Sedating aggressive patients, reader Interactions
Usually difficult, angry and manipulative patients will attempt to draw you into a shouting match, pull on your own angry emotions, and attempt to bait you into becoming verbally aggressive. This is not fair to you or the patient, potassium argon dating reliability in research and you should seek out help to sort through your feelings when you encounter aggressive patients on a frequent basis.
It is important for the nurse to calmly recognise their own feelings when dealing with this type of patient and not let emotions overwhelm them. Body Language and Other Useful Strategies Your body will tell the story of your emotions far better than your words do. Early recognition and use of de-escalation strategies aimed at diffusing a volatile situation is the preferred approach. Cool your facial expression to keep from grimacing, twisting your lips, pursing your lips, lifting your eyebrows, or scowling. Even anger over a long wait time can mask a fear of not knowing what is wrong with them.
How to Handle Difficult Patients
Manipulative patients are often looking to engage you in a heated argument. Restraints must be applied in the least restrictive maner and for the shortest period of time. Complications from chemical sedation - respiratory depression, hypotension, extrapyramidal reactions. If the patient is actually frightened, then you will have to approach them differently than if they are truly angry over something, such as a long wait time.
Your patient may throw things at you, spit at you, or physically try to attack you. There seems to be a lot of heterogeneity in the literature time to sedation, medication regimens, etc. Keep your hands and arms placed in front of your body, but not crossed as this can seem confrontational. This article quotes shockingly high numbers of assault and abuse.
The best course of action is to carefully interview the patient to draw out what they are feeling. However, this article supports the use of combination therapy over lone benzodiazepine use. Antipsychotics and combination therapy were more effective, requiring less repeat doses for sedation than benzodiazepines.
This can be facilitated following an assessment by local mental health clinicians. If you are seething with anger and attempt to use the above positive responses, yet you are wound tighter than a drum, the patient will notice.
When patients are demanding and descend into aggression, it just may be a breaking point for some nurses. How to Handle Difficult Patients When dealing with difficult patients, it helps to watch your language as closely as possible to prevent the situation from escalating. Physical restraint should always be followed up with chemical and mechanical restraints.
They simply are stuck on their version of events and will not budge from their beliefs. The bottom line here is chemical sedation can be variable and no one single aspect should be a marker of clinical efficacy. In general, most would agree an efficacious chemical sedation regimen should have rapid onset of action.
Clinical Practice Guidelines
It is usually the patients that make the sore feet, paperwork, and hours without a bathroom break worth it. Dealing With Angry Patients Someone who is acting angry may simply be frightened, defensive or resistant to what is going on around them. This statement allows the patient to be heard and allows you to state your side of the argument. Occasionally, those moments escalate into pure aggression on the part of the patient. For instance, maybe an older woman lashed out at you, and now you feel that all older women are going to be difficult.
Whether you encounter a patient who is angry, manipulative, demanding, or downright nasty, sometimes these patients can make you question why you became a nurse in the first place. Dealing With Manipulative Patients Manipulative patients are the ones who threaten, cajole, cry, or throw temper tantrums in an attempt to get their way.
Studies not including antipsychotic medications and benzodiazepines were not included in this review i. It is ideally chaired by an objective facilitator who was not involved in the restraint process.
Sometimes, we want something longer acting, like for an aggressive and violently decompensated psychiatric patient. This was a good attempt at a meta analysis of a subject of prime importance, chemical sedation of agitated patients.
Your fear of an aggressive patient can colour the way you care for certain patient types. Aggressive Patients We have all had those patients.
Eye contact is important, and it conveys honesty and openness. They are more likely to respond to the message that is coming from your body cues than your voice cues, and that is why it is important to relax and control your body in a heated situation. Nearly every nurse has experienced a patient shouting at them, berating them, and telling them where to go. Sometimes, a nurse can feel like it is too much. You have to first calm yourself and take stock of your own emotions.
Some nurses may feel that they have personally failed when a patient acts out against them. It just takes another step of education to diffuse these tense situations and come out of the encounter with your compassion intact. Giving patients isolated doses of benzodiazepines is often regarded as a prudent and cautious route for sedation.
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