As nurses we will be in situations where we may feel threatened for our safety. Our job is to help people in distress. A patient’s response to a situation may become heated verbally and sometimes physically. APCNA wants to ensure we all have the knowledge and skills to identify situations early and keep both ourselves and the patients safe.
If a nurse feels like the situation is getting heated, the patient or the nurse is getting agitated, here are some tips to help.
1. Respect personal space. Respect the patient’s and your own personal space.
2. Do not be provocative. Avoid escalation by making sure your body language is congruent with what you are saying.
3. Establish verbal contact only one person should verbally interact with the patient. Introduce yourself, provide orientation and reassurance.
4. Be concise. Use simple vocabulary and repeat your message to the patient until it is heard.
5. Identify wants and feelings. Pay attention to both what the patient is saying and their body language.
6. Listen closely to what the patient is saying. Use active listening
7. Agree or agree to disagree. Find something about the patient’s position that you can agree with.
8. Set clear limits. Establish limits in a reasonable and respectful manner.
9. Offer choices and optimism. Choice is a source of empowerment for a patient who feels physical violence is a necessary response.
10. Debrief the patient and staff. Helps to restore the therapeutic relationship and alleviate the traumatic nature of the intervention.
Other tips include
Let the individual say what they need to say. Do not interrupt them. This will only increase their anger and frustration.
Understand that you may not know what the person is going through in their lives
Always keep a safe distance. 2 arm lengths away.
Keep the tone of your voice low and calm.
LISTEN
If you feel like you're becoming frustrated or irritated, take a break. Politely excuse yourself. Do some calm breathing.
Be aware of the questions you ask. "Help me understand what your frustrated about" instead of "how are you feeling?
Call emergency services if the situation escalates.
Create a plan with smart goals in mind.
Remember to take time to regulate your own emotions. Take time and review how the situation went with a coworker.
(A. Singh-Pelletier, LPN. Certified Mental Health Nurse)
It’s important for each nurse to perform a risk assessment with every patient encounter. Never allow the patient to be between you and an exit. Position yourself where you can easily leave the situation.
Also consider alerting co-workers if you know, or have the intuition, that the patient(s) may become agitated.
And be aware of safety devices like call bells, alarms or other means of getting attention if needed.
If you want to learn more to improve your nursing practice, here are some professional resources to learn more: https://ctrinstitute.com/resources/
CLPNA Confront, Address and Prevent Disruptive Behavior and Bullying in the Workplace
CRNA Practice advice: Addressing unsafe practice situations
CNPS Education & resources - publications
Comments