NUR3312 - Crossing Arms in Front of the Chest - Nursing Assignment Help

Assignment Task

Comparison
For the two (2) strategies or behaviours discussed from the literature in your student report, identify and describe an example of each being implemented in the expert case. This can be provided in a table format (see example below). If the strategy or behaviour was not evident please state this.
Provide an additional two (2) strategies or behaviours you observed in the expert case. Describe how it was used in the expert case to de-escalate Ben.
  
Student Report Strategy/Behaviour Example/Description of use in Expert Case
1 2 Additional Strategy/Behaviour Example/Description of use in Expert Case
1 2 Reflection on learning
Reflect on your learning around strategies for de-escalation from this case, and discuss how this will influence your future clinical practice, for patients and families who display violence and aggression. 
Take home message: Briefly state one key piece of learning from your reflection.
Impact on Practice.
Based on your reflection on learning, identify and clearly discuss one (1) strategy for managing workplace violence and aggression, that you will bring into your practice as a graduate nurse.
Provide a brief and appropriate explanation of how you will implement this strategy int your future practice.

Part A
Defensive posture (arms crossed)
Nursing workload -> Impatience and lack of time
Attitude towards aggression
Touching of the patient
Body language and facial expressions that convey defensiveness include crossing arms in front of the chest (Edward et al., 2014). As a result, defensive body language exhibited by the nurse can often initiate discomfort and anger among patients (Edward et al., 2014). Defensive body language is a negative indicator that decreases authenticity and compassion towards individuals (Edward et al., 2014). As a nurse, their reaction can significantly influence the emotional reactivity of highly agitated patients (Viottini et al., 2020). Patients are more likely to overreact to situations when nurses do not remain calm and sustain a neutral appearance, resulting in nurses losing control of the problem (Edward et al., 2014).
Nursing workload contributes to a decrease in the nurses' ability to balance patient care with other nursing tasks; the reduction of their ability to offset patient care reflects their work performance (Magalhães et al., 2017). Furthermore, the workload influences patients' frustration and aggression and nurses in several ways (Magalhães et al., 2017). In addition to increasing fatigue, impatience and decreasing nurses' time to care for patients, nurses are under more stress (Magalhães et al., 2017). Nurse's then do not fully understand the needs of their patients when expressed (Magalhães et al., 2017).
Touch does not universally result in positive emotions, which leads to misinterpretation (Van Wijk et al., 2014). Individual circumstances could be construed touch as a violation of preferred interpersonal distance (Van Wijk et al., 2014). The use of contact awakens patients, gets their attention or adds emphasis to explanations (Van Wijk et al., 2014). Without cues indicating the welcoming of touch, this could be misinterpreted and aggravate aggressive patients, demonstrating the power and dominance even more (Van Wijk et al., 2014).
The attitudes of healthcare professionals towards aggression can impact how they respond to this behaviour (Viottini et al., 2020). For example, positive attitudes may affect the adoption of person-centred approaches, whereas negative attitudes may contribute to pre-determined biased attitudes towards the patient (Viottini et al., 2020). This behaviour exists attributable to interpersonal problems resulting from unfavourable situational events such as 'accusing of the stolen phone' and poor interaction with nurse and patient in the setting (Viottini et al., 2020).
Many elements are associated with recognising, de-escalating, and managing conflict circumstances (Fernández-Costa et al., 2020). The strategy one must employ when resolving a conflict occasionally need to be processed and implemented concisely (Fernández-Costa et al., 2020). Verbal de-escalation can be considered an ongoing strategy to establish a calm and safe environment; while in a position of authority (Fernández-Costa et al., 2020). Health care professionals will need to learn to communicate with patients appropriately, involving de-escalation and nonverbal skills (Richmond et al., 2012). Verbal de-escalation involves a complex therapeutic interactive process, with the critical aspect of knowing how to talk to individuals to calm them down (Richmond et al., 2012). It insinuates the actuality of a set of verbal and non-verbal skills, which, if used selectively and appropriately, may decrease the level of an aggressor's hostility by calming anger and lowering arousal (Richmond et al., 2012). The healthcare professionals should make every attempt to initiate a good rapport and make the patient feel respected (Richmond et al., 2012). Asking open-ended questions and repeating the patient's concerns will allow patients to express themselves and tell healthcare providers the underlying problem (Richmond et al., 2012). Making our presence known by introducing ourselves and our title will reinforce our position and authority (Richmond et al., 2012). Ensuring posture is relaxed and comfortable while still assuring a safe exit from the room, a defensive stance like arms crossed could send a threatening message towards the patients (Fernández-Costa et al., 2020). Reiterating said statements allows the patient to know that we are actively listening to them (Fernández-Costa et al., 2020). When people are paid attention to, they feel validated, and it will clarify unclear information and ultimately stop aggression in the workplace (Richmond et al., 2012).
Presuming the patient's aggression improves accompanied these approaches, discussion to avert the re-escalation of threatening behaviour is required (Richmond et al., 2012). Conversely, if de-escalation techniques have failed, pharmacological intervention may be obligatory (Price et al., 2017). A typical specific strategy to prevent aggressive behaviour is a pharmacologic intervention to treat the underlying psychiatric illness (Vieta et al., 2017). For example, increasing a patient's dosage or adding a PRN dose of antipsychotic medication for patients with a history of aggression could be beneficial (Price et al., 2017). Thus, leading to decrease current reactivity and impulsivity, hence reducing the risk of current aggressive behaviour (Price et al., 2017). Such medication-based approaches, if successful, can aid in the prevention of aggression (Price et al., 2017). Furthermore, identifying aggressive behaviour triggers can help inform prevention strategies by revealing individualised patterns through trials of different approaches because the traditional system is ineffective (Richmond et al., 2012). Although evidence of aggressive behaviour in many clinical situations through mental illness, impulsive aggressive behaviour has the same neurochemical basis in almost all psychiatric diagnoses; therefore, using medications could help combat underlying aggression (Vieta et al., 2017). Mechanical restraint is another management strategy for aggressive patients who pose a substantial risk to nursing staff (Price et al., 2017). Intention to prevent patients from injuring themselves or others. When preventative de-escalation techniques (such as defusing, negotiating, or mediation) fail due to an unstable environment or when developing a treatment program requires the nurse and patient protection is vital for the safety of everyone (Vieta et al., 2017).

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