How do you handle situations where a patient or family member is displaying aggressive or violent behavior?

This is always a tough situation. I think you can be proactive and set expectations early, even before they are needed. Working on that therapeutic rapport from admission helps them to trust you, and gives you better insight into what might be causing the behaviors you are seeing. What is their need? Do they need to vent, are they scared because they don't know what is going on, or are they hungry/thirsty/in pain? If you speak with confidence but not raising your voice, and give clear binary choices (Would you like the lights on or off? Can you keep your hands to yourself now or am I coming back later when you can keep your hands to yourself?) many patients or family members will respond positively.

It is also important to know your resources. Who is available on your unit or in the facility that may be able to de-escalate the situation? What is the policy on visitors and how do you get assistance from security/safety when you need it? Can you ask a colleague to check on you if you are not out of the room in a pre-set time, or to stand by while you provide necessary care?

If you have an interdisciplinary team or can make suggestions to the treatment team, you can advocate for safety there as well. Request that visitors be limited based on specific, observed actions or quoted words that show aggression or violence when needed. Request that a care plan for aggression be considered if necessary (meds, sitter, distractions, specified staff, etc.).

Seek out de-escalation training. Give more space and offer coping skills and distractions when someone becomes agitated. Be aware of your surroundings. And build trust in your team since they are the ones who will have your back and you will have theirs when an aggressive situation does occur.