Behavioral Health Enterprise Risk Management (ERM) Patient Safety/Clinical Care

10 Tips to Defuse Agitated Patients

In working with patients, their families and visitors, at some point we all encounter someone who is angry, hostile or frustrated. Conflict is inevitable and happens when two parties do not agree (Taylor, 2014). How we respond as professionals is vital when the agitated person is losing emotional control. You must consider not only the upset patient but also the safety of staff and others in the area.

Here are 10 De-escalation Tips

  1. Trust your gut

If you are sensing warning signs as you observe a person’s behavior, trust your intuition. Typically, instincts provide clues as when to take heed and take extra steps to keep the situation calm (Sawyer, 2015).

  1. Avoid being judgmental

There are times when we are unsure why something would upset someone. Whether you believe the situation is real or not, the issues are real enough for the patient to tell you about the situation. Take the time to learn more from the patient. Avoid criticizing or judging (Taylor, 2014).

  1. Be mindful of where you stand

As caregivers, we may be inclined to hug or place a gentle hand on someone’s shoulder when they are upset. This would be one time to reconsider such a step. Touch is a private and at times intimate gesture that requires asking permission first. When someone is upset, honor their personal space. Remaining at least 18 inches to 3 feet away is a best practice. In this way, you show respect but also have some distance from the agitated person should the situation worsen (CPI, 2016).

  1. Calm your voice

Keep your voice soft and speak more definitely by slowing your words down slightly. Be mindful of your facial expression. Ensure your body language is not seen as defensive such as by placing a hand on your hip or crossing your arms. It is important to keep your voice and body language as neutral as possible (Sawyer, 2015).

  1. Don’t make promises

Focus on the present issues at hand and reassure the person that you are here to help. Don’t agree to something in the hopes that the agreement will calm the person down, if you can’t deliver on the promise (Sawyer, 2015).

  1. Acknowledge feelings

Use the person’s name to acknowledge and demonstrate respect. Use supportive words to let the person know you are hearing them (Sawyer, 2015).

  1. Avoid meeting an angry person alone

Make certain either someone additional is present or ensure a back-up is close at hand and within hearing distance (Sawyer, 2015).

  1. Set limits

When a person become defensive, irrational or disruptive, give them clear enforceable limits. Offer positive choices such as completing the admission paperwork or at a future rescheduled appointment (CPI, 2016).

  1. Remain calm

You are in charge of your own behavior. Stay calm and professional and do your best not to take rude comments personally. Remain positive and as neutral as possible (Taylor, 2014).

  1. Allow time

A person’s stress level rises when they are upset. Allow time for the person to take a breath and think through what you are saying before making any decisions. When offering choices, allow for the person to reflect on them. Stop talking and allow the person time to think (CPI, 2016).

Resources:

Eilers, E. (2017) CPI’s Top 10 De-Escalation Tips. Retrieved from: https://www.crisisprevention.com/Blog/October-2017/CPI-s-Top-10-De-Escalation-Tips-Revisited

Sawyer, J. (2016). 12 Methods to De-Escalate Violent Situations. Security Magazine. Retrieved from: https://www.securitymagazine.com/articles/86543-methods-to-de-escalate-violent-situations

Taylor, S. (2014). Verbal De-Escalation Techniques that Actual Work. Security Solutions. Retrieved from: http://www.securitysolutionsmagazine.biz/2014/08/20/verbal-de-escalation-techniques-that-actually-work/

 Joan M. Porcaro, RN, BSN, MM, CPHRM, is a senior risk management consultant at the Mutual Insurance Company of Arizona.

Sign Up for ASHRM Forum Updates