Although anger is normal, it is often perceived as a negative feeling. Many people are not comfortable expressing anger directly. Nevertheless, anger can be a normal and healthy reaction when situations or circumstances are unfair or unjust, personal rights are not respected, or realistic expectations are not met. If only the person can express his or her anger assertively, problem solving or conflict resolution then becomes possible. A client’s angry behavior can be very alarming for a nursing assistant since things can get out of control and might cause chaos on the facility as a whole.
Anger becomes negative when the person denies it, suppresses it, or expresses it inappropriately. A person may deny or suppress angry feelings if he or she is uncomfortable expressing anger. Possible consequences are physical problems such as migraine headaches or ulcers and emotional problems such as depression and low self-esteem. Anger that is expressed inappropriately can lead to hostility and aggression. The nurse can help clients express anger appropriately by serving as a model and by role-playing assertive communication techniques. Assertive statements allow appropriate expression of anger and can lead to productive problem-solving discussions and reduced anger.
- The anger is vented out either verbally or non-verbally.
- The client advances in such as a way that he or she invades your personal space.
- The actions seems to be threatening to the others and caregivers.
- The eye contact is fierce and the tone of their voice is very different when they are on a calm state.
Hostile and aggressive behavior can be sudden and unexpected. Behavior escalation may lead to physical aggression. Therefore, interventions during the triggering and escalation phases are keys to preventing physically aggressive behavior.
7 practical recommendations on helping de-escalate a client’s angry behavior:
- The nurse assistant should approach the client in a calm, nonthreatening manner.
- Try to convey empathy for the client’s anger or frustration.
- Encourage the client to express his or her feelings verbally or in a constructive way, suggesting that the client is still in control and can maintain that control.
- Use clear, simple, short statements when talking to the client.
- The nurse should allow the client time to express himself or herself.
- The nurse can suggest that the client go to a quiet area or may get assistance to move other clients to decrease stimulation.
- Medications can be offered.
When the above steps are unsuccessful in lowering the client’s temper, a plan B must be employed:
- The nurse assistant should be directive in giving instructions to the client in a calm, firm voice.
- Try to use break periods or “time-out” in order to allow the client to cool down and may realize what he or she is doing might be wrong.
- The nurse assistant must recognize that an escalating angry behavior of the patient means that he or she is asking for help. Assist the client to services or needs that might answer his or her angry actions.
- With the supervision of a registered nurse, observe and encourage the client to take anti-anxiety medications to calm his or her state.
As a nursing care assistant, remember to be aware of yourself as well as how you may vent out angry feelings so that you can also understand why your patient is in an escalating state of angry behavior. In this manner, you can take control and de-escalate the client’s angry behavior.