Managing Aggressive Patient Behavior

When you work within the healthcare industry, there are certain responsibilities that come with the job, such as administering IVs, reading patient charts, and speaking with concerned family members. However, tolerating aggressive behavior from patients should not be something that employees expect or accept as “just part of the job.” Unfortunately, statistics tell a different story—according to the U.S. Bureau of Labor Statistics, healthcare and social services workers in the private sector experience more non-fatal violent incidents than workers in any other industry.[1] A portion of these incidents include patients who act aggressively toward healthcare staff.

Patients can exhibit aggressive behavior for a variety of reasons, and it’s important to approach and understand the causes with sensitivity and empathy. Not all aggressive behavior is malicious or even intentional. Knowing the potential triggers that can lead to these types of events is critical to reducing the risk of injury to both patients and caregivers. Triggers can include:

  • Mental and physical factors, such as side effects of medication, vision impairment, psychiatric disturbances, or substance abuse
  • Emotional factors, such as fear of the hospital, frustration with rules, or feelings of loneliness or depression
  • Situational, emotional, and cultural factors, such as change in routine, lack of privacy, or language barriers

Handling an Incident

Aggressive behavior is often unpredictable and can quickly escalate from signs of anxiousness and defensiveness to physical responses. However, there are steps you can take to help protect your staff and facility from these situations and minimize the risk of injuries. These include:

  • Organizing and training patient teams to respond to these and other types of emergency situations. It’s important to ensure there are teams available during all shifts.
  • Training staff on how to address individuals exhibiting aggressive behavior. Training should address potential causes, how to assess a patient’s verbal and nonverbal cues, different ways to respond based on the individual’s behavior, and locations of alarms.
  • Setting up a system so employees can readily identify patients who have exhibited violent or assaultive behavior. Privacy rights vary by jurisdiction, so consult with your legal counsel to determine what steps you may take.
  • Reviewing your facility’s layout to ensure the number and locations of alarm systems and security devices are adequate. Be sure to check equipment on a regular basis to confirm it is working properly.

In addition, encourage staff to promptly report these types of incidents. While staff may be hesitant to do so for fear of embarrassment or reprisal, any delay could keep staff and patients from getting medical treatment for injuries sustained during the event and expose your facility to additional liability. Conducting a review of each incident is also important to determine possible triggers and ways to avoid or diffuse similar situations in the future.



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The illustrations, instructions, and principles in this material are general in scope and, to the best of our knowledge, current at the time of publication. No attempt has been made to interpret any referenced codes, standards, or regulations nor to identify all potential risks or requirements.