Tips and Strategies for De-Escalating Aggressive, Hostile, or Violent Patients
Managing patient complaints and dissatisfaction is an unpleasant but certain reality in healthcare. Despite best efforts, situations will occur in which patients are unhappy and feel compelled to voice their displeasure and concerns. In some cases, patients’ emotions might escalate, and they may become aggressive, hostile, or violent.
Violence in healthcare is an unfortunate reality, and chiropractors and staff members should be prepared to handle tense and potentially violent situations if they occur. Understanding the risks of violence and learning strategies to address such behavior is an imperative safety measure.
Foremost, recognizing that no single response will work in every situation is crucial. You should consider the individual patient, the circumstances, and the broader context of the situation when responding to escalating behavior. An article from the Western Journal of Emergency Medicine notes four main objectives when working with an agitated person. They include:
- Ensuring the safety of the patient, staff, and others in the area
- Helping the patient (a) manage his/her emotions and distress, and (b) maintain or regain control of their behavior
- Avoiding the use of restraint when possible
- Avoiding coercive interventions that escalate agitation1
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Endnotes
1 Richmond, J. S., Berlin, J. S., Fishkind, A. B., Holloman, G. H., Zeller, S. L., Wilson, M. P. . . . Ng, A. T. (2012, February). Verbal de-escalation of the agitated patient: Consensus statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup. Western Journal of Emergency Medicine, 13(1), 17—25.
This document should not be construed as legal or medical advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors if you have any questions related to your legal or medical obligations or rights, state or federal laws, contract interpretation, or other legal questions.
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