title: The practices of expert psychiatric nurses: accompanying the patient to a calmer personal space.
abstract: The focus of the care of potentially aggressive psychiatric patients has been on the use of seclusion and restraints. Recent concerns, however, about the potential for patient injury have made it imperative that nurses use alternative methods to calm patients who are escalating. Little is known about how expert nurses de-escalate the escalating patient. The purpose of this interpretive phenomenological study was to uncover and describe the knowledge embedded in the stories of psychiatric nurses who are skilled in the practices of de-escalating an escalating patient. Twenty registered nurses were interviewed using an unstructured format. The analysis of the data revealed that these nurses were skilled at noticing the patient, reading the situation and the patient, knowing where the patient was on the continuum, understanding the meaning of the behavior, knowing what the patient needed, connecting with the patient, and matching the intervention with the patient's needs.
authors.affiliation: Rush University College of Nursing, Armour Academic Center-1042D, 600 S. Paulina St., Chicago, IL 60612, USA. mjohnson1@rushu.rush.edu
authors.forename: M E
authors.initials: ME
authors.lastname: Johnson
authors.forename: P M
authors.initials: PM
authors.lastname: Hauser
mesh_terms: D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000523:psychology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000451:nursing* / Q000523:psychology; D009723:Nurse-Patient Relations; D011568:Psychiatric Nursing; D014754:Violence / Q000517:prevention & control* / Q000523:psychology