Running Head: Review of Aggressive Patient Case Study and Problem Solving Approach

Review of Aggressive Patient Case Study and Problem Solving Approach Iris Gwynne Simmons College

This article Care of a client who displays violent and aggressive behaviour: a case study by Angus Sturrock, relates to the course content of Nursing Fundamentals because it presents a real-life case and discusses the nursing process of problem solving for the case. It provides useful information for future cases when dealing with angry or aggressive patients. The evidence-based case and methods used to deal with the aggressive patient can influence nursing practice for caregivers dealing with similar problems. The author notes that managing violent and aggressive patients is a major challenge for healthcare personnel. Violence and anger have negative impacts on the general health of the patient and therefore managing this violent behavior must be included, not separated from, the routine care of the patient. The author states this purpose at the end of the introduction. He leads into by providing background info based on literature review. He includes evidence cited by Write et al (2002) that that violent

Running Head: Review of Aggressive Patient Case Study and Problem Solving Approach

behavior of patients has been an increasing problem in the health field. The author also uses evidence from Newell and Gourney (2008) that anger and aggression can be signs ill health. The author describes a patient who is referred to as Rohema to protect her identity. Rohema attempted suicide and was placed in mental health facility against her will. She has bipolar disorder and is in the manic stage of the illness. She displays violent and aggressive behavior and poses risks to those around her. The author goes through the nursing process in Rohemas specific case and stresses the point that managing Rohemas anger is key in managing her overall health. The first step of the nursing process is assessment, and knowing that Rohema had attempted suicide, assessment was carried out by interviewing her and observing her behavior and mood. A full risk assessment was carried out because of her recent suicide attempt and her spiritual and culture needs were also taken into account. The author stresses holistic care of the patient and how important it is that mental health nurses possess the awareness, knowledge and sensitivity to provide competent care to culturally diverse groups of clients (Sturrock, 2010, p. 9). The next step of the nursing process is planning. Addressing Rohemas aggression issues was a high priority since it was a major threat to her wellbeing. The multidisciplinary team agreed that interventions and health progress could be achieved more effectively if first Rohemas aggression and violence was taken care of. Rohema was given certain medications to help he relax, sleep, and ease her manic episodes. She was also given relaxation therapy. The possibility of having to use restraint or isolation with Rohema was discussed as well.

Running Head: Review of Aggressive Patient Case Study and Problem Solving Approach

Next in the nursing process is implementation. Rohema became very violent within a day of being admitted to the mental health facility. She was throwing plates and smashing windows and posed a threat to others around her. When nothing else seemed to calm her, the nurses had no choice but to use seclusion. Rohema was then sedated and was able to go to her bed. At this point the author stresses the importance of the nurse/patient relationship because Rohema probably felt she was punished and may feel even more hostile towards the nurses. It is important for the nurses to explain to Rohema why she was secluded and offer ways for her to deal with her anger, including an anger diary. The diary allowed for Rohema to have deeper discussions with her primary nurse about her feelings. Rohema admitted that the diary helped her become more aware of her anger. Also part of implementation process, Rohema attended relaxation sessions. Evaluation is the final stage in the nursing process.

References

Sturrock, A. (2010). Care of a client who displays violent and aggressive behaviour: a case study. Mental Health Nursing, 30(4), 8-13.