Mitigating Escalated Behavior

Mitigating Escalated Behavior

A violence prevention expert shares how children’s hospitals and pediatric caregivers can diffuse difficult situations.

The adrenaline and heightened emotions inherent in the children’s hospital environment can potentially lead to confrontations—and sometimes violence.

The numbers bear that out: workplace violence is four times more prevalent in health care than it is in other industries. And 1 in 4 nurses report they have been assaulted on the job.

Susan Driscoll collaborates with professionals across several industries—including health care—to provide training programs focused on the mitigation of behavior escalation. Children’s Hospitals Today spoke with Driscoll, president of the Crisis Prevention Institute, to discuss the latest trends and how children’s hospitals can handle these situations more effectively.

What challenges do children’s hospitals face, and what trends are you seeing in those environments around escalating behavior?

When a family has a child in the hospital, they're already in a very heightened emotional state. There are certain things that have always been difficult, like when a child doesn't want to take their medicine or they're resisting blood draws. But beyond those typical problems, parents can be anxious .

One of the more recent trends we’re seeing across health care is a lack of respect for hospital employees, doctors or nurses that there once was—people feel like they can challenge anybody or anything. There's more aggressive behavior because it’s more accepted than it used to be.

It's a double whammy for caregivers. You've got a child who's anxious and then you've got a parent who's anxious—and the child sometimes take cues from the parents. It requires strength and resilience for hospital workers to maintain their composure throughout the day.

What advice would you give caregivers to help them manage these pressures?

Behavior influences behavior—so your behavior will influence the outcome. Stay calm in the moment, practice breathing or relaxation, or take a break when you feel your emotions starting to take over.

It’s also key for staff members to support each other. Everybody needs more empathy, and empathy for your peers is incredibly important right now. If you see somebody whose emotions are taking over, step in and offer support.

It's also important to recognize that staff members are more anxious too. Everything that's happening in the world to children and their parents is also happening to staff members. One of the most important concepts we teach is rational detachment. It enables somebody to stay rational in the moment, avoid what we call the “amygdala hijack,” and keep their emotions in check.

You can't control somebody's behavior, but you can control your behavior—both by staying calm and applying the right intervention at the right crisis stage. That approach is more important now than ever before.

What can children’s hospitals do?

Organizations need to ensure they are paying enough attention to the needs of their staff members. It seems like everybody is just trying to get through the day. Focus on resilience, well-being and techniques that can help people get through all of this.

Building a workplace violence prevention function within an organization is important too—recognizing this is a problem that doesn't cure itself and making it an organizational priority can make a huge difference.

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