#Workplace Safety
By Team Seaglass
Aggression from patients can be one of the most challenging and stressful parts of working in healthcare. Whether it’s a confused senior, a patient in pain, or someone experiencing a mental health crisis, verbal or physical aggression can happen unexpectedly. That’s why learning and practicing de-escalation techniques is not just helpful—it’s essential.
What Is De-Escalation?
De-escalation refers to the actions healthcare workers take to reduce the intensity of a tense or aggressive situation before it becomes unsafe. It involves remaining calm, understanding triggers, and using verbal and non-verbal techniques to help a patient regain control.
Why It Matters…
- Protects both staff and patients
- Prevents escalation to physical aggression
- Builds trust and rapport among patient/caregiver relationships
- Promotes a safe and respectful care environment
Here are some real-life scenarios paired with simple de-escalation tips that healthcare workers can use right away.
Scenario 1: The Yelling Patient
Situation:
You enter a patient’s home and ask them to get ready for their bath. They begin yelling, “You’re always rushing me! I told you I don’t want a bath today!”
De-Escalation Tips:
- Stay calm and lower your voice. Respond slowly and softly to counterbalance their volume.
- Acknowledge their feelings. Try: “I can see you’re upset. I want to understand what’s bothering you.”
- Offer choices. Instead of forcing the bath, say: “Would you prefer to wait 15 minutes, or would you like to just wash up at the sink today?”
Scenario 2: The Accusatory Patient
Situation:
An elderly patient with dementia suddenly accuses you of stealing their wallet. “Where is it? I saw you near my purse!”
De-Escalation Tips:
- Don’t take it personally. Recognize that memory loss or confusion may be influencing the accusation.
- Redirect attention. Say: “That sounds upsetting. Let’s take a look together and see if we can find it.”
- Reassure, don’t argue. Keep your tone light and say, “You’re safe here. Let’s figure this out together.”
Scenario 3: The Patient Refusing Care
Situation:
A patient refuses to take medication or let you help them change their clothes, and they are crossing their arms and glaring.
De-Escalation Tips:
- Avoid forcing compliance. Instead, explore the “why” behind the refusal: “Is something bothering you today?”
- Empower the patient. Give them control: “Would you like to take your medicine before or after breakfast?”
- Maintain respectful space. Don’t stand over them—keep a calm, non-threatening posture, typically angled away from them, with your hands visible.
Scenario 4: Physical Gestures of Aggression
Situation:
While helping a patient stand, they suddenly slap your hand away and shout “Don’t touch me like that!”
De-Escalation Tips:
- Take a step back. Create space to reduce their feeling of being overwhelmed.
- Speak gently. “I’m sorry that felt uncomfortable. Let’s try again when you’re ready.”
- Don’t rush. Give them a moment to calm down before trying again.
Scenario 5: Verbal Threats
Situation:
A patient begins making hostile remarks: “Get out of my house or I’ll make you!”
De-Escalation Tips:
- Know when to disengage. If the situation feels unsafe, step away and alert your supervisor or emergency contact.
- Use clear but calm language. “I’m going to step out for a moment. I’ll check back in a few minutes.”
- Document the incident. Record exactly what happened and notify your agency or supervisor.
Final Thought: Empathy Is Your Strongest Tool
Most aggression stems from fear, confusion, or unmet needs. By staying calm, showing empathy, and using proven de-escalation techniques, healthcare workers can defuse tension and ensure that care continues in a safe and respectful environment—for everyone involved.