How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 78

This book is in B&W, not color - Print page in Grayscale for Correct view! during the previous interaction. Frequently going back enabled nurses to check on patients’ safety, and could be reassuring for them, developing a sense of security. Persistence (16/28) This communicates interest and commitment to the patient, being persistent and not giving up despite any lack of progress demonstrated concern for the patient. Such persistence could be rewarded by the patient starting to respond verbally, ‘become open’, ‘start to trust’ the nurse, or ‘come out more from her room and joining activity groups’. Constant persistent offers of contact, without ‘getting exasperated’, enabled nurses to seize on those occasional moments when the patient concerned was receptive. Not giving up over the longer term was also important for aggressive or otherwise difficult and disruptive patients. “It will take dips, and just not to give up and try other ways or restart again. Trying to build that relationship and always being open with them after an aggressive period, and explaining things to them after a period where they’ve been quite aggressive.” Aggression/irritability Choose language (4/28) Just a few hints were given as to how to modify language to deal with irritable patients. Saying ‘you sound very grumpy’ was seen as more acceptable and less likely to give offence than accusing someone of being irritable. And talking in terms of ‘we or us’ was seen as more likely to lead to a resolution than ‘me and you’ or just ‘you’, as this makes people feel less isolated, for example ‘it would be good if we could all come to an agreement or an understanding about how we can make this situation better or different or less irritating for you, or less dangerous and frightening for those of us here’. Sentence and question construction could also be undertaken in less rather than more confrontational ways: ‘I can go in and say why did you hurt the nurse, instead of that it’s like I was kind of saying what happened that the nurse got hurt, tell me how that nurse got hurt?’ Non-verbal non-threatening (14/28) Nurses recommended the use of ‘open hands, open gestures’, and refraining from any gestures associated with ordering, commanding, hierarchy and authoritarianism, such as: ‘wagging your finger’, ‘staring people out’, ‘pointing at people’, ‘folding arms’ and ‘standing with hands on your hips’. Emotional regulation Warm and genuine concern for patients was critical to all interactions with patients, and was presented under ‘moral stance’. In this section we present other material related to the emotional experience, presentation and self-regulation of nurses. Most of this ran across all symptoms domains, but potential problems seemed to be most acute around nurses’ reactions to aggressive and irritable patients. Low levels of negative emotion or responsivity were deployed by nurses as a dampening mechanism that provided the social environment patients seemed to require in order to settle and reduce their psychotic symptoms. No anxiety (26/28) Not being frightened or scared by the expression of psychotic symptoms, whether they be thought disorder, hallucination or whatever, instead expressing to patients a calm, confident, knowledgeable response, such as ‘I’ve met a lot of people who have these experiences, and it’s almost like, I’m not frightened by you having this and I’ve come across it before’. Being ‘calm’ and ‘relaxed’ was also important in the face of agitation and overactivity, both of which could be made worse by tension and anxiety in the nurse, indeed one nurse said it was not a good idea mirror patents agitation, or ‘be drawn into it’. Nurses also had to be able to emotionally ‘contain peoples’ distress’, by being calm, rather than ‘feeding into situations, making a drama out of it in terms of someone’s disclosed For [email protected] Property of Bookemon, do NOT distribute 80