Suggestions on Redirecting Pts

First, Mashira, I want to reinterate MrChicagoRN's advice: Give statements which are to the point.

Sometimes merely ignoring inappropriate behavior is the best tact to take. No fuel to feed the flames, so to speak.

However, when behaviors require confrontation, I have found some successful methods for quelling inappropriate behavior.

Always consider your body language. Subtle clues can be immediately conveyed this way.

When I'm attemprting to quell a Patient's behavior, I hold my open-palmed hand next to me, facing the patient, slightly lower than shoulder height. This gives the subliminal message STOP.

Do not extend your arm in the least. To extend your open palm could be taken as, "talk to the hand" or "in your face", which could be interpretted as aggressive.

Next, I consciously lower the lids of my eyes. This gesture conveys assuredness and comfortability.

I face the Individual, allowing them their biological space- say three feet, and not much closer. I'm attempting to convey subtle, yet firm, confrontation. Being within another's biological space connotes aggression or intimacy.

Then, I speak in low tones, with a well-paced cadence. I choose each word very carefully and make my action apparent. This conveys seriousness. I've said many of these types of statements so many times, many of them are rote.

I give clear, concise directions. "You need to stop this behavior." I refrain from using the word "should". Should seems to echo many Individuals' Parent Tapes. And a lot of People are angry with their Parents. The word, should, can incite.

Then, I respond according to the Individual's statements. Always focus on the subject. Never allow the Individual to use Fallicies in Logic, or deterrents, to change the focus. An example of this would be an inappropriate compliment to deter your focus.

Stay focused. Under these circumstances, don't say, "Thank you, but..." If you thank the Patient , you've given him a stroke for his ego and some momentum for continued inappropriate behavior. You could even roll your eyes before you say, "Let's stay focused." Rolling your eyes subliminally puts a negative spin on the inappropriate behavior and your appropriate follow-up statement will reinforce the focus of the interaction.

"I am a Nurse and you are a Patient. You need to do as I request, or you will have to deal with the ramifications of your inappropriate behavior." A rather strong statement, but I'm relatively sure you understand what I'm attempting to convey: "Do as I request and no good will come of your inappropriate behavior".

If I'm making objective, factual statements about the Patient's inappropriate behavior, I am simultaneously shaking my head "no". This subliminally conveys negativity. If I'm speaking of appropriate behavior, or giving reinforcement for appropriate behavior, I'm similtaneously nodding my head, subliminally accentuating the postive.

There are SO many variables and comebacks that there is no way I can cover the whole enchilada.

I hope my basic framework gives you a general idea of how to deal with inappropriate comments from male Patients. You are doing the right thing in seeking data before applying actions to the specific situation. Continue to do this. Talk to your peers. Use good, sound general techniques in communicating with all.

And remember the old axiom: "Practise provides opportunity for possible improvement." Role play. Even if by yourself, with a mirror. Actors do that the same thing to assure they're conveying the correct expression.

PM me, if you wish. The best to you, Mashira.

Dave