aggressive behavior

OBNURSEHEATHER · Mar 20, 2003

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

night owl · Mar 20, 2003

Originally posted by OBNURSEHEATHER
Dual Diagnosis... Psych/Chemical Dependency.

WOW, you've got guts girl!...psycho drug addicts...You be careful out there. Some have no warning signs. As I learned the hard way...Was speaking to a paranoid schiz, kept my distance, one foot in front of the other, but since I only have a size 5.5-6 shoe size, and he was very tall with very long arms, no signs at all of aggression {{WHAM}} punched right in the eye...ouch!!!!!!!!!!! Felt like my eye went out the back of my head. Only received a corneal abraison, but it still hurt like H*LL! I'll Never forget it.

Sleepyeyes · Mar 20, 2003

Originally posted by OBNURSEHEATHER
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

I've been caught off-guard a couple of times by sudden, unpredictable behavior from a pt, and only by the grace of God that I haven't been injured. Other staff members --and sometimes other pts-- weren't so lucky.

It's helpful, IMO, to have a clue from somewhere that you're dealing with a pt with potential for violence. After all, what's worse? Having a pt. suddenly get violent and hurt someone or having the knowledge to be prepared to help this person regain control quickly?

To me, a potential for violent behavior is as valid a concern as "fall precautions," and a staff that is prepared is a staff that can better protect the pt, other pts, and themselves from harm.

mattsmom81 · Mar 21, 2003

Originally posted by Sleepyeyes
I've been caught off-guard a couple of times by sudden, unpredictable behavior from a pt, and only by the grace of God that I haven't been injured. Other staff members --and sometimes other pts-- weren't so lucky.

It's helpful, IMO, to have a clue from somewhere that you're dealing with a pt with potential for violence. After all, what's worse? Having a pt. suddenly get violent and hurt someone or having the knowledge to be prepared to help this person regain control quickly?

To me, a potential for violent behavior is as valid a concern as "fall precautions," and a staff that is prepared is a staff that can better protect the pt, other pts, and themselves from harm.

So true Sleepyeyes! I've been injured on the job twice in my career and both times by violent outburst in ICU ...psychotic episodes that could have been prevented if addressed and managed correctly. Often nursing and/or medical staff allows violence/aggression to progress to staff injury. It shows the disregard for nurses' wellbeing out there in the minds of some administrators, docs and even other nurses. Time it stops, IMO, and I'm glad violence in the workplace is a hot topic these days.

I'd like to see protocols for all units not just psych. I'm tired of docs prioritizing their patient diagnoses fears over the wellbeing of the staff ie 'He's a COPD'r so you can't medicate him at all for aggressive assaultive behavior'. I've seen too many nurses get hurt on med surg units by these types of patients.