De-Escalation Training for Healthcare Workers

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Written by Katherine Zheng, PhD, BSN Content Writer, IntelyCare
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Reviewed by Alexa Davidson, MSN, RN Content Writer, IntelyCare
A nurse and doctor try to de-escalate a tense moment with a patient.

While workplace violence can happen in any industry, healthcare workers are at especially high risk of physical and verbal abuse through their frequent patient interactions. With these incidents being four times more likely to occur in a hospital than any other setting, implementing de-escalation training for healthcare workers is an essential safety measure for facilities.

If you’re a facility leader seeking ways to protect your staff from workplace violence, we’ve got you covered. We’ll walk through all the fundamentals of de-escalation training and provide tips on how you can implement a program to reduce the risk of incidents among your staff.

What Is De-Escalation Training in Healthcare?

De-escalation in healthcare — also known as talk down or diffusion — refers to methods used to identify and reduce agitation in a patient before they injure a worker. De-escalation training teaches staff how to identify and respond to high-risk scenarios using techniques that convey empathy, respect, and understanding.

Why Is De-Escalation Training Important?

Nearly one-third of nurses have reported experiencing workplace violence from patients or visitors. Such unsafe working conditions contribute to staff burnout and can further add to nurse turnover at your facility. It’s important for healthcare employers to empower staff with the right resources and working conditions to carry out their duties safely.

The use of chemical or physical restraints can be considered as a last-resort safety measure for patients at risk for harming themselves or others. When implemented according to best-practice guidelines, restraints can be used safely and judiciously to protect patients from harm. But, while restraints may be necessary in certain situations, de-escalation is a necessary step in crisis management in most instances.

In addition to maintaining the safety and dignity of all parties involved in a situation, de-escalation training for hospitals has been shown to:

  • Prevent violent behavior
  • Reduce patient agitation and anger
  • Improve patient-provider relationships
  • Allow patients to regain self-control
  • Enhance overall quality of care

De-Escalation Training for Healthcare Workers: 3 Key Areas

The type of de-escalation model that facilities should employ will depend on the patients they serve. For instance, when implementing de-escalation training, mental health facilities may have different considerations to factor in compared to acute care hospitals. However, focusing on these key areas can help ensure that your training program is comprehensive and effective.

1. Risk Assessment

Risk assessment refers to the identification of patients who are at high risk of aggressive or harmful behavior. Inappropriately applying de-escalation methods can worsen a situation and even put a staff member in more danger. Because of this, facilities should train their staff to identify situations that warrant their use. Educate your staff on how to:

  • Assess the patient’s medical history and inclinations toward harmful behaviors.
  • Weigh the potential danger and impact that the patient’s actions may have on others.
  • Scopeout potential weapons or exit barriers that make the environment high-risk.

2. De-Escalation Techniques

De-escalation techniques are the actual actions taken by staff to respond to an aggressive patient. The types of techniques used will depend on the situation at hand. However, de-escalation training for healthcare workers should typically focus on teaching:

  • Active listening — Staff can actively listen to patients by providing their undivided attention and acknowledging what they’re saying.
  • Validation of feelings — It’s important for staff to reassure a patient in distress and make it clear that they’re allowed to feel the way that they do.
  • Non-threatening body language — Staff should be mindful of their own expressions, stance, and tone of voice. This can help them maintain a calm demeanor and avoid movements that may come off as a threat.
  • Respect for personal space — Respecting a patient’s personal space may involve leaving the room entirely or avoiding actions a patient feels uncomfortable with.

To better illustrate how each of these techniques can be applied in practice, we can take a look at two different examples of de-escalation scenarios for nurses.

Example 1: Active listening and validation of feelings

Scenario: A patient is experiencing heightened anxiety about going into a surgical procedure and begins resisting a nurse assigned to bring her to the operating room.

De-Escalation: The nurse pauses and allows her to express all her feelings. She reassures the patient by nodding and saying “it’s totally understandable that you feel this way.”

Outcome: The patient feels more at ease after realizing that the nurse is not going to force her into the operating room. Together they discuss strategies to reduce her anxiety.

Example 2: Respect of personal space and non-threatening body language

Scenario: A patient feels uncomfortable about receiving a physical assessment from a nurse and shouts that he wants to be left alone, becoming increasingly more defensive.

De-Escalation: The nurse smiles in acknowledgement, calmly telling the patient that she can step out to give him some space and come back at a later time. She quietly leaves the room.

Outcome: The patient feels more at ease and is able to take time to reflect on what might have caused discomfort. Once the nurse returns, he is able to more calmly express his needs to her.

3. Boundary Setting

Boundary setting allows for staff to maintain mutual respect and uphold their own needs in a heightened situation. While it’s important to convey empathy and understanding toward patients, healthcare workers should be encouraged to advocate for their own boundaries as well. Encourage staff to practice boundary setting by providing resources on how to:

  • Recognize personal expectations and needs.
  • Identify when to call for security or reinforcement from other staff.
  • Communicate boundaries to patients in a safe and respectful way.

Learn More Ways To Promote Staff Safety

De-escalation training for healthcare workers is one of many ways to protect your staff from harmful situations, while demonstrating a commitment to creating a supportive, safe workplace. Don’t miss out on other helpful tips and strategies for supporting your workforce by accessing IntelyCare’s free newsletter today.