A client displaying acute mania has driven staff to the end of their tolerance by noon. The client has
joked, manipulated, insulted, and fought his way through the morning. Staff are feeling defensive
and exhausted.
The best action to take is to
a. call the physician to come to the unit to evaluate the client and write a seclusion
order.
b. seclude the client, then call the physician to come to the unit to write a seclusion
order.
c. hold a staff meeting to discuss staff consistency and limit-setting approaches.
d. explain to the client that his behavior is unacceptable and seek his cooperation.
C
When staff members are at their wits' end, the client has succeeded in keeping the environment
unsettled and avoided outside controls on behavior. Staff meetings can help minimize staff splitting
and feelings of anger, helplessness, confusion, and frustration.
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