PRACTICE PARTNER
Keeping Cool When
Patients Get Hot
I
n a packed hospital ED, a patient
is agitated. He’s clearly in distress,
complaining loudly. When he’s
finally seen, he protests the medical
attention and gets even more belligerent.
Suddenly, he takes a swing. Meanwhile, in
a long-term care home a resident is upset at
meal time. After unleashing verbal abuse at
staff, she flings her tray.
Violent episodes are a huge problem
in health care. In fact, just this past
DOC TALK November, gunshots were fired inside
By Stuart Foxman
a Kingston hospital. In a world where
code whites are increasingly com-
mon, how do you crack the code to reduce
or prevent incidents of aggressive or violent
patients?
Curbing aggression
and violence requires
de-escalation skills
The causes and remedies are complex.
For instance, some medical conditions and
circumstances – from dementia, to metabolic
disturbances, to the effects of certain drugs –
boost the chances of acting out. Sometimes
patients won’t respond to reason or can’t due
to psychosis. Other times weapons, or items
that can be used as weapons, are involved,
posing an imminent threat.
There are different challenges in different
health-care settings. This patient and work-
place safety issue requires responses on many
fronts. That includes systemic action around
issues like staffing, security and risk assess-
ments. Doctors and health care colleagues
also play a key role in taking steps to try and
de-escalate.
ISSUE 4, 2018 DIALOGUE
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