5 De-escalation Techniques for Those in Health Systems

Violence in America is a problem. Although mass shootings usually grab headlines — in 2024, there were more than 500 mass shootings, according to the Gun Violence Archive — the increase in violence in healthcare settings has been particularly noticeable since the coronavirus pandemic. 

According to research, healthcare workers have been targeted in a dehumanizing way — including experiencing increasing incidents of verbal abuse, threats, and physical assaults — especially in emergency departments, many of which have open-door policies. 

Ensuring that all staff members, including security officers, are trained in de-escalation techniques may help health systems maintain a safe, calming environment. 

Practice Active Listening:

‍Active listening is a cornerstone of effective de-escalation. It requires that individuals who are becoming agitated (such as patients or family members) are given the health system employees’ undivided attention. Those who are interacting with agitated individuals should show that they are listening by acknowledging the individual’s feelings and validating their emotions. It is important to use their own words when possible. When they are speaking, be sure to nod and maintain appropriate eye contact.

Use Nonverbal Communication:

‍Although many individuals focus on saying the right thing when acting with an aggressive individual, it is important to note that one’s body language speaks volumes. Take a non-threatening pose by using open body language and a relaxed posture. Be aware of space and try to maintain some distance between yourself and the aggressive individual. 

Speak Clearly and Concisely:

‍Promote a sense of calm by using a low voice, short sentences, and simple vocabulary. Individuals in medical facilities can often become overwhelmed when they do not understand what is happening to their loved ones. Instead of using jargon or abbreviations that may confuse or frustrate patients. Instead, use terms that everyone can understand. Give individuals time to process information and ask questions, if possible. Repeat key messages until they are understood.

Change the Environment

‍Hospital settings can be overwhelming. Individuals who are starting to become aggressive may benefit from being moved to a secure, single room which can provide additional privacy. This also allows them to have additional control over their environment (e.g., reducing lighting and noise). 

Set Boundaries

‍Although it may seem helpful to maintain flexibility in constantly evolving situations, establishing clear boundaries helps maintain control of the situation. This authoritative, rather than authoritarian, approach helps individuals understand what is happening, why, and what control they have over various interactions. For example, if someone must leave a family member’s room, but have the option to stay in a waiting area, please let them know.By incorporating these techniques into your work, you can create a safer, more patient-centered healthcare environment that will help keep you and your colleagues safe.