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Nursing Assignment 代写 : 护理工作场所暴力

Nursing  Assignment 代写 : 护理工作场所暴力


Nursing  Assignment 代写 : 护理工作场所暴力

In the United States there are 1.7 million incidents each year where workplace violence has taken place (Mattingly, 1994-2011). Twelve percent of the incident involved a healthcare worker or a mental health worker (Mattingly, 1994-2011). In the Midwest sixty seven percent of nurses have been physically assaulted at least once within six months (Mattingly, 1994-2011). For the longest time they have been using only chemical restraints and seclusion and restraints as an intervention for dealing with agitated patients (Mattingly, 1994-2011). This has been an intervention used by healthcare workers for a long time. They use this method to deal with aggressive agitated patients in both the emergency room and the psychiatric hospitals (Mattingly, 1994-2011). A new method that has been introduced is de-escalation. According to International Journal of Mental Health Nursing the definition of de-escalation is the gradual resolution of a potentially violent and or an aggressive situation through the use of verbal and physical expression of empathy, alliance and non-confrontational limit setting that is based on respect (Cowen, Davies, Estall, Berlin, Fitzgerald, & Hoot, 2003). Most health care workers do not have the skills needed to care for the mentally ill population. This paper will discuss: what causes this problem; what is the nurse role in caring for the patient; other alternatives and the outcomes and how a nurse would use these interventions in practice .

There are several factors that cause healthcare providers to face difficulties while dealing with aggressive and mentally ill patients. Nowadays they have been working under limited conditions (Bigwood & Crowe, 2008). These units lack teamwork, leadership and they are much very unorganized (Cowen, Davies, Estall, Berlin, Fitzgerald, & Hoot, 2003). Hospital units are overcrowded. In many regions, in order to get a bed in the psychiatric hospital, patients have to wait in the emergency room until a bed becomes available (Cowen, Davies, Estall, Berlin, Fitzgerald, & Hoot, 2003). This ends in an overcrowded emergency room, low staffing ratio, the nurse is unable to exercise patience, and the patient is becoming increasingly agitated because they are confined to a bed in a little corner of an emergency room (Cowen, Davies, Estall, Berlin, Fitzgerald, & Hoot, 2003). Hospitals are not taking the time to properly train these healthcare providers that are caring for this group (Cowen, Davies, Estall, Berlin, Fitzgerald, & Hoot, 2003). They are also unorganized when it comes to delegating functions and roles to the staff (Cowen, Davies, Estall, Berlin, Fitzgerald, & Hoot, 2003). In a crisis situation when a patient is agitated, if functions and roles are delegated everyone would be able to know what part they will partake in the situation (Cowen, Davies, Estall, Berlin, Fitzgerald, & Hoot, 2003). Without this training the healthcare provider tends to lack the confidence in caring and dealing with these patients (Cowen, Davies, Estall, Berlin, Fitzgerald, & Hoot, 2003).

There are interventions to take when it comes to de-escalating a patient. The role of the nurse is to recognize the warning signs (Townsend, 2006). People do not just start off escalated. It starts off with small stages. The patient may become anxious. This may be a sign of impeding danger or threat that the patient faces discomfort (Townsend, 2006). They may start pacing, which is a back and forward movement (Townsend, 2006). Patients usually pace as a way to deal with stress or anxiety. They might exhibit excessive body movements which include: tremors, non-purposeful movements and shaking (Townsend, 2006). They also increase the volume and tempo of their voice, and their facial expression (Townsend, 2006). Recognizing these signs can help eliminate an escalating situation (Townsend, 2006) (Cowen, Davies, Estall, Berlin, Fitzgerald, & Hoot, 2003).



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