Curbing ED Dangers Requires Strong Leadership

Alexandra Wilson Pecci, for HealthLeaders Media , April 24, 2012

But perhaps most importantly, nurses are learning to recognize which patients may become disruptive and how to de-escalate situations so they don't turn violent in the first place.

For example, patients or family members often get angry when they've been waiting for a long time; if they don't like the information that they're getting—or not getting—from staff; or if they aren't receiving the medical treatments that they want or expect. Often these patients are highly stressed, frustrated, and scared.

"Sometimes you see those [types of patients] in your lobby because they're tired of waiting, or they don't feel like they're being updated or kept apprised of whatever situation is going on," Johnson-Kelley says. "It's the anxiety of not knowing."

The crisis prevention training teaches nurses how recognize when patients might feel this way. The nurses are encouraged to share information with patients and family about what's happening and why.

"A lot of times that can help deescalate the situation," Johnson-Kelley says.

In fact, she says, a lot of the training involves "how to talk to patients, almost scripting on how to de-escalate," as well as how to read patients' body language early—before they get angry.

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