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Difficulty: MediumCrisis Intervention

Family members are waiting in the surgical center lobby when one of them suddenly begins pacing rapidly, shouting profanities, and throwing magazines across the room. The practical nurse (PN) is the first staff member to arrive on the scene. Which initial actions should the PN take? (Select all that apply.)

  1. Position oneself with an unobstructed path to the nearest exit.Answer
  2. B
    Ask the individual to explain exactly why they are feeling so angry.
  3. Speak in short, simple sentences using a low, calm tone.Answer
  4. D
    Instruct the individual that their current behavior violates facility rules.
  5. Direct other visitors in the waiting area to move to a secure location.Answer
  6. F
    Initiate the application of physical restraints to prevent property damage.

Answer

The correct actions include positioning oneself with a clear path to the exit, speaking in short, simple sentences with a calm tone, and directing other visitors away from the area.
During a behavioral crisis, the primary focus is ensuring physical safety and employing verbal de-escalation. Maintaining an unobstructed path to the exit ensures the nurse's safety if the situation turns violent. Speaking in short, simple sentences with a calm tone helps reduce sensory overload and models emotional control. Removing other individuals from the area protects bystanders and decreases the audience, which can naturally lower the intensity of the situation.

Step-by-Step Solution

1
Assess the immediate environment for physical safety.
The nurse ensures an unobstructed escape route and removes bystanders from the waiting area.
Safety for the staff and other individuals is the absolute first priority in any behavioral crisis.
2
Implement initial verbal de-escalation techniques.
The nurse uses a low, calm tone and simple sentences to communicate.
A person in crisis cannot process complex information; simple, calm communication prevents further escalation.
3
Avoid confrontational or non-therapeutic approaches.
The nurse refrains from asking 'why' questions, enforcing rules, or prematurely considering physical restraints.
Confrontation, complex logical demands, or immediate use of restraints will exacerbate the crisis and violate the principle of least restrictive intervention.

Key Concept

Crisis Intervention and De-escalation Priorities
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Topics

Crisis Intervention

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