Displaced Anger From Patients, Visitors, And Others

Displaced anger is the mental process of redirecting one's anger away from the real target onto an unrelated target that seems safer. Once vented, that anger can swiftly explode and set the stage for an unstable situation.

Unfortunately, bedside nurses are common recipients of displaced anger from patients, visitors, coworkers, and others, because the public views us as nonthreatening targets. For instance, the young adult patient is seething with rage because the surgeon has refused to increase the scheduled dose of Dilaudid, so he verbally abuses the nurse and loudly yells obscenities. Although the nurse in the aforementioned scenario is not the real target of the patient's anger, he has mentally determined that he can safely unleash his rage onto nursing staff.

According to Pecci (2009), patients or family members often get angry when they've been waiting for a long time; if they don't like the information that they're getting-or not getting-from staff; or if they aren't receiving the medical treatments that they want or expect. Even though these frustrating experiences might not be the direct fault of nursing staff, patients and families often direct their anger toward the nurse. In settings where pediatric patients are treated, parents who secretly resent the fact that their child is disabled and multi-handicapped may displace their anger onto nursing staff by screaming, criticizing their actions, 'firing' nurses from their child's care, and making false allegations.

Physicians are under tremendous stress because, due to constraints caused by managed care and insurance companies, they feel increasingly unable to provide much-needed care to patients. Rather, they must seek/beg for permission from some non-physician (MBA) at the other end of an 800 line to approve or disapprove of each procedure based on cost (Anderson, 2009). Hence, some physicians displace their anger and frustration on nursing staff members because they see us as a much safer target than the people who work for the insurance company. For instance, the doctor is angry that the patient's managed care plan will not pay for an elective procedure, so (s)he abruptly slams a chart onto the nurses station.

How do we deal with displaced anger? First of all, people need to be held accountable for their actions. Patients, family members, coworkers, and physicians must personally recognize and handle their own anger instead of displacing it onto others or allowing it to explode. But perhaps most importantly, nurses are learning to recognize which patients may become disruptive and how to de-escalate situations so they don't turn violent in the first place (Pecci, 2012). Crisis prevention training equips nursing staff with tools to recognize when patients, visitors, and colleagues might explode with rage, and to de-escalate potentially challenging situations.

Of course, therapeutic communication can go a long way. When someone is displacing anger and you know you're not the intended target, presenting reality is a form of therapeutic communication: "You called me an idiot. I am a nurse, not an idiot." Also, you can therapeutically communicate by encouraging the patient to form a plan of action: "I will return to your room when you are ready to behave." Another therapeutically communicative technique involves the use of broad openings to get the person to open up about the true object of his or her displaced anger: "Tell me what you'd like to talk about."

Keep in mind that the expression of anger varies from person to person, and that most people learned their current methods for dealing with anger during their growing-up years. While you cannot change the manner in which another individual manages their anger, perhaps you can affect the person's treatment of you. Good luck, and stay safe.

work-cited.txt