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Managing patient rage quiz: part 1

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Did you know that violence against nurses has actually become a felony in some states? But unfortunately, nurses can’t depend on legislature alone to prevent patient (and lateral!) violence, so nurses are taking action to learn to protect themselves. Test your knowledge of managing angry patients with our Managing Patient Rage quiz.

This is part 1 of 3, so be sure to look for the other portions soon!

Managing Patient Rage Quiz Part 1
(10 questions total)

Which of the following is NOT an example of aggressive behavior by patients that should be documented:





A patient likely to experience an "expectation gap" - the difference between a patient's expectations and the actual interactions or outcomes with a nurse - would least likely fit the following description:





When a nurse allows an angry patient to vent, the following nonverbal behaviour may help de-escalate the situation:





When a nurse allows an angry patient to vent, the following nonverbal behaviour may help de-escalate the situation:





One of the first steps a nurse should take to resolve a dispute with an angry patient is to:





When attempting to defuse a patient's anger, a nurse should always address the patient by title and last name, e.g., Mr. Smith, Mrs. Jones, etc.



Always document problems with aggressive patients in their medical record.



Patients may experience expectation gaps despite interactions or outcomes that would be considered reasonably acceptable by professional standards.



If a nurse or staff member is assaulted by a patient, he or she should get medical treatment regardless of the severity of the injury.



Allowing an angry patient to vent without interruption encourages adversarial behavior.





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7 Responses to Managing patient rage quiz: part 1

  1. I work in an acute locked psych ward, I have found that choosing your battles helps, for example a pt with explosive disorder plus an addiction issue asks for a snack after snack time. A) Tell him no way it is past snack time and that is the rules, in response he flips out, the cops have to come up and wrestle him for an IM of something to “calm” him and upset and wake up the entire place or B) Give him some fricking cheerios and he goes to bed.

    • nellie272003 RN

      I completely agree with you. I work on a medical unit with 6 beds dedicated to med/psych patients. I find that your rule of thumb is good to use with all patients. It is amazing how agitated/aggressive little 80 yr olds become after not receiving their tea. On the other hand though, these patients need to realize that time is of the essence. If I have a patient coding, I won’t stop to give the 80 yr old some tea. So I like your rule of thumb, but it has to be within reason and patients need to understand that we are not waiters! I would love to create a pamphlet/a video or something to inform patients of the “rules” when they are admitted. That way perhaps the expectations of the patients might be more in touch with reality.

  2. Granny Rene, RN x 35 yrs.

    The test writer(s) should re-check the way in which some of these questions are worded. Particularly: Which of the following is NOT an example of aggressive behavior by patients that should be documented:
    AND: A patient likely to experience an “expectation gap” – the difference between a patient’s expectations and the actual interactions or outcomes with a nurse – would least likely fit the following description:
    Also, addressing a patient by his/her ‘given’ first name may be unacceptable in certain situations or cultures.

  3. lee

    Hi, I work in an assisted care setting in a locked unit with TBI patients and other traumatic injuries. One of my patients likes to try and “control and manipulate the care” and makes rude inappropriate comments towards staff. I find that when she uses this kind of behavior it is best not to respond to it which tends to difuse the situation so that care can be given. By ignoring the patients rude behavioer and comments you give her less power and control. And it’d important not to take it “personally” and try to realize “this is a brain injury patient. Remember we are proffesionals and need to set an examle for other staff members and all be consistent with care and expectations.

    • nellie272003 RN

      It is truly amazing how far ignoring a patient can go-especially their comments and especially a patient who is rude. Patients who are rude to me are informed that their rudeness is not acceptable or appreciated. I then inform them that if they continue to be rude, I will no longer engage in the conversation with them. I then chart all of the above. There used to be signs everywhere in our unit saying “Verbal abuse will not be tolerated”. This is so far from the truth-it is amazing how many patients have screamed/yelled/have said racial slurs to me and nothing is done. Sadly, we still have to care for these kinds of people. For me, I just need to focus on letting myself get angry with them and end up on the same level as them…It is hard to hear the stuff they say to me =sometimes but sometimes the easiest/healthiest thing to do is to walk away.

  4. DENISE PEACE

    In my setting, aggressive behavior is often the reason they are at the Hospital. These issues are of vital importance, and an important part of the clinical record.

    • nellie272003 RN

      I agree-I will always always chart the aggression-whether it is verba or physical. I don’t tend to write exactly what they say -because I’ve heard it all-some nurses will write the specific swear words the patient uses. I just write that they swore at me. We are told over and over to chart all aggresion but with facts, and the patients’ specific actions. I think we do this to cover ourselves, and so the patient can’t turn around and say “well you hit me first!”. So, I disagree with the answer for the question-we should ALWAYS CHART AGGRESSION! (verbal and physical).

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