Working in an emergency room as a doctor or a nurse, it is unavoidable that they will encounter some kind of abusive or unstable patient. Some people might have had a bit too much to drink while others could be mentally unstable. The safety of the patient and the staff is the most important thing so it is possible that the patient has to be restrained. Before this there should be a few things done to avoid this type of situation and they are as follows.
Find Staff Who Has Worked With This Person Before
The emergency room tends to have repeat visitors that can be unstable or has been taken to the hospital for an overdose on a substance. It can be important in these situations to have doctors or nurses who have worked with these people before help them again. The familiar face can help decrease aggression or anger as the staff has worked with this person in the past. This can also help expedite the times it takes for these people to be processed because the patient could just be off of their medicine or needs to be spoken to in a certain fashion. Easy patients generally equal fast patients as they do not waste the time of staff or other patients.
Identify The Cause
There are times when somebody just hasn’t taken their psychiatric meds for a few days and are having a mental meltdown. In other cases a person could be drunk or high on drugs as well as the combination of both. For the safety of the patient it is important to have them disclose what drugs and the amount of alcohol that they have consumed. Something as simple as getting a hostile patients a new pillow or mattress topper can help ease their anxiety. The comfort of unstable or abusive patients is still important but make sure to not cater to their comfort as the cost of safety of staff and other patients. Someone who is high on drugs might have to be strapped down so they do not cause any harm to themselves or others around them.
Don’t Escalate The Situation
There will be people who just don’t want to be helped and will fight regardless of what is said. Not engaging or showing any aggression towards verbally abusive patients is important. If they are drunk this might just take a while for them to fall asleep or sober up. If a patient is verbally abusive it is important to not engage with them in this conversation. Say something to help take the energy out of the conversation like “Sorry that you think that” as it disarms the conversation. It can be difficult to not blow up on a patient who is being abusive after a long shift but even abusive and unstable patients have the right to the same care as everyone else. Diffusing the situation might be difficult but it is possible in most cases. The safety of an unstable or abusive patient is important so do not allow them to hurt anyone else or themselves. Each doctor or nurse will read a situation differently so sometimes there is not a one size fits all policy or plan. Being prepared to deal with these types of patients might take time but asking some of the veterans of the ER might help speed up the learning process!
