A male patient with a history of violence directed toward others becomes very excited and agitated during the nurse's interview. Which intervention should the nurse implement to foster therapeutic communication?

Question

a. Call the security staff for assistance.
b. Ask the patient if he will use self-control.
c. Lean forward and touch the patient's arm.
d. Assume an open, nonthreatening posture.

Answer 1

D
The nurse should use neutralizing skills and assume an open, nonthreatening posture that conveys respect and acceptance, creating an atmosphere in which the patient can communicate without feeling threatened or defensive. Depending on the extent of this nurse-patient relationship, the patient can be posturing as they get to know one another; however, before entering the room in the future, the nurse should plan for personal safety by keeping the door open and letting others know that he or she is with the potentially violent patient. Calling security in the patient's presence is likely to aggravate the patient and escalate the potential for violence because it is humiliating, conveys the nurse's rejection of the patient, and threatens to take all control away from him. Asking the patient if he will use self-control is reprimanding him, humiliating, and conveys rejection and lack of respect by the nurse. The patient can perceive leaning and touching as threatening.