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?
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.
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.
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.
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.
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
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
.
pattyjo, MSN, RN
105 Posts
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