MANAGING VIOLENCE WITHOUT COERCION

Managing violence has become a priority for nurses working in health c are settings (AAN Expert Panel, 1993; Editorial, 1992; Lipscomb & Love , 1992). Although psychiatric nurses have a long history of dealing wi th and managing violent situations, very little attention has been giv en to a critical analysis of our traditional methods of managing viole nce. The purpose of this paper is: (a) to present an interactional the ory of aggression and violence that argues for the coercive nature of violence in persons with a mental illness (Morrison, 1990b, 1992b, 199 3b), and (b) to propose a different approach to managing violent situa tions that emphasizes negotiation and collaboration, rather than contr ol. Vignettes of violent situations provided by a clinical nurse speci alist are used to highlight the presence of this coercive interactiona l style in patients, as well as to critically examine interventions fo r managing violence. It is hoped that an honest examination will assis t nurses to re-evaluate current practices for managing potentially dif ficult situations. Copyright (C) 1995 by W.B. Saunders Company