De-escalation is a vital part of a nurse's career. The patients who nurses work with, and their families, are often experiencing traumatic health changes, and some may even have a mental health component that makes them prone to violent outbursts. For this reason, it's important for nurses to understand how to de-escalate a situation to protect themselves, their patients and their coworkers from workplace violence.
Prevention Is The First Step
The best way to handle workplace violence is to take steps to prevent the chances of it being an issue. Familiarize yourself with your facility's policies on violence in the workplace so you know what measures of protection are already in place. Beth Zoller, JD, and Legal Editor of Xpert HR, notes that creating a "culture of safety in the workplace" is a major concern for companies and their employees.
"The best way to address a threat of workplace violence is to actively prepare employees and supervisors," she says. "Put policies in place for visitor safety, workplace violence prevention and domestic violence and ban weapons from the workplace to the extent permissible by state law.
"These suggestions may reduce the opportunity for violence in the workplace, but they won't eliminate it entirely. This means nurses must still be vigilant.
Identify The Warning Signs Of Violence
Violence often comes from a lack of control. When a person feels they are unable to control a situation, it often leads to negative emotions, such as anger and frustration. If left unchecked, these feelings can lead to physical harm. Fortunately, there are several signs to help nurses identify the potential for danger:
- higher pitched speech
- use of excessive profanity
- verbal threats
- inappropriate laughing
- defensive or argumentative
- depersonalization of others
- violation of personal space
- flushed face
- finger pointing
- heavy breathing
- crossed arms
De-Escalate The Situation
If you notice these signs in someone with whom you're interacting, it's likely time to start de-escalation. If you find yourself in this situation, the following tips can help you work through the situation.
However, tense a situation may feel, raising your voice or issuing threats is only going to make matters worse. Instead, calmly give the person your full attention.
Watch Your Body Language
We often mimic the motions of the people we interact with, and being faced with aggression may cause you to adopt the stance and body language of the aggressor. Be mindful of this, and attempt to keep yourself from taking on a dominant stance. Cowering can also increase someone's anger impulses, so try to stay confidently neutral.
Move With Care
You never want to make sudden movements when faced with someone who is showing signs of potential violence, and you shouldn't try to get close to them. Instead, keep your motions slow and deliberate while maintaining the space you have between you.
Identify An Escape
Even if you do everything right, there is always the potential that de-escalating won't work. For your safety, make sure you have an exit strategy in case the situation devolves. It can also be helpful to bring in a second person, so you don't have to face the threat alone. Keep in mind, however, that too many people could make the aggressor feel threatened and push them into violence.
Listen To Their Concerns
Sometimes just listening to a person's perspective is enough to get them to calm down. This is especially true with patients. They are often afraid and simply want to know that their doctors and nurses are empathetic to their situation.
Ask Neutral Questions
Ask questions about what they've said to show you're actively engaged, but make sure to choose your words, so they don't come across as judgmental. Speak slowly and calmly to encourage a subconscious matching to your tone. This will begin to calm their emotions.
Be Honest About What You Can Do
Never make promises you can't keep and address their concerns by offering them solutions that are realistically available. Remember that the aggression is often coming from a place of helplessness and loss of control, so reminding them of their options may help them feel more grounded. A little sympathy can go a long way to making someone feel understood.
Workplace violence is a very real threat in every profession and nurses should be aware of ways to protect themselves. These tips can help you in the moment, but it's also important to discuss any safety concerns you have with management to see if additional steps can be taken.
Put your de-escalation skills to work with patients in a variety of situations by applying for a travel nurse position