Establish effective boundaries that meet both the patients' expressed needs & provide...

Disruptive Behaviors: 3 Levels

The following behaviors are 3 general categories of behavior. Each institution may have different levels that apply to their particular facility and/or demographic.Level 1: Inappropriate/Disrespectful Persistent BehaviorsLevel 2: Dangerous/Safety-Compromising BehaviorsLevel 3: Physically Dangerous or Criminal Behaviors

Considerations when working with behaviors

Self Assess. Take note of the 'space' that we are in. Are we stressed out, exhausted or in a bad mood. If we are not in a good place it will be difficult to manage disruptive behavior in the work settings. It is important to RESPOND to issues instead of  to REACT. Classify disruptive behavior. Knowledge of the level of disruptive behavior will allow staff to respond appropriately. Situation will not improve if response is directed at one level of behavior and patient/caregiver is displaying characteristics common to a different level. Source of behavior. When staff is able to determine the source of the behavior (pain, anger, fear, hopelessness, learned behavior, etc.) they can use restatement and empathy to confirm. Communication skills. Staff should be aware that 7% of communication is verbal, 55% is non-verbal, and 38% is para-verbal (cadence, volume, tone of voice).

Principle of Effective Boundaries

Need to be clear and non-threatening (take considerations from previous slide into account). Need to offer clear and reasonable choices. Part of the process to diffuse a difficult situation is the ability to offer alternatives to the current situation that allow the patient/caregiver to choose (choosing will empower them to commit to a solution that they 'buy' into. Need to establish limits that can be enforced. If there are no parameters established on behavior, it is difficult to monitor and document. A pattern of unenforced boundaries will be difficult to remedy in the future. Limits should be set early.  Need to communicate with staff. It is imperative that management and staff work together on maintaining a consistent front when addressing behavior. Win-win. Overcoming difficult situations can ultimately lead to a better patient experience overall.