A client in a community outpatient clinic becomes upset and begins shouting at staff about a sudden change in their appointment schedule. The practical nurse (PN) intervenes to help de-escalate the situation. Which actions are appropriate for the PN to take? (Select all that apply.)
- Speak to the client using a soft, neutral, and steady tone of voice.Answer
- BPosition oneself between the client and the exit door.
- CState to the client, "Everything will be fine once you sit down and calm down."
- Acknowledge the client's frustration regarding the schedule change.Answer
- Ensure there is adequate physical space between the nurse and the client.Answer
- FInitiate the application of physical restraints to prevent further disruption.
Answer
The correct actions are to speak using a soft and steady tone, acknowledge the client's frustration, and ensure adequate physical space.
In a behavioral crisis or escalation, the primary goals are ensuring safety and therapeutically de-escalating the client. A soft, steady tone of voice prevents the nurse from matching the client's heightened emotional state. Acknowledging their frustration validates their feelings without necessarily agreeing with their behavior, which builds rapport. Maintaining a safe physical distance protects the nurse and prevents the client from feeling crowded or threatened.
Step-by-Step Solution
Key Concept
Crisis De-escalation and Safety