To enable nurses to ensure both their own and their patients’ safety when managing aggressive patients.
- Recognise signs of escalating aggression
- Use empathy, active listening and non-threatening communication to calm an aggressive patient
- Apply appropriate safety protocols (safe positioning, safe distance) and environmental awareness (identifying escape routes) to ensure the safety of staff, patients and the aggressive individual
- Collaborate with team members (coordinating roles, calling for assistance)
- Maintain composure and professionalism (assertive demeanour, safety-first mindset) under pressure during a high-stress situation
Characters
Aggressive Patient: 25-year-old homeless man, experiencing a mental health crisis
Nurse 1: Senior nurse, skilled in de-escalation techniques. The senior nurse focuses on communication.
Nurse 2: Junior nurse, observing and assisting the senior nurse. The junior nurse is focused on the environment.
Emergency room of a busy hospital. Besides the aggressive patient, there are two other patients behind the curtains, unable to evacuate.
After transfer to the emergency admission, the patient was fitted with a blood pressure cuff; he was not communicating but talking to himself. He complied with prompts only sporadically, but did not resist examination by a physician.
Background
The ambulance service treated a 25-year-old homeless man who was found on a street, hypothermic with frostbite of the first degree on his lower limbs.
Objectively, the patient was awake, disoriented as to time, had amnesia about recent events.
The patient reported a diagnosis of schizophrenia following methamphetamine use (he is supposed to be taking medication but is not).
He confirmed hallucinations (unspecified), hatred of people and himself, and confirmed that he had used amphetamines by sniffing the previous day. In cooperation with the police, a saliva test for addictive substances was carried out, which was negative at that moment, as well as a breath test for the presence of alcohol in the breath.
The ambulance transferred the patient to the nearest emergency room.
Setting
Emergency room of a busy hospital. Besides the aggressive patient, there are two other patients behind the curtains, unable to evacuate.
After transfer to the emergency admission, the patient was fitted with a blood pressure cuff; he was not communicating but talking to himself. He complied with prompts only sporadically, but did not resist examination by a physician.
Situation now
However, after the blood tests (biochemistry) were performed, he suddenly started screaming, got up from the bed without warning and tried to pull down the curtains separating him from two other patients. He is now being physically aggressive towards objects in his way. He yells someone is trying to kill him.