Question

NSG 350 XTRA Assignment: Anger, Aggression & Violence Case Study

Olivia is a nursing student completing a practicum at the local hospital. She is shadowing Nina, a long-time RN on the medical-surgical unit. As the two nurses begin their shift, Nina gives Olivia a brief history of the first patients they will be assessing. Mr. Musick, aged 44, who is being treated for pancreatitis, has been on the unit for 3 days. He has a history of cigarette smoking (20 years) and a history of gallstones. He denies being a “heavy drinker,” but admits to having one or two drinks after work most days and more on weekends.

​During his stay, Mr. Musick has repeatedly raised his voice, cursed, and even screamed loudly at various nurses and other staff. At times, he is angry about an invasive procedure, such as when the night nurse needs to restart his IV in another vein. At other times, Mr. Musick’s anger seems random. As Nina explains to Olivia, “He just blames everyone else for how miserable he is. And since it is everyone else’s fault, then he figures everyone else ought to fix it—now.”

​During the change-of-shift report, Olivia learned that earlier this morning, Mr. Musick became extremely irritable for not being allowed to smoke anywhere in this “damned place.” The nurse explained that the patient got up from his bed as though “he thought he was heading to a smoking lounge,” pulling out his IV in the process. When the nurse told him, he could not be up and walking, Mr. Musick screamed, “Doesn’t anybody realize that I just need a drink to calm my nerves?” When the nurse called for help, Mr. Musick threatened to “take out” anyone who touched him. The nurse was able to calm him down and convince him to get back into his bed, but she said that he continued to be verbally abusive throughout the shift.

​As Nina leads Olivia down the hall to Mr. Musick’s room, he is heard yelling at a nurse, “You people are incompetent. That is why I’m still here after 3 days! I’m getting worse, not better!”

1. How would you characterize Mr. Musick’s coping skills? Does he seem to be a patient with healthy coping skills who is simply overwhelmed by current circumstances? Or do you think he had marginal coping skills before coming to the hospital? Explain.

2. If Mr. Musick continues to verbally abuse the nurses, do you think it would be more effective for the nurses to try to ignore his outbursts to avoid further escalation or to challenge his behavior? Explain.

3. Are anger and aggressive behavior becoming more common? Or do we simply see it more often because more of our words, actions, and demeanor are recorded in this age of smart phones and social media?

Answer 1

Coping strategies or skills are the reactions or behaviors one adopts to dealt with difficult scenarios.Humans learns coping strategies from those they come in contact with while growing up.Coping skills can be positive or negative.

I think Mr Musick had marginal coping skills as he manifests anger which swifts from anxiety to aggression.This is especially true for patients with chemical dependence who may be anxious about being cut off from their substance abuse.Many patients with marginal coping have personality styles that externalize blame as Mr Musick does.That is ,they see the source of their discomfort and anxiety as being outside themselves and demands relief from outside sources such as nurses or medication.

2. If Mr. Musick continues to verbally abuse the nurses, it would be more effective for the nurses to try to commence or attempts to understand and meet patients needs than ignore his outbursts.Anxiety can be reduced by minimising ambiguity.This strategy includes clear and concrete communication.Patients must have a clear view abiut what the nurses can provide and what cannot .Patients with a high level of baseline anxiety and limited coping skills are helped when their interactions with the treatment team are predictable

3. Anger and aggressive behavior becoming more common than before. This may be because the influence of environmental factors exposure to vilence ,how you were raised ,stressed and hectic life stlye.Though it is a fact that we may notice it morebecause more of our words, actions, and demeanor are recorded in social media and other modern media,it doesn't mean that these current scenario is making a fantacy world of aggression.People are stressed and hormonically imbalanced while compared with the past hence, are aggressive.