Nurses' feelings when accommodating an agitated and aggressive psychiatric patient

Paula Fernanda Lopes, Vanessa Pellegrino Toledo

Abstract


Objective: to understand how the nurse feels when welcoming the agitated and aggressive psychiatric patient in an emergency unit. Method: this is a qualitative, descriptive study, with 13 nurses who work daily in the reception room of an Emergency Unit, based on recorded interviews, transcribed and analyzed by the theoretical methodological framework of Social Phenomenology. Results: the nurses reported discomfort and concern about their safety and physical integrity when welcoming the agitated and aggressive psychiatric patient, understanding these presentations as obstacles, as well as their lack of personal preparation. It was highlighted that the place is unfavorable for welcoming, with an excess of environmental stimuli. Thus, their expectations are characterized by the need for a reserved and calm environment. Conclusion: it was shown, by understanding the nurses' feelings, that they do not feel comfortable in this action, which negatively impacts the way they act. It became possible to understand that techniques for handling and using therapeutic interpersonal relationships can be strategies to facilitate the approach of these patients in emergency units. Descriptors: User Embracement; Psychomotor Agitation; Psychiatric Nursing; Mental Health; Nursing; Qualitative Research.

Resumo

Objetivo: compreender como o enfermeiro se sente ao acolher o paciente psiquiátrico agitado e agressivo em uma unidade de emergência. Método: trata-se de estudo qualitativo, descritivo, com 13 enfermeiros que atuam diuturnamente na sala de acolhimento de uma Unidade de Emergência, a partir de entrevistas gravadas, transcritas e analisadas pelo referencial teórico metodológico da Fenomenologia Social. Resultados: relataram-se, pelos enfermeiros, desconforto e preocupação com sua segurança e integridade física ao acolher o paciente psiquiátrico agitado e agressivo, entendendo essas apresentações como obstáculos, assim como a sua falta de preparo pessoal. Destacou-se que o local é desfavorável para o acolhimento, com excesso de estímulos ambientais. Caracterizam-se, assim, as suas expectativas pela necessidade de ambiente reservado e calmo. Conclusão: mostrou-se, pela compreensão dos sentimentos dos enfermeiros, que não se sentem confortáveis nessa ação, o que impacta negativamente o modo como atuam. Tornou-se possível entender que técnicas de manejo e utilização do relacionamento interpessoal terapêutico podem ser estratégias para facilitar a abordagem desses pacientes em unidades de emergência. Descritores: Acolhimento; Agitação Psicomotora; Enfermagem Psiquiátrica; Saúde Mental; Enfermagem; Pesquisa Qualitativa.

Resumen

Objetivo: comprender cómo se siente el enfermero cuando recibe al paciente psiquiátrico agitado y agresivo en una unidad de emergencia. Método: es un estudio cualitativo, descriptivo, con 13 enfermeros que trabajan diariamente en la sala de recepción de una Unidad de Emergencia, a partir de entrevistas grabadas, transcritas y analizadas por el marco metodológico teórico de la Fenomenología Social. Resultados: los enfermeros informaron incomodidad y preocupación por su seguridad e integridad física al dar la bienvenida al paciente psiquiátrico agitado y agresivo, entendiendo estas presentaciones como obstáculos, así como su falta de preparación personal. Se destacó que el lugar es desfavorable para acoger, con un exceso de estímulos ambientales. Por lo tanto, sus expectativas se caracterizan por la necesidad de un ambiente reservado y tranquilo. Conclusión: se demostró, al comprender los sentimientos de los enfermeros, que no se sienten cómodos en esta acción, lo que afecta negativamente su forma de actuar. Se ha hecho posible comprender que las técnicas para manejar y usar las relaciones terapéuticas interpersonales pueden ser estrategias para facilitar el abordaje de estos pacientes en unidades de emergencia. Descriptores: Acogimiento; Agitación Psicomotora; Enfermería Psiquiátrica; Salud Mental; Enfermería; Investigación Cualitativa.


Keywords


User Embracement; Psychomotor Agitation; Psychiatric Nursing; Mental Health; Nursing; Qualitative Research.

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DOI: https://doi.org/10.5205/1981-8963.2020.244485



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