7 hours in the emergency room or of that family member who would break through walls in order to have news of his daughter , and in the waiting, always alert and active, who also the organization moves to undertake structural and organizational measures that are essential for the prevention of acts of violence .
What if you are the victim of superiors or colleagues?
De-escalation techniques as a defense tool
A ” communication tool of defense ” that the operator can learn to use are the de-escalation techniques, that is the set of measures based on verbal and non-verbal communication that aim to reduce tension and aggression in a relationship interpersonal.
De-escalation techniques can concretely help operators manage the aggressive patient. They represent the best way to respond to a hostile or angry client. They are the key to avoiding physical confrontation with someone who is losing control of their behavior.
The Joint Commission has acknowledged the suggestions developed by the CPI (Crisis Prevention Institute) to implement adequate communication methods to contain the escalation of aggression during interpersonal relationships that have communication as a key factor and that every doctor, nurse and operator can try. to make their own and implement in their work contexts.
Expert advice for dealing with the aggressive patient
1) BE EMPATHIC AND NOT JUDGING .
Keep in mind that whatever the person in front of you is going through may be the most important to their life at the moment. If the other person also says something that seems strange or irrational to you, he tries not to judge and not to belittle his feelings about him.
2) RESPECT THE PERSONAL SPACE.
If you have to enter another person’s personal space to provide assistance, explain what you are doing so the other person will feel less afraid and confused. Providing the other person’s personal space, if possible, decreases the agitation and allows you to stay at a safe distance.
3) USE NON-VERBAL NOT THREATENING COMMUNICATION.
Maintaining a neutral, non-aggressive tone of voice and body language will help you defuse potentially risky situations. The more a person loses control, the less he will listen to your words and the more he will react to your non-verbal communication.
4) AVOID EXCESSIVE REACTIONS.
Positive thoughts (“I can do this …” “I can handle the situation …”) will help you stay calm and rational. Stay calm, rational and professional. You can’t control the other person’s behaviors, but how you respond to their behaviors will affect how the situation progresses.
5) FOCUS ON FEELINGS.
See and hear the real message of the person in front of you. The facts are important, but what the other really feels is at the heart of the matter. Sometimes people don’t even realize they are angry and scared, try to make them understand that you understand what they are feeling.
6) IGNORE THE CHALLENGES.
Ignore the challenge but not the person, focus on how to solve the problem together. If you respond to the challenges, you enter an endless tug-of-war. If the other defies your authority, bring him back to the original question.
7) DEFINE YOUR LIMITS.
An agitated or upset person may not understand what you are saying: speak clearly and simply, offering alternatives. If the other’s behavior is belligerent, defensive and disturbing, give him clear and insurmountable limits.
8) CHOOSE WITH WISDOM WHAT TO INSIST ON .
If you are able to offer the other alternatives and flexibility, you will have the ability to avoid confrontations. It is important to carefully consider which rules are negotiable and which are not.
9) ALLOW TIME TO REFLECT.
Believe it or not, silence is a strong communication tool. Silence allows the person to reflect on what is happening and to decide how to continue.
10) GIVE TIME TO DECIDE.
A person’s stress increases when they are put under pressure. People who are upset or agitated do not have the ability to think clearly, give them time to think for a moment about what you have said.