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Discussion

aggressive behavior

It's often difficult to know exactly what to "subject" the message in order to get the most views, and therefore, get some feedback.

If you are reading this, hopefully you have experience with patients/clients/residents with aggressive behavior.

Here is my question: In your area of work do you have systems that identify a patient/client/resident as potential for being or becoming aggressive. Specifically something other than the careplan.

Scenario: Client A strikes out when other residents speak to them. Client B asks Client A a question, Client A strikes client B.

How are staff alerted that Client A will behave in such a way, in order to intervene and avoid incident?

Any ideas, thoughts?

Featured Replies

  • Author

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?

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.

  • Author
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.

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.

  • Author

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.

Originally posted by OBNURSEHEATHER

LOVING it! :D

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:

Originally posted by night owl

Heather,

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

Dual Diagnosis... Psych/Chemical Dependency. :D

  • Expert
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 ;).

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. :D

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.

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.

Originally posted by passing thru

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.

Excellent post! I will, however, disagree that there are no cues. There are usually distinct signs of escalation. But perhaps those not used to that type of behavior don't pick up on them as well?

Before my first job in an inpatient rehab, I had to take a 2 day seminar on escalating behaviors and self defense. I'll actually be retraining soon.

Heather

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