Management of Aggressive Behavior
Aggressive behavior involves a patient raising their voice towards the nurse or violent attack using a weapon or an object. These threats pose a serious threat to the physical and psychological wellbeing of the nursing staff. To manage these aggressive behavior certain containment measures can be used. A possible way of managing this aggressive behavior involves the calming of the patient using verbal and persuasive approaches that will ultimately calm the patient. In cases where this does not work, physical contact may be required to manage the aggressive behavior.
According to Foster, Bowers and Nijman (2007), methods such as restraint, seclusion, and compulsory medication can also be used. However, these methods can be more distressing to the patients. In cases where there are patient conflict behaviors, the use of restraint may be an effective means to contain the situation. Using physical restraint may be necessary in emergencies to avoid the patient from harming others or themselves (McDonell, 2011). Verbal aggression may be best controlled through the use of time out and verbal and persuasive approaches (Foster, Bowers, and Nijman, 2007). Certain situations may warrant the use of medication where the patient is highly aggressive. Prior to injecting medication, physical restraint will have to be used to ensure that the medication is administered correctly.
Reduction of aggressive behavior in the psych wards depends on how the nursing staff respond to the different situations. According to Foster, Bowers and Nijman (2007), the factors that lead to patients acting aggressively needs to be addressed. This will help better manage how to respond to the aggressive situation.
Presentation to Nurses and CNAs
As a nurse or a CNA in the psychic ward, it becomes necessary to understand the factors, which may contribute towards the aggressive behavior of patients. Some of the methods used such as physical restraint may contribute towards frequent aggressive behavior from the patients. The nurses need to understand that the environment the patient is in contributes to the levels of aggressive behaviors. According to Duxbury (2005), the nurse needs to avoid certain environmental factors, which may cause patient aggression. These include the use of authoritarian nursing style, coercion, and aversive stimulation.
Nurses need to be aware that incidences of patient aggression are increasing. This has contributed to having a reduction in the nursing staff. Further, the management of aggressive behavior requires the nurses to be properly trained. The training may help to avoid injuries to patients when using certain techniques, which require physical contact. Furthermore, developing relationships that are therapeutic with the patients may assist in managing aggressive behavior (Duxbury, 2005).
The nurse and the CNA have to be very careful in choosing the approach to manage the aggressive patient. Use of restraint on a patient that has no history of physical aggression may help trigger further aggressive behavior in the future. The management of aggressive behavior requires the environment of the psychic ward to be accommodating to the patient. This will help when using strategies such as verbal and persuasive approaches, which provide no form of harm to the patient and ensures that safety of the nurse and the patient remains intact. Furthermore, the nurse or the CNA needs to have confidence when managing the aggressive situations. This ensures that there is a higher chance of initiating psychosocial intervention (McGowan, Wynaden, Harding, Yassine and Parker, 1999).
References
Duxbury, J., & Whittington, R. (2005). Causes and management of patient aggression and violence: staff and patient perspectives. Journal of Advanced Nursing, 50(5), 469-478.
Foster, C., Bowers, L., & Nijman, H. (2007). Aggressive behavior on acute psychiatric wards: prevalence, severity, and management. Journal of Advanced Nursing, 58(2), 140-149.
McDonnell, A. A. (2010). Managing aggressive behavior in care settings understanding and applying low arousal approaches. Chichester, West Sussex, UK: Wiley-Blackwell.
McGowan, S., Wynaden, D., Harding, N., Yassine, A., & Parker, J. (1999). Staff confidence in dealing with aggressive patients: A benchmarking exercise. Australian & New Zealand Journal of Mental Health Nursing, 8(3), 104-108.
