When to run?

302queen · Feb 25, 2013

luckly i have not been chased.

greenbeanio · Feb 25, 2013

When someone is about to attack, I don't know that there would be time to run. The psych nurses I know who were attacked and injured were very experienced psych nurses and even they never saw it coming.

So I guess I'd say forget about running. You probably wouldn't have the time, it involves turning your back which is even more dangerous, and sends a dangerous message to the patient - I do think it can make things worse. A quiet and dignified retreat, in the spirit of giving the patient some space and not escalating the situation by continuing to be "in their face", might be a good choice, but not running.

greenbeanio · Feb 25, 2013

Building trust and a rapport with patients will help to keep them from directing their anger at staff.

Normally I'd say yes, exactly. But today a schizophrenic patient who is normally very pleasant and with whom I thought I had a very good relationship suddenly got really irritable with me. All I said was "Hi X, when you have a moment can I get your blood pressure?" and he said "Yes you can, but I don't like you." and proceeded to be extremely irritable about even the gentlest things I said. So I just let it go and didn't even try to connect any further because it wasn't going anywhere right then, and I didn't want him to escalate. I have never, ever seen him like this! This is the same guy who had been smiling and totally pleasant 45 minutes ago. But I guess a lot can change in 45 minutes, especially if "the voices" are telling him I'm the devil or whatever. So yes, build rapport, build trust, but remember that certain patients can be very unpredictable and you don't always know which ones. So having a plan B is a good idea, instead of relying 100% on your rapport and trust building.