How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 92

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Explore solutions (9/28)
These can either be offered as possibilities by the nurse, or the patient can be asked what support
would help them: ‘how can we make this better for you?’ A helpful move could be to ask if they
have felt this way before, and what has happened previously, what has helped and what hasn’t.
Alternatively, to elicit their own ideas, the patient could be asked ‘what would you tell a friend in
your situation?’
Take action to relieve cause (6/28)
If it is something causing the distress that the nursing team can remedy in some way, then
appropriate action can be taken. No specific examples were given.
Distraction (6/28)
Involving the patient in various activities was recommended as a way of distracting them from their
distress: walks, meals, self-care activities, socialising with fellow patients were all things mentioned
by interviewees.
Assess suicide risk (2/28)
Two nurses suggested that distress might indicate raised risk of suicide, and that risk needed to be
re-evaluated and assessed when patients were upset.
High arousal
Many interviewees gave mixed responses under both agitation/overactivity and aggression
irritability. It was therefore difficult to treat these two areas separately, and they have been merged
and considered together under this single heading.
Hear the patient, listen (26/28)
Nurses indicated that it was a mistake to prejudge the aroused patient, or to think of them as being
bad, or badly behaved. Instead the correct approach was based on the assumption that ‘something
has made them feel that way, and it’s trying to discover what that something is’. So, when the
person concerned may be ‘pacing’, ‘snappy’, ‘hostile’, ‘cross’, ‘looking at you in an intimidating
way’, ‘shouting and hitting the walls’, ‘threatening verbally’, or ‘screaming’, the first question is