Aggressive behaviour is not restricted to mental patients alone: people who are not equipped to deal with frustration, fear or anxiety may exhibit aggressive and violent behaviour too. Patients who are in pain and are unable to deal with it often tend to be nasty towards their caretakers- and often nurses have to bear the brunt of their hostility. Aggression or violence could also result as a side-effect of therapeutic medication such as corticosteroids. Again, patients with neurological disorders could also have personality changes that may result in anger and abusive behaviour. Drug or alcohol abusers may get hallucinations or delusions which could make them respond with anger. There are many reasons why patients, who under normal circumstances may be very even-tempered, would behave uncharacteristically when faced with an illness.
Mental patients of course may be prone to aggression because of the very nature of their poor mental health. They often experience mental states such as periods of confusion or disorientation which could precipitate aggression and violence.
All this makes it very important that healthcare personnel should be aware of common triggers that could start an episode of physical aggression, how to avoid such triggers and how to deal with such behaviour. Nurses have reported that their own reactions to such behaviour could range from anger and frustration to inconsistency of care. They may also feel the desire to stop such behaviour by simply giving in to the demands of such disturbed patients. Some nurses may choose to avoid such patients altogether. Needless to say, these reactions are inappropriate and nurses must learn how to deal with the situation and with their own emotions.
While considering the care of such patients, ensure that the patient stays safe at all times, and so do you and everyone around you. The best way to handle such patients would be through empathy and building a relationship of trust. Understand what his or her triggers may be, and try to avoid them at all costs. Such patients should be encouraged to be more engaged with their social or support network, and to develop other activities which relieve them of their preoccupation with their illness. Counselling should be provided for frustration, fear and anxiety.
If an episode of aggression has been precipitated, stay calm and try to de-escalate the situation. Speak in a calm and neutral tone, try to make the patient sit down and communicate with you. Clearly indicate your empathy and understanding of the patient’s feelings, and try to calm down and control their emotions. Ensure the safety of the patient, other staff and yourself. There are many policies and procedures in place for dealing with aggressive incidents and they must be strictly followed.
Training in aggression management is an important part of the professional development of a healthcare professional. The course material is designed to support the delivery of healthcare and improve patient safety through prevention, treatment and control of aggressive and violent behaviour in patients.
Take care of yourself.