Nursing Component Task
Nursing procedures & clinical learning

Registered Mental Health Nursing (RMN)

INTERVIEWING THE AGGRESSIVE AND ELATED/OVERACTIVE PATIENT

This is an interaction between the nurse and the patient who is either angry or extremely excited for the purpose of obtaining or giving information. It is one of the methods/tools used by nurses to assess the feelings, perceptions, thoughts and attitudes of the aggressive and elated/overactive patient.

Purpose

  • Build therapeutic relationship with the patient
  • Gain a better understanding of patient’s problem
  • Obtain useful information in formulating a nursing diagnosis
  • Reduce patient’s level of over activity
  • Promote healing and rehabilitation

Equipment

  • Table
  • Two chairs
  • Pen and note pad
  • Recorder
  • Patient’s folder (Electronic/Manual)
  • Serene environment

Procedure steps

  • Advance Preparation
  • -BFormulate goals for the interview
  • Consider time needed for effective communication and interaction with the patient
  • Determine issues to focus on during the interview
  • Decide on the type to use (structured, semi-structured or unstructured)
  • Prepare patient and physical environment
  • Determine the appropriate techniques of communicating with the patient
  • Establish rapport (refer procedure)
  • Explain procedure and reassure patient
  • Prepare the interview setting and arrange the chairs as appropriate
  • Sit patient comfortably across table from you in a serene environment
  • Sit down avoiding crossing of arms and legs
  • Seek patient’s consent to record the interview in any form and assure him/her of confidentiality
  • Initiate the dialogue in a simple language the patient can understand
  • Maintain composure and speak to patient in a calm, firm, clear and relaxed tone
  • Employ the use of verbal, nonverbal and therapeutic communication techniques (e.g. maintain eye contact, appropriate use of body language, feedback, use of silence, restating, etc.)
  • Check frequently on patient’s state of anger/excitement throughout the interaction
  • Focus on specifics (i.e. chief compliant: cause of anger or excitement etc.)
  • Use assertive behavoiur throughout the interaction but do not instruct or command patient
  • Use questions that require only short answers
  • Listen and observe for patient’s nonverbal cues (e.g. facial expression, posture, gestures, etc.)
  • Give patient enough time to express him/herself
  • Avoid interrupting patient when he/she is speaking (active listening)
  • Restate patient’s statement by rephrasing or paraphrasing
  • Use appropriate questioning techniques
  • Ask patient to clarify statements
  • Use silence to listen to patient
  • Summarize with patient what has been discussed during the interview
  • Record salient points and close the session
  • Express appreciation to patient and inform patient on what to do next
  • Document findings in the nurses’ note/patient’s folder
  • Report the outcome from the interview to the Charge Nurse

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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