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How do you deal with Agressive Patients

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  Quote Guests Quote  Post ReplyReply Direct Link To This Post Topic: How do you deal with Agressive Patients
    Posted: 27 July 2005 at 5:27pm

Hi - we are discussing how effective nurses can be in dealing with aggressive patients.

your experinces welcomed



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  Quote Incitefull Quote  Post ReplyReply Direct Link To This Post Posted: 27 July 2005 at 5:38pm
http://www.incitewithinsight.co.ukI was wondering how the training the government have been pushing has been? I am very curious to understand how effective such a small amount of training can be...

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  Quote karen59 Quote  Post ReplyReply Direct Link To This Post Posted: 28 July 2005 at 8:49am
Hi have left my opnions on learnign disability forum on how I deal with aggression and disruptive behaviour. Karen
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  Quote Incitefull Quote  Post ReplyReply Direct Link To This Post Posted: 28 July 2005 at 10:36am
Hiya, I gather that has been cleared off? I have seen they way that Nurses get spoken to by internal staff as well as families of patients too, it seems to me that most of the skills are upstream of anything physical?
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  Quote karen59 Quote  Post ReplyReply Direct Link To This Post Posted: 28 July 2005 at 1:39pm

Hi Incitefull,

when people talk of aggressive behaviour they often use terminology and mention CBT cognitive behavioural therapy, I prefer to talk about practical ways which for me personally in a rehab unit for behavioural problems, work. Itis about communication, how you respond to the person, how well you know them in the first place (can you anticipate their change in behaviour or is it unpredicted behaviour). With disruption and aggression you have to weigh up that individual situation, safety is first, for the person, others, your staff and you. Can you approach person and communicate or is it a situation to stand back and let it diffuse. Will they listen to you, would you put yourself at risk by approaching? I usually ensure safety, if neceesary remove others (cant always move that person as they wont listen and dont want to move), if approaching I keep my tone level calm at same pitch no matter what, I ask them to calm down and suggest they go to quiet area, or go for walk, and inform them that when they are ready I will listen, I want to help them, they can tell me what has happened and we can deal with issues together. On rare occassions have had to call in the police to have them removed (if behaviour due to drugs or alcohol abuse). At end of it all, supervision to those who need it, self, staff, other people, the person. And dont hold the aggression against that perosn, the next shift is a new start.

Don't know if that made sense. karen

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  Quote Incitefull Quote  Post ReplyReply Direct Link To This Post Posted: 04 August 2005 at 11:34am

Hi Karen

I enjoyed reading your thoughts, it is good to hear someone talking about this stuff from the point of 'self' as I personally believe that is the place where true resolution will begin. Letting go of past 'aggressive' can be very hard........

 

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  Quote linda Quote  Post ReplyReply Direct Link To This Post Posted: 25 August 2005 at 12:12am

at the end of the day we do not know what exact;y it is that makes the person have challenging behaviour. each day is different.  as karen i have worked with learning dis and challenging behaivoue.  i too have flet that styaying calm and making sure you are up to date with training and working as a team help. if the other team memnmbers know where you are they can help at al l times as if you need to call for help they know where you are.

also staying calm trying to keep eye contact, if it is wanted and sometimes just sitting down to let them be above you can sometimes help as it makes them feel you are not threatened by them.  most of the time the patient wants to frighten you or dont know how to cope with what they are feeling.  by giving them reasurrance is the best.  each day is different each person is an individual.   you learn each day.  you never know what is to happen next.  you have to think on you r feet and try to be calm.  try to stay in control of yourself.

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  Quote rickday Quote  Post ReplyReply Direct Link To This Post Posted: 31 August 2005 at 11:07pm

Dealing with aggressive behaviour is part of the job as a learning disability nurse or a mental health nurse, that dsoesn't mean that it's acceptable, but you learn to live with it.

From a personal point of view I try to redirect where I can, I try to get the client to focus on something else rather than me, I may ask them if they want a drink, or something to eat, all the time I keep an arms length away, I try to keep my body postures open & non threatening & the same goes for my facial expressions. I talk calmly & slowly & in a manner that they understand, this doesn't allways work, don't be afraid to run, if no-one is at risk & the area is safe leave them to it. Afterwards don't go over what has happened, you may cause problems, talk to your colleagues about what has happened, but don't take what has happened personally start each day fresh as if nothing had happened & you'll be fine    

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  Quote karen59 Quote  Post ReplyReply Direct Link To This Post Posted: 05 October 2005 at 8:03pm
I will be working with challenging behaviour with my new unit, the work is work dementia patients at later stages, bless them. Althought the place I have worked at for last 6 and half years is challenging behaviour, this will be totally different. I shall keep checking this message area for tips and will ask advice when I need it. Karen
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  Quote shaz1 Quote  Post ReplyReply Direct Link To This Post Posted: 11 October 2005 at 8:15pm
working in a&e,, i deal with this all the time,, form a nurse getting her nose broken to a doctor getting puched in the mouth,, i got called a ****ing slut,,, ( given the chance he,he,)  we are now being sent on conflict courses how to defend are selves,,, more zero tolerance,,, and more high profile security,,, but alot of hospitals won`t fund this,,  does a member of the nursing profession have to be wounded badly or killed,,, in scotland assaulting a nurse carries the same penatly as assaulting a police officer,,, hope this comes to england ASAP,,, you all take care loads of love shazxxxxxxxxxxxxxxxxxxxxxxx oops sorry (slut)
shazza xx.. i missed you all xxx
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  Quote Pure Maiden Quote  Post ReplyReply Direct Link To This Post Posted: 24 March 2006 at 9:23pm
Wey to go shaz!

I agree wholeheartedly and this should also extend to older people who do not have a mental illness and are physically very fit for their age!

Had one old man tell me that all nurses are just tarts really and especially the ones like me with my blonde hair

I would not have minded that much but I had lank, greasy hair in a claw clip, no makeup and dressed in the very sexy Uni standard uniform of blue & white striped tunic top and navy blue trousers and (worn and battered) black tie up comfy shoes.

I think he had been watching too many carry on movies with Barbara Windsor in them!.

Power to the ones in the shop front (A&E) in your case lol,lol,lol.







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  Quote smiler Quote  Post ReplyReply Direct Link To This Post Posted: 25 March 2006 at 5:04pm

yes we are very often on the recieving end of challenging behaviour with learning disabilites.  it makes me cross when people see them as dangerous first and then the person later.

WHen you go into a home the first thing you are told is be careful of that one he has challening behaviour. and then the long list of things tey may do.  This is often said in front of the service user.  Perhaps if they wasnt subjected tot this they would give us the benefit of the doubt, because i feel once they know that we know, they will try it on to see how far they can go. i have personally found that by giving the person time to express their feeling etc and not give a response straight away can help.

 

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  Quote smiler Quote  Post ReplyReply Direct Link To This Post Posted: 25 March 2006 at 5:12pm

sorry just realised that i have posted the above on the wrong one sorry.

Anyway.  just recently i lost my rag with a nurse who was in with m specialist.  I didnt hit or punch or anything like that but i did answer back rather sharply.  I have problem i was born with , was told i need an op and when i started to cry the nurse turned round to my mum and said oh this is your fault. yours and your husband.  As you can imagine my mum has had a nervous breakdown in the past, and one of the things that caused it is because of her guilt over my problem.  I have never blamed my parents. it was just one of those things.  I lost my rag with the nurse and when i told her she should be more careful of what she says, she told me i dont know what im talking about. Therefore i quite quickly told her that i work in the care field and know how people shold be spoken to.  SHe then turned round and said but i bet you have never had to tell anyone their family member has died.  IN the nursing home in charge of the residential part i on many occasion had to break the news to relatives, someones with a nurse present but many times on my own. 

THe nurse did nothing to try to difuse this sitiuation, and due to me being upset already and my mum ending in tears the other nurse in the area, had to come over to diffuse this arguement.  I felt very ashamed as i went against all my principles and what i have been taught. but im afraid this time i have reported her to the management of the hospital.  In no circumstances am i saying i was right to do this and i am very much behind nurses who want help to stop any violence in hospitals etc. but on this occasion i still stand by what i said to her.  does anyone have any reflection on this. would love to hear responses. xx

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  Quote Pure Maiden Quote  Post ReplyReply Direct Link To This Post Posted: 27 March 2006 at 11:54pm
Don't worry smiler, I know where you intended your posts to be and i am glad that you realised, as I for one do not post my opinions allways in the correct section, untill it is too late and someone more professional like Lu... puts me in my place!

We are at the beck and call of all those that have the knowledge on this site and forgive me for being a beginner, even now, but I do not posess the knowledge to advise you either way but i do reccommend that you take other opinions more seriously unless i think I know what is what and am prepared to argue the point!

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  Quote elaine Quote  Post ReplyReply Direct Link To This Post Posted: 19 April 2006 at 5:24pm
Challenging behaviour comes in all shapes and sizes.My bf works looking after teenage boys who have been taking away from their families as they have been disruptive, on drugs in trouble with the police etc.It's three boys in the care home where they are staffed by two members at all times, have private tutoring, £50 clothing allowance a month plus £50 pocket money, holidays,takeaway every friday, home visits every other weekend and every week they go out to cinema or an activity of there choice.they live in an amazing house in the middle of know where with sky tv dvd players playstations snooker table mini recording studio and ping pong table.I agree with the boys needing to go into care they regularly hit out at staff or eachother break windows and run away etc etc.But I do not think they are having a "normal" upbringing rather than encorporate them into the community they are taken away from it given all these material things that alot of children wouldnt have and not put back into mainstream schools.Of course I feel sorry for the children but feel sometimes social services try and over compensate.
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  Quote karen59 Quote  Post ReplyReply Direct Link To This Post Posted: 11 May 2006 at 8:51pm
oh Elaine I think I want your boyfriends job. seriously must be stressful.To think I thought getting my children thru teenage years was hard enough. Think i had it easy after all.

karen x
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  Quote karen59 Quote  Post ReplyReply Direct Link To This Post Posted: 11 May 2006 at 8:54pm
I dont think people should be scared of writting what they think (have just re read this section of messages), we are all entitled to our opinions and views and freespirit so say all thats on your chest is my motto.

Me off to have sniffles, got bad cold and cough so am trying not to send any virus (bacterial type) across he computer to you all.

feel free to say hello anytime think most know how to send me pm messages if not ask. karen x
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  Quote smiler Quote  Post ReplyReply Direct Link To This Post Posted: 12 May 2006 at 11:07pm
yeah very sad. all the guys i work with have come from homes that are like what your bfs are like elaine. taken from their families or the families gave them up etc. lived out in the sticks away from home and communities. we have worked to get them back into the community. they go to day services, college etc, go shopping etc just as we ould in our own homes. if they make a mess through challenging behaviour we givve them chance to calm down then get them to clean up the mess etc. that way they are learning by their own actions. and we are gaining respect from them. thus the behaviour is only a rare occurance now.
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  Quote Pure Maiden Quote  Post ReplyReply Direct Link To This Post Posted: 12 May 2006 at 11:58pm
Originally posted by elaine

My bf works looking after teenage boys who have been taking away from their families as they have been disruptive, on drugs in trouble with the police etc.I agree with the boys needing to go into care they regularly hit out at staff or eachother break windows and run away etc etc.But I do not think they are having a "normal" upbringing rather than encorporate them into the community they are taken away from it given all these material things that alot of children wouldnt have and not put back into mainstream schools.Of course I feel sorry for the children but feel sometimes social services try and over compensate.


This could almost be my brother you are talking about and
me also, as I was in a childrens home and I did get a lot of material things and outings etc...etc..but to speak the truth here, I had never been to the seaside untill I was 12(age taken into care), did not start school till 7, where were birthdays and christmas????

Long story, but both myself and brother fostered and they could not handle his violent behaviour(younger brother)and decided to keep me and seperate us and he went to the place like where your bf works!

It was not his fault and more importantly the kids in these places seem to get 'everything' and to some extent they do, but on a personal level my brother only wanted a proper mum and dad! and to this day all the nice things these kids get never really make up for the emotional scars of not having their real parents!

Some of these kids a real bad, but most have more than a reason to feel this way.

He seemed to have more than me in material ways, but I had the continuity of a loving, although strict teenage life!

The comparison now on how our lives have worked out is truly remarkable in that he is an alcholic and has a history of failed relationships and is living in a single room with no friends and also no family-apart from me to look to for advice and comfort! bit like when we were little!





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  Quote elaine Quote  Post ReplyReply Direct Link To This Post Posted: 28 May 2006 at 8:20pm
its a hard situation t manage and not many success stories but pure is clearly one of them
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  Quote Pure Maiden Quote  Post ReplyReply Direct Link To This Post Posted: 29 May 2006 at 10:05pm
Originally posted by elaine

its a hard situation t manage and not many success stories but pure is clearly one of them


I hope so! Even now I wonder what would have been??

Thankyou elaine, that means a lot to me!
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  Quote elaine Quote  Post ReplyReply Direct Link To This Post Posted: 02 June 2006 at 9:02pm
I guess this is what has made you the person you are today strong and independant.i think with your experiences in life + being a mother will make you a very empathetic and bril nurse.
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  Quote Flutterby Quote  Post ReplyReply Direct Link To This Post Posted: 24 June 2006 at 1:44pm
I too had MANY bad experiences as a child, I started to type a few of them here but thought better of it as it may have disturbed some readers.

I salute you Pure Maiden and congratulate you on getting where you are today!

For the record, I am one of the most 'normal' people I know! I think it kind of goes one way or the other doesn't it?

I hope things work out for your brother.

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  Quote Pure Maiden Quote  Post ReplyReply Direct Link To This Post Posted: 24 June 2006 at 1:51pm
Thankyou that was very kind! and yes your right! Sometimes I think is good that we are able to talk about things and use them as a measure of how luck we really are today!

I also quite like sharing some of the shocking things and I have had a lot worse than the above also, as it helps me in a therapeutic way and may also make others aware they do not suffer things alone, there is always someone a lot worse off than ourselves and I find this reassuring and not abnormal!
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  Quote colinj Quote  Post ReplyReply Direct Link To This Post Posted: 25 July 2006 at 7:01pm
In autistic care we were told to adhere to the care plan & step away. This was not always possible if you needed to protect them & I suffered horrendous bites kicks scratches & head buts. I still have the deep scars As the only Male I was always having to be with this Service user. I would have enjoyed the work if I was just given a break but the female staff just wanted to fool around be on their mobiles & smoke like Chimneys. They always! had a good shift when I would leave very often in tears. In hindsight it was a poorly run home with no real passion from the staff. Except me who really loved it.

It is hard to protect yourself from challenging behaviour & it takes a patient person to put up with it. Perhaps my training a SC helped a bit but I am a patient person anyway. This SU could go on all 12 hours of the shift & I found it so exhuasting.
Phew. finished now.


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  Quote wizbix Quote  Post ReplyReply Direct Link To This Post Posted: 25 July 2006 at 10:31pm
Your experiences Colinj make me angry so I can only imagine how they have left you feeling.

For those that are reading - not all homes are like that, although you would be forgiven for believing so particualarly with the recent reports concerning homes in Cornwall.

Im glad there are people like you Colinj who dont secumb to the same ways as the staff members you've described; Welcome to the site.
"It is never too late to give up our prejudices.." Henry D Thoreau (1854)
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  Quote Porkchop Quote  Post ReplyReply Direct Link To This Post Posted: 26 July 2006 at 3:07am
We are having a terrible problem in the large long term care home in which I am employed full time...One resident in particular is terribly nasty, calls us all sorts of awful names, kicks, hits and scratches us, and throws whatever she can grab.There is no tried and true method of dealing with her either, it all depends on her mood. Management has told us to "take her off the unit for a walk or something" when she is like this, but who on earth has the time?????? Very frustrating for those nurses involved, and very, very hard on the morale!
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  Quote Pure Maiden Quote  Post ReplyReply Direct Link To This Post Posted: 07 August 2006 at 1:04pm
Hello Porkchop,

Sounds like a real problem!! Just another option, I have been reading somewhere that music may help her at times like this, you just need to find the type she likes or makes her calmer, I think it comes under the heading of distraction. I saw this one film once called awakenings where they found that certain music helped the patiens do certain things like eat for instance without assistance, I know the patiens had something specific wrong with them that I can't remember, but might just work???

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  Quote wizbix Quote  Post ReplyReply Direct Link To This Post Posted: 28 August 2006 at 8:45pm
Every (challenging) behaviour has a reason (for the person) behind it.
"It is never too late to give up our prejudices.." Henry D Thoreau (1854)
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  Quote Oldman Quote  Post ReplyReply Direct Link To This Post Posted: 31 January 2009 at 3:00am
Hi SHAZ1, there is one area that doesn't always work out when you are assaulted and that is on of a person with a mental health label. Lawyers alway's defend the person by stating they have a "drug habit" "are an alcoholic or has a drink problem. When will the criminal justice system get tougher on these people?
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