Patients can behave rudely, or turn downright aggressive if they feel they’ve been wronged, ignored or dealt a bad card. Some patients maintain high and sometimes unrealistic expectations of a doctor’s power to treat them. When they feel that their demands are not met or are delayed, these patients can demonstrate their frustration and anxiety through aggression. Sometimes, aggression marks poor or absent interpersonal and communication skills. As a nurse, you’ll have to learn how to keep your cool and calm an aggressive patient down. If a patient is over aggressive, your calm attitude and presence of mind will help you stay safe.
Watch Out For Aggressive Tendencies
You cannot predict which patient can turn violent. However, there will be some indication during consultation and at the time of admission and treatment. Watch out for signs of agitation, angry voice tone, clenched fists and abrupt movements. Speak to your head nurse and the treating doctor about these observations. Check the front desk system for comments against a patient’s name that indicate aggression. Being forewarned about the patients in your care is being forearmed.
Stay Calm
No matter how agitated the patient becomes, keep your inner core calm and collected. Don’t show your own agitation or alarm. If a patient is being rude and not aggressive, remember that aggression can be only moments away. Maintain a calm, friendly, polite but firm attitude but do not come across as patronizing. Keep your voice at a conversational level.
Keep Your Body Language Neutral
Remember that 80% of human communication is non-verbal. Even if you don’t give out verbal signs of your own agitation, your patient might be picking up on your fear, disgust and dislike. Work on your body language. Don’t clench your fist, or thin your lips, narrow your eyes, or hold your shoulders stiff.
Maintain Eye Contact
Maintain eye contact and keep your gaze neutral so that the patient can see that even if he is being unreasonable, you’re willing to give him a chance. Maintaining eye contact also indicates that you respect the patient’s viewpoints and you are willing to reason with him or her. A patient demonstrates rude or aggressive behavior mostly to be heard and have someone’s attention focused fully on them.
Demonstrate Your Empathy
Shown your empathy can help; indicate through your words and your body language that you do understand the root of the patient’s anger. Explain in a clear voice that while you do understand that they’d been kept waiting, you’d like to help them with their issue now. Make it look like you’re not questioning a patient’s aggressive behavior, and you feel they’re almost justified. This is only to diffuse the situation.
Ask Questions
You can regain control of a situation that’s potentially volatile by distracting the patient. Ask the patients to tell you their side of the story. Make the patients feel that you feel they should be heard, but do not take sides. Do not make any comments that could be expensive for the facility later on. Ask questions about the patient’s needs, expectations, and health concerns and try to identify the cause of his or her aggression. Document patient’s concerns and your conversations carefully.
Keep Your Physical Distance
Don’t ever turn your back on a potentially aggressive patient. Position your body closest to the open door, just in case you need to make a quick escape.
Never Say No To A Violent Patient
Never say no to the face of a violent or potentially violent person. For example, if the patient wants more pain killers, or specific care, explain that you don’t have it right now and that you’ll need to speak to a hospital consultant. Offer alternatives and keep the patient’s options open. When completely negated, aggressive patients lose control.
Know Where Panic Alarms Are Located
If you find yourself alone with a patient and it’s late in the evening, you could find yourself in a potentially dangerous situation. It’s best that you know where panic alarms are located in the hospital. You never know when you’ll need to press one. It’s a fact that 44% of practices experienced problems with panic alarms. If an incident occurs during a home visit, use an attack alarm to stun the patient. Never go alone to visit a potentially aggressive patient at home.
Keep Your Head Nurse And Doctor Informed
Also make sure that if you suspect a particular patient under your care has aggressive tendencies, you keep your head nurse and treating doctor informed. Keep them informed of any untoward behavior from the patient such as:
• sexual harassment
• rude comments
• physical violence with objects
• verbal or physical abuse
• threats or gestures
• discriminatory abuse
• stalking
• inappropriate emotional attachment
