RISK FOR OTHER - DIRECTED VIOLENCE Nursing Care Plan

        We will share to you a sample of nursing care plan (NCP) of violence, risk for other-directed. This is a nursing care plan sample about risk for other-directed violence of Mr. Dutman, 65 years old, lawyer. Mr. Dutman is very good lawyer with an outstanding records throughout his career. He has 88% win rate of all his cases that makes him popular in his field. He also wrote a book that helps beginners to attain professional level in the field of law. He is so workaholic until he was turned 65 years of age. He needs to forcefully retire due to his age and he didn't want it to. Now that he had no longer have a job, he, for him, have nothing else important to do. Mr. Dutman became violent, always mad at something and almost changes his behavior for unknown reason. Always remember that do not use this diagnosis to address other problems such as anxiety and poor self-esteem, but instead should make and refer to ANXIETY Nursing Care Plan and Effective Coping.

ASSESSMENT:

Subjective:
"I will kill everyone!” as verbalized by the patient.

Objective:
- Clenching of fist
- Facial flaring
- Shouting
- Flaring eyes
- Grunting of teeth

Diagnosis:

        Risk for other-directed violence related to aggressive acts and manic excitement as manifested by shouting and clenching of fist.

Planning:

After 2 hours of nursing intervention, the client will refrain from threatening, loud language towards others and identifies calming strategies.

INTERVENTIONS:

- Promote trust to Mr. Dutman first by acknowledging his feelings. Tell Mr. Dutman: "You are having a rough time." Just be genuine and empathetic and tell Mr. Dutman that you will help him and do not do anything destructive.

- Set limits when Mr. Dutman poses a risk to others. Do not touch him, avoid feelings of physical entrapment but do not do this intervention alone, presence of three to four staffs is necessary in order for Mr. Dutman not to lose control. Offer choices, sometimes it is necessary to give necessary demands to avoid a power struggle. Also encourage Mr. Dutman to express anger by saying or verbally instead of acting out.

- Do not take the verbal abuse of Mr. Dutman personally because it may lead to disruptive or strain nursing care. Be calm at all times, if you become upset, leave the situation to others and a break or focus attention to others. After the nursing intervention, discuss your feelings about the situation to other staffs.

- Remove Mr. Dutman from the environment if it contributes to the aggressive behavior using the least amount of control needed, like asking others to leave or taking Mr. Dutman to the quiet room. Repeatedly tell Mr. Dutman what will go to happen before external control begins.

- Explore what precipitates Mr. Dutman out of control. Assist him to recall the physical symptoms associated with his anger. Teach Mr. Dutman the use of deep breaths and relaxation breathing.

- Encourage increased recreational activities.

Evaluation:

After 2 hours of nursing intervention, the client refrained from threatening, loud language towards others and identified calming strategies.

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