2. Introductory section

This module on the “SAFEMEDIC” platform includes:

·      an introductory video

·      an introduction to the “Violence in the Healthcare” coursebook

The section was prepared by the Czech partner -  Vysoka skola zdravotnicka (Medical College) in Prague. The described facts, despite references to the situation in Czech Republic, are universal.

The motto of the course in the form of a video was prepared for the course participants by paramedics from the Polish Council of Medical Rescuers.


Course summary

This module introduces the subject of violence in healthcare through reading materials, discussion, and exchange of experiences.

It discusses some of the ways to prevent violence and techniques for de-escalating verbal abuse, including between co-workers. It offers introductory exercises relating to typical medical staff – patient conflict situations.

 

Objectives of the course

·      to broaden the knowledge about the context of violence against health care workers

·      to offer initial training of skills in the field of non-verbal and verbal communication techniques

 

Contents of the course

1. Context of violence in the healthcare sector - first contact with a violent patient

1.1. Operational definition of violence in health care

1.2. A special form of violence - good aggression

1.3. Questions for discussion

2. Main causes of violence in the area of ​​healthcare

2.1. Group 1: the healthcare worker evokes negative emotions in the patient

2.2. Group 2: the patient causes negative emotions in the health care professional

2.3. Questions for discussion

3. Prevention of violence

4. Verbal de-escalation - dealing with a person using violence

5. De-escalation

 

The subject of our training courses concerns situations known to participants from their own experience (in the case of professionally active healthcare professionals) or from media reports and reports from older colleagues (in the case of students). In line with Kolb's cycle, we first refer to their previous experiences.

In class, ask pairs of students to improvise short role-plays of conflict between healthcare worker and an aggressive patient.

  • If there are both students and professionally active healthcare workers in the group, ask the students to act the short role-plays, then ask the professionals to comment on the plausibility/reality of the scenes presented.
  • Start a discussion about possible reasons for the success / failure in resolving the situation in the role-play.
  • Self-reflection: participants analyse their strengths and weaknesses in the context of the conflict.

•       Refer to the material provided in the coursebook "Violence in the healthcare sector" to discuss the context of violence in the healthcare sector, the operational definition of violence in healthcare, and "good aggression".

Discussion

  • How would you define violence?
  • What are your experiences with the unprofessional behaviour of medical staff?
  • How do the media in your country cover the attacks on health workers?
  • Do you know of any healthcare violence analysis projects in your country?

 •       Refer to the material in the coursebook "Violence in the Healthcare Sector" to discuss the main causes of violence in the area of healthcare.

Discussion

  • How do you perceive violence in health care after reflecting on the causes?
  • What causes are typical for your environment?
  • What is your experience with violence in hospitals?

•       Based on chapters 3-5 of the "Violence in the healthcare sector" coursebook, present the issue of violence prevention and de-escalation.

 

Role-plays activate the prior knowledge of the student, encourage them to engage, enable reflection and help them to search for new solutions.

Motto for students: "If you are patient in one moment of anger, you will escape a hundred days of sorrow" - Chinese proverb.

Students role-play the following situations:

Situation 1

Student A

You are very upset. A colleague was taken to Emergency after he collapsed at a birthday barbecue. You followed him. There is a long line of patients in front of you. Nobody is telling you anything. You feel your anger building up.

Student B

You work at A&E. You have a lot of urgent work. This man is under the influence of alcohol, he demands information immediately.

 

Situation 2

Student A

You watch a friend trying to calm down an aggressive patient. Find errors in his / her approach and correct them in contact with the same patient.

Student B

A patient is standing in front of your desk and they are getting increasingly agitated. You urgently need to fill in important documents online, so you look at the computer screen and type, but you can hear what the patient is saying. You explain to him that you will give him an ECG and an USG and maybe a CT, you ask him what HDL and LDL readings are, but the patient is getting increasingly angry. You tell him he'll get a painful injection if he doesn't calm down.

Student C

You are 80 years old. Something hurts in your chest, maybe stomach, you don't remember what medications you take, you are afraid of hospitals, clinics, and most of all – of injections. The person at the desk is ignoring you. You're nervous.