Patients become ‘challenging’ for a number of reasons. Here, we advise on managing the patient while protecting yourself, staff and other patients. Show
14 June 2021
Why do patients become 'challenging'?Patients, and sometimes their carers, become challenging, difficult, uncooperative or aggressive for a number of reasons:
Their behaviour may take the form of:
Identifying the problemIs it the patient?Always consider first whether the patient's behaviour is caused by a medical condition. If so, treat the patient as far as possible without putting yourself or others at risk. Is it a lack of resources?Long waiting times, lack of available appointments or beds, locums unfamiliar with the department, poor communication by staff, etc. may all contribute to a patient's deteriorating mood or behaviour. Is it the doctor?Competing pressures on the doctor (time, resources, personal) may affect their communication style and potentially exacerbate the situation. Assessing the riskEven if you are not in a position to determine the security policy at the trust or practice, you can seek ways to protect yourself, colleagues and other patients.
Defusing a violent situationDealing with an aggressive patient takes care, judgement and self-control.
What can you do?Patients must not be denied necessary treatment even though they may be aggressive or violent. Treatment must be based on clinical need, however demanding the patient. Nevertheless, you should assess and minimise the risks to yourself, the patient and others. In some cases it may be reasonable and necessary to consider alternative arrangements for providing treatment. If systems, policies or availability of resources are compromising patient care, you must raise your concerns. It's advisable to train staff in conflict resolution and dealing with aggressive behaviour. Consider your security requirements. Your LSMS is responsible for security in your practice area and can advise you. If you have concerns about the safety of your environment, raise them with your security management director or the LSMS. GPs training in England and Wales can save 70% on their first year of GP membership, with further savings for the following four years. Find out more here. This page was correct at publication on 14/06/2021. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers. This preview shows page 159 - 161 out of 334 pages. 30.One of the first steps that a nurse should take to deal effectively with aggressive clientsis which of the following?A)Reflect on abilities to handle own feelings of angerB)Learn professional skills of anger managementC)Become proficient using reflective communication techniquesD)Understand how to activate crisis response teamsAns: AFeedback:The nurse must be aware of how he or she deals with anger before helping clients do so.The nurse who is afraid of angry feelings may avoid a client's anger, which allows theclient's behavior to escalate. If the nurse's response is angry, the situation can escalateinto a power struggle, and the nurse loses the opportunity to ìtalk downî the client'sanger. Identifying how you handle angry feelings is an initial task. Once the nurseunderstands his or her own experiences with anger, the clients can be helped throughlearning the use of assertive communication and conflict resolution. Increasing yourskills in dealing with your angry feelings will help you to work more effectively withclients. Activating a crisis response is a late option in dealing with anger.NursingNotesArt Page 1331.Which of the following is most important to maintain therapeutic boundaries whenworking with aggressive clients?A)Encourage clients to express how the nurse can avoid causing emotional irritation.B)Discuss difficult patient care situations with a supervisor.C)Reflect on your actions that may have instigated the client's anger,D)Do not personalize a client's angerAns: DFeedback:Do not take the client's anger or aggressive behavior personally or as a measure of youreffectiveness as a nurse. The client's aggressive behavior, however, does not necessarilyreflect the nurse's skills and abilities. Clients should not dictate nurses' behaviors. Thenurse is not responsible for angering the client. Individuals are responsible for their ownemotional control. If the nurse cannot maintain boundaries, assistance should be soughtform a supervisor.32.Which of the following are important issues for nurses to be aware of when workingwith angry, hostile, or aggressive clients? Select all that apply.A)Nurses must be aware of their own feelings about anger and their use of assertivecommunication and conflict resolution.B)Nurses must not allow themselves to become angry under any circumstances.C)Nurses must know that a client's anger or aggressive behavior is preventable by askilled nurse.D)Nurses must discuss situations or the care of potentially aggressive clients withexperienced nurses.E)Nurses must be calm, nonjudgmental, and nonpunitive when using techniques tocontrol a client's aggressive behavior.Ans: A, D, EFeedback:Nurses must identify how they handle angry feelings and assess their use of assertivecommunication and conflict resolution. Increasing their skills in dealing with their angryfeelings will help the nurses to work more effectively with the client. Nurses must nottake the client's anger or aggressive behavior personally or as a measure of theireffectiveness as a nurse. Nurses must discuss situations or the care of potentiallyaggressive clients with experienced nurses. Nurses must be calm, nonjudgmental, andnonpunitive when using techniques to control a client's aggressive behavior. Upload your study docs or become a Course Hero member to access this document Upload your study docs or become a Course Hero member to access this document End of preview. Want to read all 334 pages? Upload your study docs or become a Course Hero member to access this document What is one strategy for dealing with an aggressive client?Stay calm and keep your emotions in check. Adopt a passive and non-threatening body posture (e.g. hands by your side with empty palms facing forward, body at a 45 degree angle to the aggressor). Let the client air his/her feelings and acknowledge them. Ask open-ended questions to keep a dialogue going.
How do you deal with aggressive behavior?Key Things to remember when dealing with aggressive behaviour. Be self-aware. Try to avoid any physical contact unless absolutely necessary as this may cause provocation. ... . Remain objective. ... . Non-verbal communication. ... . Active listening. ... . Provide solutions.. Which issue would be most important for nurses to be aware of when working with angry aggressive or violent clients select all that apply?Which of the following are important issues for nurses to be aware of when working with angry, hostile, or aggressive clients? - Nurses must be aware of their own feelings about anger and their use of assertive communication and conflict resolution.
What plays important role in managing aggression?Alterations in the functioning of limbic system may result in an increase or decrease in the potential for aggressive behavior. In particular, the amygdala, part of the limbic system, mediates the expression of the rage and fear.
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