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Back to the Basics: Patient & Family Centered Care and the Aggressive Patient?

Back to the Basics: Patient & Family Centered Care and the Aggressive Patient?

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Back to the Basics: Patient & Family Centered Care and the Aggressive Patient?

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  1. Back to the Basics: Patient & Family Centered Care and the Aggressive Patient? Event: AHCAP 2013 conference Presenters: Joy Fealy-Kalar, PFCC Coordinator/Customer Service Manager Ralph H. Johnson VAMC James G. McDonagh, Psy.D., Clinical Psychologist/Local Recovery Coordinator Ralph H. Johnson VAMC Date: 8/1/13

  2. Story • A man is sitting at the dinning room table eating his meal, when all of a sudden his wife comes up behind him and whacks him over the head with a frying pan. The startled man turns around and says to his wife, ‘why did you do that?’

  3. Story (cont) • The wife replies, ‘I found this piece of paper in your shirt pocket with the name Dixie on it and a number next to it. Are you having an affair on me?’ • The Husband nervously says, ‘no, Dixie is the name of the horse that I bet on yesterday at the track.’

  4. Story (cont.) • The wife pauses and says, ‘oh, ok, I’m sorry.’ • The next day, again, the man was sitting at the dinning room table and his wife comes up behind him and whacks him over the head with a frying pan. The man says, ‘what was that for?’

  5. Story (cont.) • The wife says, ‘your horse just called.’

  6. Agenda • Patient and Family Centered Care (PFCC) & Customer Service - Review of core principles • What? Our patient is a curmudgeon? • Aggression and persons with mental illness – A review • Can we/should we adhere to PFCC Principles when we have a curmudgeon in our mitts?

  7. Patient- and Family-Centered Care Core Concepts • People are treated withrespect and dignity. • Health care providers communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. • Individuals and families build on their strengths through participation in experiences that enhance control and independence. • Collaboration among patients, families, and providers occurs in policy and program development and professional education, as well as in the delivery of care.

  8. Curmudgeon • Definition: A surely, difficult, cantankerous person. http://www.youtube.com/watch?v=smsa-xSOudM

  9. Mental Illness & Aggression • Mental Illness - any of various disorders in which a person's thoughts, emotions, or behavior are so abnormal as to cause suffering to himself, herself, or other people. • Aggression- interactions that fall along a continuum of severity that produce harm to the biological, psychological, and/or to the metaphysical nature of another.

  10. PTSD • Mental health diagnosis marked by: • Exposure to a trauma or series of traumas • Symptoms cluster in three main areas: • 1. Re-experiencing • 2. Avoidance • 3. Hyper-arousal • Physiology: Mind-body connection • Co- Occurring Conditions: Depression, Substance Use

  11. Aggression/Violence - Qualified • Aggression can have an impulsive, vehement, and/or an emotionally agitated quality to it. • Aggression can also have a deliberate, calm, calculated, and composed quality to it. • http://www.youtube.com/watch?v=HWTMa76BzH0

  12. Which patients are the most aggressive? • Quiz: • Males or Females? • Young patients, middle-aged patients, or elderly patients? • Individuals with chronic pain? • Individuals with substance use/abuse conditions? • Individuals with a history of aggression? • Individuals with family, employment, and/or financial stressors? • Individuals without a conscience? • Individuals with an adolescent at home?

  13. So, what do we do when we are faced with an aggressive patient? • It Depends! • If low severity aggression, use EMPATHY. • If moderate severity aggression, EMPATHIZE & REPORT. • If high severity aggression, RUN/HIDE like heck.

  14. Empathy • Empathy is the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experiences of another.

  15. REPORT • Most health care organizations are required to have plans/strategies that address violence in the workplace. • Know it. • Use it. • Why?

  16. RUN/HIDE • Sadly, this is a very rare, but a very real and a very devastating issue in workplaces. • http://www.youtube.com/watch?v=yWfoHx7nmjk • Facts & Figures: • Every year in the U.S., an average of more than 100K people are shot, according to the Brady Campaign • One person is killed by a firearm every 17 minutes, 87 people are killed during an average day, and 609 are killed every week. (source: CDC)

  17. Should We? • A discussion of Ethics among health care professionals

  18. Questions?

  19. Thank you- http://www.youtube.com/watch?v=KqRPOEa3P44