14. Preparation - Scenario questions 2

Candidate One (Rachel) Response to the question:

"How would you deal with a relative who was aggressive and verbally abusive?"

Interviewer:

How would you deal with a relative who was aggressive and verbally abusive?

Rachel:

Well, aggression and verbal and physical abuse are completely unacceptable, particularly in the clinical environment. Not only from a professional perspective of a nurse who is on the receiving end of the aggression, but also from the patient’s perspective of terms of patient safety and security. It may provoke feelings of anxiety amongst other patients on the ward. So as a nurse I think it’s my responsibility to ensure that I’m upholding patient safety. So, I would approach the individual, who shown the aggression, I’d approach them very calmly but also with confidence and control. I’d ask them if they want to go to a quiet room on the ward. Where we can sit down and discuss what might have motivated their behaviour. I’d keep in mind that there may be many reasons that might have motivated their behaviour, for example they may might have just received sad news about their relative. I’d ensure that I approached them with sensitivity as well. In doing this will demonstrate that I adopt a family centred approach to care.

I would use my verbal and non-verbal communication skills to empathise with them, I would use my active listening skills to ensure that they feel cared for. However, if my efforts weren’t effective and they continued to show the aggression and violence, I would firstly seek assistance from another colleague, and if this persisted, I would also escalate my concerns further, to my nurse in charge. After this, if it was required, I would contact security for additional support.

After this I would, I would, because safety and safeguarding are particular issues that are raised, it might be appropriate to make safeguarding referral. It would also need communicating in several different ways. So, it would documenting in the patients notes, accurately. It would also need an incident form completing and also it would need communicating via handover to the next set of nurses who are coming on shift. Finally I think that I would ensure that I supported rest of my colleagues, sort of seek an informal debrief with them in order to promote our mental and physical wellbeing. So, I would also ask them if they could give me their support as well, so that I ensure that I feel okay. I would also seek feedback from my manager, who might make suggestions of how I can improve if the scenario was to arise again.

Candidate Two (Gemma) Response to the question:

"How would you deal with a relative who was aggressive and verbally abusive?"

Interviewer:

Okay, so question then, how would you deal with a relative who was aggressive and verbally abusive?

Gemma Birkett:

Okay So I had that experience recently on placement, so I will tell you my experience if that’s alright.

So I had a partner outside the postnatal ward, he was being quite aggressive to the maternity assistant. Because he wanted to come in and visit his wife. But his wife was currently in the treatment room and she hadn’t started receiving treatment yet as we were very busy on the ward and there was nobody to care for her. And in the treatment room it’s quite a small space and I couldn’t have had him and his daughter, who was quite young, in there with no member of staff ready to come and see her as it could be a while.

So when the maternity assistant came and told me that he was being aggressive, I went out to calmly explain to him the situation of the ward, and why we weren’t seeing his wife yet, and why we couldn’t let him on the ward at this present moment of time, I think there was an emergency going off in another so it was quite serious. And he got very aggressive with me. But before I went out there I did check the camera, to make sure he wasn’t going to harm me in any way or any other member of staff. He was quite aggressive verbally with me, even though I had sat down next to him and spoke to him a calm manner and explained everything.

And then I went inside to escalate to a senior member of staff and check the safeguarding notes to check there hadn’t been any previous violence or aggression and there had been. So at that point I escalated then to the safeguarding midwife to let her know he was here and this was occurring and after that I rang security to come up and talk to him because he was still being quite aggressive outside. And we went in to the women and let her know what was happening, and that we had to escalate to security and that her partner was outside.

And I think that was quite a good way of dealing with things, because we all talked about it afterwards and had a de-brief and discussed if he was going to be allowed on to the ward at later points and what we could do about it so I think that was quite a good example.