Managing difficult situations

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Week 6

tab.png Context

"Mentally ill people in hospital sometimes behave aggressively. They may try to harm other patients, staff, property or themselves. In the UK, the National Audit of Violence found that a third of inpatients had been treatened or made to feel unsafe while in care. This figure rose to 44% for clinical staff and 72% of nursing staff working in these units. Such aggression can result in injuries, sometimes severe, to patients or to staff, causing staff absence and hampering the efficiency of the psychiatric service. The ways in which aggressive behaviour is managed by staff is contentious and emotive, and there is little evidence or agreement about their effectiveness" (King's College London, 2011).

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Legislation

—Before considering how to deal with difficult situations, especially those that might require restraint of a patient, all health care workers need to understand the legislative framework in which they practice. It is also always better to get someone experienced and skilled in de-escalation to deal with these situations if they are available.
 
We should remember that  every adult has a right to: a life free of fear; to be treated with dignity; and to have their choices respected and not be forced to do anything against their will. Similarly with children, —“the action we take to promote the welfare of children and protect them from harm - is everyone’s responsibility. Everyone who comes into contact with children and families has a role to play” (Department of Education, 2013)

De-escalation

De-escalation is a technique used during a potential crisis situation in an attempt to prevent a person from causing harm to us, themselves or others. The principles are to 'Control yourself', show 'Respect & Empathy',  and them move through 'Delimit' to 'Clarify' to 'Resolve', as shown below:

—deescalation.png
 
 

tab.png References and Further Reading

Department of Education (2013) Working together to safeguard children. London: The Stationary Office

Kings College London (2011) Inpatient violence and aggression: a literature review. London: Institute of Psychiatry

Safeguarding Vulnerable Groups Act 2006. London: The Stationary Office