aggressive behavior

pattyjo, MSN, RN · Mar 19, 2003

Hi Ursula: A question: are you working in psych or a LTC/Alzheimer's/dementia setting? And how many patients are we talking about here?

I agree with everyone who has said the color coding thing is a bit odd. Privacy issues, yes, but also dignity, and my guess is, all the patients will have figured out the code in about 30 minutes, so you have effectively "branded" the patients among their peers, and any visitors who show up.

Do you do any type of assessment to determine the potential for aggression? (Although as others have already said, in certain settings there is *always* the potential for violence/aggression.)

We don't have formal orders for specific precautions, but do pass on in report any suspicions. To some degree, we can anticipate escalating behavior, but there is always that impulsive, unpredictable outburst to deal with.

Patty

monkijr · Mar 19, 2003

I work in a LTC facility, and the aggression is not necessarily dementia related.

I am having a difficult time convincing the staff that the color thing is a bit odd, and how it is a dignity issue, They just don't get it!!!!

Assessments are in place, care plans are in place, interventions taught, what they are looking for is a way to avoid in my opinion that which sometimes cannot be predicted or unavoided, unless you have one on one with each resident.

It's not going to be easy, but my goal is to avoid "branding/labeling" but I need to suggest another solution.

any thoughts?

jemb · Mar 19, 2003

Where I work, any employee can write a complaint about an aggresive patient. If the organization receives complaints about three different incidents, the client's coverage is discontinued.

No one should have to put up with abuse in the name of customer service.

monkijr · Mar 19, 2003

Originally posted by sunnygirl272
/hipppppaaaa(can never remember if it's 2 p's or 2 a's...

the argument that it is a hippa (hee hee I can't even get it right) issue

It's HIPAA Health Insurance Portability and Accountability Act And I have to look it up most the time.

Don't know if I'll ever get it correct, since I heard it referred to hippo, forever.

Sleepyeyes · Mar 19, 2003

We use color-coded bracelets at our facility, but not for aggressive pts.

We generally use them for elopement precautions or fall precautions.

For example, orange is for elopement precautions, red is for allergies, blue is thickened liquids, etc. You might try something like that, like neon yellow to mean "approach cautiously" or something.

And just like with someone on restraints, this would have to be something that was frequently and regularly re-evaluated for appropriateness.

I don't believe this causes any harm to a person's dignity; it may very well be for a short-term period and the pt. is more protected by staff who are aware that the pt is in DT's or whatever.

monkijr · Mar 19, 2003

I will certainly suggest this an option, still am looking for *other* options, however, still don't know what they might be.

Maybe I am not being realistic?, can always think outside the box.

night owl · Mar 20, 2003

Originally posted by OBNURSEHEATHER
LOVING it!

I guess I didn't realize how much I enjoyed the psych aspect until I was admitting my first paranoid schizophrenic, and I got that thrilling/excited/adrenaline-pumping feeling when he kept "SHHH!"-ing the voices. :chuckle

Thanks for asking!

Heather,

You work on a psych unit now???:rotfl: :rotfl:

OBNURSEHEATHER · Mar 20, 2003

Originally posted by night owl
Heather,
You work on a psych unit now???:rotfl: :rotfl:

Dual Diagnosis... Psych/Chemical Dependency.

Nurse Ratched, RN · Mar 20, 2003

Originally posted by night owl
Heather,
You work on a psych unit now???:rotfl: :rotfl:

Too cool, huh? You know she must ROCK at it :). No wusses in psych .

OBNURSEHEATHER · Mar 20, 2003

Originally posted by Nurse Ratched
Too cool, huh? You know she must ROCK at it :). No wusses in psych .

Awwwww..... how sweet!

I do feel right at home.

passing thru · Mar 20, 2003

I am just getting to this thread as I have been consumed with IRS and receipts and baskets full of "little pieces of paper", (deductions), but I would like to say I enjoyed 272'S definition of elopement immensely.

passing thru · Mar 20, 2003

Is the "system" to protect the staff or the residents??

According to your examples; wouldn't you initially be alerted by the examining docs' diagnosis??

Wouldn't the patients/clients/residents/ give you clues? A lot of people who are not professionally trained can pick up on verbal and body language cues that signal another person's

explosive "potential."

Few people don't give cues prior to actual striking. Hostility, the patient feeling trapped, the patient feeling manipulated, verbal warnings and threats, etc, will all result in aggression.. same as you or I would exhibit.

Listen and look, you don't need a "system" or color coded shirt to avoid

an unexpected outburst/attack.