De-escalation is a critical skill in healthcare, particularly in environments where emotions run high, and patients and their families may be under significant stress. Effective de-escalation requires not only the ability to manage conflict but also an understanding of human emotions, empathy, and a well-practiced response to high-tension situations.
In healthcare facilities, every team member plays a role in maintaining a safe atmosphere. However, it is essential to recognize that not everyone responds to de-escalation in the same way. Individuals, based on personal attributes and environmental factors, may require different levels of training and approaches to ensure the safety and well-being of everyone involved. Promoting a variety of strategies can help your teams successfully de-escalate tense situations.
Lead with Empathy
In a hospital setting, staff regularly interact with individuals facing health crises – whether they are urgent or long-term, these individuals are often experiencing some of the most challenging moments of their lives. One of the most effective ways to defuse an escalating situation is through empathy.
Whether a patient is in pain or a family member is frustrated by a diagnosis, understanding the underlying context of their situation is crucial for healthcare providers. By leading with empathy, healthcare workers can communicate understanding and validation of the emotions of those involved. Small gestures such as active listening, a calm demeanor, and acknowledging frustrations can make a significant difference. Offering grace, especially in challenging moments, can turn a potentially volatile situation into a more manageable one. This also helps the provider stay calm and steady in their approach, to avoid escalating with the patient’s or family member’s behavior.
Practice and Train
De-escalation requires continuous practice and training. One of the most common mistakes is assuming that de-escalation will come naturally in a crisis. In reality, consistent practice is necessary to develop the skills and confidence required to navigate high-pressure situations effectively.
Training should not be a one-time event. Leaders should organize regular de-escalation training sessions throughout the year to keep skills fresh and refine techniques. These training sessions can include role-playing, in which staff members act out scenarios in huddles or during team meetings. Additionally, training sessions can be distinguished between basic de-escalation techniques for frontline staff and more advanced strategies for those with greater responsibility or higher-risk exposure.
With each level of training, staff can build confidence in their ability to manage different levels of escalation, ensuring that they are equipped to handle whatever situation arises.
Support and Empower
De-escalation is not just about the individuals involved; it’s also about the organizational structure that supports them. Today, the healthcare landscape is not an easy terrain to navigate, and healthcare workers need to feel empowered with the tools and resources to handle tense situations effectively.
Offering staff additional support can make a significant impact on their ability to perform well under pressure. Technology like a wearable duress button, for example, can be a vital resource when access to immediate help is needed. When staff know that help is only moments away, they are better able to focus on applying their de-escalation skills.
Moreover, these systems can significantly reduce response times, ensuring that assistance always arrives swiftly. Empowering staff in this way reinforces their confidence and helps encourage participation in de-escalation.
Lean on Your Team
While de-escalation training is crucial, it’s equally important to recognize the value of teamwork. In healthcare, the environment can often feel isolating, and one of the easiest mistakes staff fall victim to is trying to handle everything on their own.
In many situations, bringing in another team member to assist can make a big difference. A new face may bring a different approach, reassurance that more support is available, or a different perspective that can help identify specific triggers that may have been missed.
If the healthcare organization has a Behavioral Emergency Response Team (BERT) in place and encounters someone who may need a different level of support, staff should feel empowered to bring in this extra level of help. At the end of the day, every person on the team wants to deliver the best care they can for your patients and families, and sometimes it takes a village to succeed in that.
Proactively Plan
De-escalation isn’t just about reacting to crises; it’s also about proactive planning. An accessible and automated reporting system that captures data on every safety-related incident can help healthcare organizations excel in this planning. Analyzing trends and reviewing safety data can reveal patterns that help anticipate and prevent violent incidents before they escalate. Regularly tracking incidents of violence, as well as near-misses, can also offer invaluable insights into environmental or situational factors that might trigger agitation.
For example, varying staffing levels, shift changes, or external environmental factors can all contribute to heightened stress that can impact the flow of care through a hospital or healthcare facility. By proactively planning and preparing for these situations, healthcare facilities can better anticipate and remedy triggers for conflict.
The more healthcare organizations can plan, prepare, and make data-driven decisions, the stronger their safety plans will be.
Final Thoughts
De-escalation requires practice, empathy, and proper support. By leading with compassion, engaging in continuous training, empowering staff with the right resources, and fostering teamwork, healthcare organizations can create an environment where patients, families, and staff feel safe and supported.
About Andrea Greco
Andrea Greco is the SVP of Healthcare Safety at CENTEGIX. She’s spent decades partnering with customers to deliver solutions focusing on employee, patient, and family satisfaction and engagement. Her current role is focused on creating and deploying innovative, layered safety solutions that empower and protect healthcare organizations every day.
About Jennifer Schmitz, MSN, EMT-P, CEN, CPEN, FNP-C, NE-BC
Jennifer Schmitz, MSN, EMT-P, CEN, CPEN, FNP-C, NE-BC, is the 2022 president of the Emergency Nurses Association with over 23 years of healthcare experience. She’s spent her career in emergency nursing in positions including staff nurse, charge nurse, nurse educator, nurse manager, and chief nursing officer at Southern Maine Health Care. She is currently the vice president for client engagement with Engage, powered by ENA.
