Aggression is defined as a behavior in which is apparent the intention to cause painful stimuli to an individual (man or animal) or destructive intention towards objects. People aggression manifests mainly in three types: Verbal aggression, physical aggression towards others and physical aggression towards objects. Violence usually has the meaning of physical aggression towards people, thus being a subunit of aggression. [1]
A person’s (patient or visitor) aggressive behavior depends on factors from his/her background (social-economic-childhood), immediate environmental factors and possible co-existing medical conditions (organic or psychiatric). [1]
Apart from patients or visitors aggression, a situation might make the clinician aggressive
Physical restriction should be done if absolutely necessary and only to facilitate diagnosis and treatment. This type of restriction should be done by trained staff, so injuries are prevented. Monitoring must exist and be continuous or in short time intervals, once the patient is stabilized. The restrain team should enter together and begin the process. Participation of treating physician should be eliminated during this process if possible. Strict documentation should be kept, including the time and type of restriction, and the monitoring. In monitoring (that should be done every 15min or less) have to be checked: Vital signs, nutrition, hygiene, injuries, and psychological status, so when restriction is not necessary, we can release the patient from it. [5]
The above approaches, that all healthcare professionals must be familiar with, can be improved in their applications in many ways. First of all reporting of violent or aggressive behaviors should be done as much as possible when it happens. Unfortunately, there is a big percentage of underreporting. There are three reasons for this. First, the perception of professionals that patient’s aggression is a part of the job, so they feel there is not a reason to report it. Then, personnel observe that no improvement comes from reporting. At least, they do not have always the time needed to fill in report forms.
Aggression may be associated with other symptoms that are determined by the underlying disorder or illness. Ailments that influence behavior often also have psychological, cognitive, and physical symptoms. Some additional signs and symptoms may include:
Like mentioned before, any type of disruptive behavior by healthcare professionals impede the delivery of patient care. As an Health IT professionals, it is their job to, “puts essential information as effortlessly as possible into the physician’s hands, substantively and cost-effectively customized to the needs of medical specialists and sub-specialists, keeps eHealth information secure, and protects patient privacy” (Silverstein). In order to reach highest standard and provide patients with optimal care, all the healthcare professional should exhibit professional behavior and able to handle difficult situations professionally. Usually when someone mentions disruptive behavior, one thinks of overt actions that are unquestionable, such as verbal outbursts, throwing instruments during procedures, and physical threats (Juengel). But there are different ways a person can show disruptive behavior, for example, healthcare professional not communicating properly or refused to cooperate with others, and acce...
Certainly, some of these causes cannot be eliminated by nurses or even hospital administrators. For instance, one should mention the characteristics of patients who may be profoundly affected by physical pain. Similarly, their relatives inevitably struggle with intense emotional suffering. Nevertheless, in many cases, it is possible to reduce the risk of violence. Much attention should be paid to the efficiency of policies adopted in the hospital. There are several interventions that healthcare organizations should consider. In particular, it is necessary to reduce the waiting time in hospitals. This improvement is critical to alleviating the stress that patients and their relatives may experience. One should concentrate on emergency departments because physical violence is more widespread in these areas. Hospital administrators need to take several steps to achieve this goal. In particular, they should simplify registration procedures. For instance, patients can be registered directly at their bedsides. This step can remove bureaucratic barriers that often make patients very irritable. Furthermore, it is vital to ensure that the hospital is adequately staffed because the shortage of personnel can lead to the conflicts between patients and medical
Acts of incivility can include discourteous or disdainful speech, public censure, character assassination, or lack of inclusion in patient care decisions (Lachman, 2014). Incivility, both lateral and hierarchal, has been found to occur at all levels of health care including academia and direct health care settings (Lachman, 2014). The prevalence of incivility in the health care work place is a disturbing problem. According to Nikstaitis and Simko (2014) 85% percent of nursing personnel report having experienced incivility in the workplace. Additionally, 39.6% state they intend to leave their place of work due to lateral violence (Nikstaitis & Simko, 2014). Incivility leads to an unhealthy work environment in which decreased morale and high nurse turn-over result in poor patient care and outcomes (McNamara, 2012). Lachman (2015) states that in addition to the effect on staff and patients, the cost of incivility is felt by the employer in cost of new staff training and in decreased insurance reimbursement due to poor patient outcomes and
What is violence? Any dictionary can easily define violence as the use of force, action, and or energy that may cause physical harm to a person and the destruction of property. Violence may cause emotional distress to those who have experienced it as those who witness it. It may occur in the form of assault, rape, or murder.
A basic checklist was used to document the frequency of verbal aggression on a daily basis. The checklist was designed to track only the occurrence of the behavior. It was felt by the therapist that the content of the verbally aggressive message would be too open for subjective interpretation and that no meaningful data would be gained from such documentation. In addition the subject made frequent comments of significant success or failure in avoiding verbal aggression for discussion with the therapist. The weekly discussions were used to evaluate the appropriateness of the procedures used and make any necessary adjustments to the program.
Incivility is something that should not be acceptable anywhere, especially in healthcare. Everyone should be able to report this issue when it occurs because it creates friction among team members, management, and decreases patient care outcomes.
As a nurse in a psychiatry emergency room, the staff must collaborate for the safety of patients and staff. There is a triage process that must be followed when a patient comes to the Psych ED, security takes any electronic devices, keys, purses, lighters, knives, wallets, etc. A nurse takes a mini-triage, which determines whether a patient needs to go to the medical ED side, if the patient is cleared to go to the Psych ED, the nurse must then decide whether to place the patient in a locked involuntary area or unlocked voluntary area. Any patient that goes into the involuntary waiting area must be searched, and go into a patient gown. Once there the patient must be seen by a nurse, then by a doctor. If a patient is agitated to the point of
Sell, Hone, and Pound (2012) examined the importance of physical strength in shaping male psychology. Aggression and violence are fairly effective ways of winning conflict in the competition for resources between males, but can impose large costs on the loser of the conflict (Sell et al., 2012). The consequences of conflict would have put high pressure for the male brain to evolve ways of interpreting the odds of success, to determine when to avoid conflict or engage in aggressive and violent actions (Sell et al., 2012). The authors outline evolved mechanisms for aggression and their effect on the decisions of modern-day human males.
Provocation is main important factor that plays a role in aggression. Aggression can be defined as behavior that is meant to hurt others. It is generally divided into hostile aggression and instrumental aggression. Instrumental aggression is a means to an end. It is often referred to as "predatory" aggression and is associated with goal-oriented, planned, or controlled behavior. Generally, harming the person is used to obtain some other goal, such as money or benefits. Hostile aggression is accompanied by strong emotions, particularly anger. It is associated with being impulsive, unplanned, overt, uncontrolled and harming the other person is the goal.
The term aggression refers to a range of behaviors that can result in both physical and psychological harm to oneself, other or objects in the environment. This type of social interaction centers on harming another person, either physically or mentally
In order to recognize the behavioral patterns to prevent violence, one must understand the definition of workplace violence. According to the American Nurses Association, the definition of workplace violence means any sort of verbal abuse, threatening behavior, or a physical assault occurring in the workplace (“Workplace Violence” 2013). Some of the behaviors that might be observed indicating an act of violence is about to occur are: intimidating, harassing, bullying, inappropriate or aggressive behavior, increased agitation (i.e. snappy comments), inability to be still, noncompliance with simple requests, statements of desperation, references to committing suicide, direct or indirect threats. If these signs are noticed in a patient or family member, the nurse should intervene immediately. It is important to remember that other nurses are also capable of violence and looking for their behavioral warning signs are equal...
The use of restraints is a common practice in acute care and long-term care settings. According to a study regarding the use of physical restraints in 40 acute care hospitals in the United States, the overall rate of restraint use is 50 restrained patients per 1,000 patient’s days; an estimated 27,000 people are in physical restraints each day (Minnick, Mion, Johnson, Catrambone, & Leipzig, 2007). Restraints are often used in hospital settings to keep a person from hurting themselves or doing harm to others. It is also used to prevent falls. Using restraints can cause several problems and adverse patient outcomes. It has been found that physical restraints are associated with increased rates of respiratory and elimination problems, circulation
Aggression is a behavior that is intended to harm another who is motivated to avoid that harm. Aggression must be a behavior and not a feeling or thought. Within aggression, it has been put into different forms, physical, verbal and relational aggression. Forms of physical aggression is having the intent to physically harm another person who does not wish to be harmed. With researchers doing studies it is proven that men are much more likely than women to use physical aggression. Within the past two decades, researchers have been examining relational aggression and the long term effects of viewing relational aggression in the media on aggressive behavior during adolescence.
In psychology, the term aggression refers to the behaviour of an individual who has the intention to harm another person who does not wish to be harmed (Carter & Grivas 2005). It can be described by the type of aggression. Violence, is a subcategory of aggression and it refers to aggressive behaviour which causes physical harm, such as injury or death (Carter & Grivas 2005). An example of this is assault.