aggressive patients

In my new placement at ward 1 Shenton Park we often have to deal with patients that have altered cognition and behavioural problems as a result of their head injury. A patient that I was asked to help out in the gym was known to have issues with aggression and being instructed what to do and didnt often actually turn up for his sessions. I tried to help him with starting his exercises but it became quite clear that he didnt feel he needed help and resented being told what to do. I decided to step back and let him do what he wanted and was going to come back later. On returning I found him doing some exercises that he should not be due to a recent clavicle fracture. I therefore tried to explain that he should not be doing this exercise due to this but was continuely cut off by the patient whose answer to everything was that someone told him he couldnt do it so he was going to anyway. This patient did not like females telling him what to do and would do everything that he was told he should not. As I continued to try to reason with him he got more worked up and was not doing any exercises. At this point I decided to walk away from the situation and let the supervisor try to further talk to the patient. It was finally the male physio assistant that got through more to the patient but he still left the gym withthe same attitude and not really acheiving much withthe situation.

Looking back at this I dont think I handled the situation veyr well but I also don't know what I could have done differently to try to make it more effective. The patient clearly did not respect me or anything I had to say and his long standing attitude was unchanging. Does anyone have any circumstances where they have had to deal with similar patients or any ideas on what I could have done?