The patient is verbally aggressive with a nurse and threatens physical violence unless he is given an IV dose of hydromorphone (Dilaudid). Which initial action by the nurse is appropriate?

Move towards the door. Nurses and other medical professionals have a duty to protect patients; however, when a patient becomes dangerous, the greater duty is for nurses to protect themselves. Attempting to diffuse the situation is always the best first option. This does not mean complying with a request—threatening behavior should not be rewarded (unless the nurse’s life is in imminent and immediate danger and the alternative is physical harm or death). Remaining calm, however difficult that may be, is the best way to diffuse the situation. At the same time, the nurse should move to safety. Threatening violence or restraint escalates the situation. Once the nurse has reached safety, hospital security and administrative staff should be called to address the situation.

The patient is verbally aggressive with a nurse and threatens phy...

Category: Psychosocial Integrity
Difficulty: 4

Topics: Mental Health Disorders Crisis Management Health Care Ethics, Law, and Policy Health Care Quality

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