Most healthcare professionals will eventually find themselves in a difficult situation with a patient. Whether the patient is upset about their care, unhappy with their diagnosis, or generally angry, it can be tough to know how to de-escalate the situation. However, following these tips can hopefully avoid or diffuse any heated exchanges.
Identifying Agitated Patients
Identifying when the patient is agitated is step number one. Signs can be verbal or non-verbal. Here are a few emotional, behavioral, and cognitive signs of a patient becoming agitated.
Emotional Signs
- Crying
- Yelling
- Arguing
- Fear
- Inappropriate Laughter
Behavior signs
- Rocking/Swaying
- Pacing
- Rapid Breaths
- Clenched Fists
Cognitive Signs
- Defensive Statements
- Blaming
- Obsessions
Tips to De-Escalate
Remain calm
The first step in de-escalating an angry patient is to remain calm. It will only aggravate the situation if you get defensive or react angrily. According to NLOF, “De-escalation involves matching the patient’s pace until he begins to focus on what is being said rather than his fear. If the patient says, “Don’t hurt me. Don’t hurt me.” Counter with the same pace by saying, “You’re safe here. You’re safe here.” “Try to decrease the pace to help the patient calm down.”
Listen
Once you have calmed down, take the time to listen to what the patient is saying. Try to understand their perspective and what is driving their anger.
Apologize
If you have done something wrong with the patient, take responsibility and apologize. This can go a long way in diffusing the situation.
Offer Solutions
Once you have listened to the patient and understand their grievance, offer potential solutions. Again, this shows that you are trying to help resolve the issue.
Follow up
After the initial interaction, follow up with the patient to see if their issue has been resolved. This will help build trust and goodwill.
Continue to use a Calm Voice
This will help set the tone for the interaction and may help the patient calm down. If possible, try to find out what is causing the anger and see if there is anything you can say to address the issue. Sometimes simply acknowledging the problem and offering a verbal solution in a calm voice can be enough to diffuse the situation.
Don’t Take it Personally
If the patient remains angry, try not to take it personally. They are likely frustrated and may not be acting rationally. Avoid getting into an argument or debating with them, as this will escalate the situation further.
Phrases for De-Escalation
Sometimes, just a few simple words can make all the difference. If you’re looking for some phrases to help de-escalate a tense or difficult situation, here are a few to try out:
Listening
- Tell me more
- I’m here to listen
- Please continue
Acknowledging Phrases
- What I’m hearing is…
- I appreciate you sharing this with me
- That’s a difficult situation to be in
Ending/Transition Phrases
- I’ve never thought about it that way. So let me talk to my [colleagues/my office manager/the medical director] and see what [he/she/they] think.
- I’m sorry to interrupt, but I want to ensure I understand everything before it’s time to go.
Difficult situations with patients can be stressful for everyone involved. Following these tips can help de-escalate the situation and maintain a calm environment for you and the patient.
