The Guide

Quotations come from the coursebook "Verbal De-escalation. Rules for Negotiating with an Uncooperative Patient” in Module 3 on the SAFEMEDIC platform

The causes

“The causes of violence between a patient (or his relative) and a healthcare professional. Variables affecting such situations in nursing. …

Two levels of sources of violence in the contact between a healthcare professional and a patient/his relative:

1.healthcare professional evokes negative emotions in a patient

This level focuses on decreased self-control and non-professional communication. …Patients declare the following factors as nonprofessional and devaluing in their contact with a healthcare professional: (…) 

2. patient evokes negative emotions in a healthcare professional.

Contemporary studies and research deal almost without exception with patient satisfaction but not the satisfaction of the medical staff. … Factors decreasing the self-control ability of a healthcare professional. (…) “ 

Discussion - questions:

Prevention

“It is possible to prevent violent situations through appropriate communication techniques.

•       The first effective step of conflict prevention is behaviour that neutralizes initial stress and other negative emotions accumulating at the first contact.

•       The second effective step is the knowledge of phases of violent behaviour. … [5 phases of development of conflict] … The ability to recognize in which phase the patient is in makes it possible not only to reliably react but it also increases the security of healthcare personnel.” 

Questions:

Communication techniques for negotiation

“Communication is still the most important connecting link of medical care. …

In a stressful situation the communication form changes: the nonverbal part forms 50 % of communication content, 40 % is the tone of voice and only 10 % is the verbal part. Spoken words are not so important. The most important factor is the behaviour of medical staff members that can de-escalate the violent situation, or in contrast, escalate the situation.

In the following text we present a recommendation that we called verbal self-defence. It presents literature excerpts containing techniques which are practically proven to help resolve violent situations.  We are aware that every violent situation is unique and variable. Nevertheless, techniques were created that were proven to be effective in real situations (Pekara 2014).”