An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. Which is the most appropriate action by the nurse?
A.
Call for an emergency response from trained personnel.
B.
Calmly call the client by name and encourage verbal expression of anger.
C.
Approach the client and firmly say. “Stop. put it down.”
D.
Assist the client to use problem-solving techniques instead of aggression
The Correct Answer and Explanation is:
The correct answer is A. Call for an emergency response from trained personnel.
When a client becomes physically violent, such as throwing a chair, the immediate priority is ensuring the safety of everyone involved, including the client, other patients, and healthcare staff. While options such as verbal de-escalation or problem-solving techniques are valuable in managing aggression, the situation described has escalated beyond verbal intervention. At this point, the client is actively engaging in dangerous behavior, posing an imminent threat of harm to themselves or others.
Explanation:
- Safety First: In any healthcare setting, the safety of all individuals takes precedence. The client’s actions (throwing chairs and preparing to throw another) indicate an acute phase of violence where verbal de-escalation or problem-solving would likely be ineffective. Attempting to approach the client, as suggested in option C, might put the nurse at risk of physical harm.
- Trained Personnel: Healthcare facilities often have protocols for managing violent or aggressive clients, including calling for assistance from trained personnel, such as a security team or a specialized behavioral health response team. These individuals are trained to safely restrain or manage the client, using techniques that minimize the risk of injury for all involved.
- Avoid Escalation: While it might seem beneficial to encourage the client to verbally express their anger (option B) or use problem-solving techniques (option D), these strategies are more appropriate when the client is not in the midst of aggressive behavior. The client’s current state of agitation and violence suggests they are beyond rational communication, and further interaction could provoke more aggression.
- Prevention of Harm: The client’s actions, if not interrupted, could lead to serious harm. By calling for an emergency response, the nurse ensures that appropriate measures are taken to prevent injury to others and the client themselves. Trained personnel can use restraint methods or other de-escalation tactics to neutralize the immediate threat.
In summary, in situations involving physical aggression, the most appropriate response is to call for emergency assistance from personnel trained in handling violent behavior. This ensures safety and allows for appropriate measures to be taken to de-escalate the situation in a controlled and professional manner.