Dealing with angry or frustrated patients is considered an occupational hazard of working in healthcare. In a study examining the determinants of aggression in a hospital setting, 46.7% of aggressive acts were carried out by patients and 64.3% of the recipients of those acts were nurses, especially female nurses.1 This article presents techniques for managing emotional patients and avoiding verbally or physically violent outbursts.
Recognising an aggressive patient
The two major contributors of distress in patients are fear and illness.2 The medical environment creates high levels of stress for both patients and nurses – and when the patient’s fear, vulnerability and illness are added into the mix, the atmosphere is ripe for tensions to soar.
This is exacerbated by what many see as major design flaw in the healthcare system, where the focus is on aftercare rather than preventative care. The mental health of patients and their loved ones can be neglected in efforts to address the physical illness, with those emotions culminating into what can become irate or aggressive scenes.
Fortunately, you can often spot signs of an agitated patient, which gives you the opportunity to de-escalate a difficult situation before it gets out of control. The key signs of patient agitation are:3
A tightened jaw
Stiff posture
Fidgeting
Pacing
Clenched fists
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