Hi, I'm Cathy with Level Up RN. In this video, we are going to talk about aggression and violence,
and I'm going to start in on my coverage of abuse. At the end of this video, I'm going to
give you guys a little quiz, a little knowledge check to see if you understand some of the key
concepts that I will be covering in this video. So let's first talk about aggression and violence.
Unfortunately, as a nurse, it is very likely that you will encounter an aggressive or violent
patient, and it's going to be important for you to be prepared for that. So you'll not only get
questions about this on the NCLEX and your nursing school exams, but you also need to be prepared in
real life for a violent or aggressive patient. So predictors of violence can include
pacing, agitation, threatening remarks, and a combative posture. And of course,
we want to try to de-escalate the situation, and we can try to do so with a calm voice. We want
to allow for lots of personal space around the patient, so you don't want to be up in their face.
You want to provide very clear limit setting and redirection. You want to encourage relaxation
techniques and offer some distraction with a positive activity such as exercise. You definitely
want to try to get that patient to a quiet area with decreased stimuli under close observation.
And you want to move other patients away from the area and make sure that you have sufficient staff
available very close by if needed if we need them to intervene. And then you also want to
remove any dangerous items from the environment. So we're going to try all of these things to
try to de-escalate the situation. If we are not successful, then unfortunately,
we kind of have to take the next step to provide for our safety and the safety of other patients.
So this can include the administration of pharmaceuticals such as haloperidol or
lorazepam. And then if needed, we can also apply restraints or put the patient in seclusion.
A couple of other key points for all of you nurses or soon-to-be nurses out there, do not wear
necklaces. You do not want anything that someone can grab around your neck. You also want to make
sure you know your facility layout, and you want to make sure the patient is not between you and
the door. So number one, you got to keep yourself safe. You do not want to get hurt or injured,
so do what you need to do to keep yourself safe. Now we're going to transition to talking about
abuse. So there are five types of abuse, generally speaking. We have physical abuse,
which is the intentional use of physical force, which could be hitting, kicking, burning, shaking.
We have emotional abuse, which are behaviors that harm another person's
self-worth or emotional well-being. Then we have sexual abuse, which is forcing a person to engage
in sexual acts without their consent. And we have neglect, which is failure of a caretaker
to provide for the basic needs of a vulnerable person, so this can include housing, food,
education, medical care, etc. And then we have economic abuse, which is making an individual
financially dependent through the improper use of funds by a person in a trusted relationship.
Now that we have gone through the different types of abuse,
let's talk about the cycle of abuse or violence. So really, there are three phases in this cycle.
The first phase is the tension-building phase. This is where the abuser becomes judgmental,
threatening, unpredictable, and possibly verbally abusive. The victim feels like they are walking on
eggshells, and attempts to reason with or calm the abuser are unsuccessful. From the tension-building
phase, we go into the explosive phase. During this phase, there is physical, emotional,
and/or sexual abuse that occurs, and the victim may contract the authorities or they may not.
Then after this explosive phase, we go into the honeymoon phase. During this phase,
the abuser apologizes, they may give presents to the victim. They promise never to do it again. At
this point, the victim may drop charges if they had brought charges forth previously,
believing the situation will not happen again. But unfortunately, the cycle repeats again.
Let's now talk about risk factors associated with abuse.
I have divided this up on my flashcard between perpetrator risk factors and victim
risk factors. So perpetrator risk factors include poor education, low socioeconomic status,
substance abuse, family history of violence, and low self-esteem. In terms of victim risk factors,
if we're talking about intimate partner violence, being a woman places the individual at
higher risk for abuse, also, pregnancy places a woman at higher risk for abuse as well.
When we are talking about child abuse, unwanted or unplanned children are at higher risk for abuse.
Also, children with special needs will also be more likely to be abused.
And the risk of child abuse increases a great deal when domestic abuse is present in the home.
For elderly or older adults, if they have chronic health challenges such as dementia, that can place
a strain on the caregiver and then makes it more likely that they will also be abused.
Okay. Knowledge check time. I have three questions for you. Question number one,
failure of a caretaker to provide for the basic needs of another, so this includes housing, food,
medical care, and education, is considered what type of abuse?
The answer is neglect. Second question,
in the cycle of violence, what phase is characterized by the victim walking on eggshells?
That would be the tension-building phase, which is the first phase
of that cycle of violence or abuse. And then last question is a true-false question.
There is an increased risk of child abuse when there is domestic violence present in the home,
true or false? The answer is true. Okay. In my next video, we will talk about the signs of abuse
and we will talk about nursing care of abuse, so stay tuned for that. Thanks for watching.
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