Nurses combat hospital violence with de-escalation tactics

The threat of violence increasingly feels like the "new normal" for hospitals, and now emergency nurses are taking steps to prepare for such incidents, according to Nurse.com.

For example, more and more facilities train nurses in de-escalation tactics, Jenessa Williams, R.N., Adeptus Health regional nurse manager for Colorado, told the publication, These techniques include respecting a violent or potentially violent patient's personal space and looking for signs of a volatile situation.

Those signs could mean avoiding eye contact, providing evasive responses to questions or declining any treatment for their healthcare needs. It's important, the article said, that staff not accept the idea that verbal or physical abuse come with the territory, a mindset that has led many nurses to underreport violence. "It's not part of your job to have a patient be verbally or violent toward you," Williams told the publication. "Be empathetic toward patients, but hold them accountable."

Williams also offered tips for non-verbal de-escalation and preparedness, such as deliberately not reacting to a patient who becomes combative. She told the publication that most workplace violence involves patients visiting for drug- or alcohol-related reasons, so staff should be careful not to inadvertently trigger a violent reaction.

Baylor, Scott & White Health in North Texas trains nurses to look for warning signs covered by the acronym STAMP: Staring, tone of voice, anxiety, mumbling and pacing. The presence of one sign doesn't necessarily indicate a potential threat, but as the signs present increase, so does the potential risk, Kristine Powell, R.N., Baylor, Scott & White's director of emergency services, told the publication.

An often overlooked aspect of violence prevention is ensuring zero-tolerance policies apply equally to lateral violence, or workplace bullying. Studies have found nearly 9 in 10 nurses report being the victims of workplace bullying, FierceHealthcare previously reported, but, like patient violence, many have simply accepted it as part of the job.

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