Patients may become unruly for several reasons, and their behavior may make it difficult for healthcare workers to determine the cause and the underlying medical problem.
Emergency department staffs are trained to calm unruly patients by talking with them, and when necessary, restraining them physically or with medication. They follow guidelines and regulations on proper methods of restraint and each situation is later reviewed, according to David Hale, M.D., site director of the Woodwinds Hospital emergency room.
Restraints a last resort
Hospitals train staff members to avoid restraining patients unless their behavior threatens to harm the unruly patient, other patients or hospital staff, according to Hale and David Moen, M.D., emergency department director at Fairview Lakes Hospital. What works best in most cases, they say, is to summon several staff members into the room.
"If you have a huge number of people, the patient will calm down," Hale says.
"It takes multiple personnel with different skills, and how they work together as a team is critical to your success," adds Moen. "You want to have a calm environment of care, and you need to try to reassure them and make them comfortable. At the same time, you need to evaluate what the cause is and begin addressing that. It can be very difficult in the elderly, and it can be difficult when you have multiple factors going on like alcohol, drugs, medical conditions and psychiatric conditions."
What causes the behavior
Other conditions that may lead to unruly behavior include low blood sugar, low sodium, bacterial infections, meningitis, head injuries, dementia and fear of domestic abuse or violence. Hospital staff can sometimes predict a violent episode if a patient appears agitated or uses pressured speech, Hale says.
