10 ANGER, HOSTILITY, ANDAGGRESSION 203
continued from page 202Your behavior provides a role model for the client
and communicates that you can and will provide
control.Avoiding personal injury, summoning help, leav-
ing the area, or protecting other clients may be
the only things you can realistically do. You may
risk further danger by attempting to remove a
weapon or subdue an armed client.Reaching for a weapon increases your physical
vulnerability.Distracting the client’s attention may give you an
opportunity to remove the weapon or subdue the
client.Exceeding your abilities may place you in grave
danger. It is not necessary to try to deal with a
situation beyond your control or to assume per-
sonal risk.You may need assistance from staff members who
are unfamiliar with this client. They will be able
to help more effectively and safely if they are
aware of this information.The need for help may be immediate in an emer-
gency situation. Any information that can be given
to arriving staff will be helpful in ensuring safety
and effectiveness in dealing with this client.The client has a right to the fewest restrictions
possible within the limits of safety and prevention
of destructive behavior.Potentially violent people have a body space zone
much larger than that of other people (up to four
times as large). That is, you need to allow them
more space and stay farther away from them for
them to not feel trapped or threatened.Interfering with the client’s mobility without the
intent of restraint may increase the client’s frus-
tration, fears, or perception of threat.Always maintain control of yourself and the situ-
ation; remain calm. If you do not feel competent
in dealing with a situation, obtain assistance as
soon as possible.
If you are not properly trained or skilled in deal-
ing safely with a client who has a weapon, do not
attempt to remove the weapon. Keep something
(like a pillow, mattress, or a blanket wrapped
around your arm) between you and the weapon.
If it is necessary to remove the weapon, try to
kick it out of the client’s hand. (Never reach for a
knife or other weapon with your hand.)
Distract the client momentarily to remove the
weapon (throw water in the client’s face, or yell
suddenly).
*You may need to summon outside assistance
(especially if the client has a gun). When this is
done, total responsibility for decisions and actions
is delegated to the outside authorities.
*Notify the charge nurse and supervisor as soon
as possible about a (potentially) aggressive situa-
tion; give them pertinent information; including
your assessment of the situation and need for
help, the client’s name, the client’s care plan, and
orders for medication seclusion, or restraint.
*Follow the hospital staff assistance plan (e.g.,
use intercom system to page “Code _____,” area),
and then, if possible, have one staff member meet
the additional help at the unit door with neces-
sary information (the client’s name, situation,
goal, plan, and so forth).
Do not use physical restraints or techniques with-
out sufficient reason.
Remain aware of the client’s body space or terri-
tory; do not trap the client.
Allow the client freedom to move around (within
safety limits) unless you are trying to restrain
him or her.
continued on page 204