Asklemmy

Call security. It's not your job to be a hero.

Now, I have the benefit of being a tall man. That said...

In my experience emotionally compromised people cannot be dealt with in a "correct" way. People get high strung for a variety of reasons and will go looking for a fight without reasoned thought ever being involved. It doesn't help that there are a lot of people out there in need of anger management skills they do not have.

Doing that anger management for them, is impossible at best.

All you can do is your best to keep anything that matters out of the firing line. Your colleagues, your patient, yourself, your job. Being at a disadvantage when it comes to size, physical strength, authority, experience with such situations, makes this much, much harder.

It's difficult to say how much success someone else might have with it, but I like to answer implied threats like the ones you mentioned with feigned confusion. In reply to "I'm gonna be waiting for you later" I might reply "no need, we can talk this through right now, I am ready to answer all your questions as best I can". This is somewhat passive-aggressive, but the intention is to refuse to acknowledge or entertain that there is a possibility of the situation escalating beyond civil behaviour (although it already has). By behaving as if their outburst was a reasonable thing to say, you also allow them to save face, but doing so without coming across condescending is an acquired skill. For me, acting just dumb enough to have them wondering if I'm even capable of saying one thing while intending another has proven most defusing.

In all but the worst cases, such implied threats are a desperate effort to force one's will. If someone actually throws a punch, that will immediately make them the aggressor in the eyes of any observer, which in a civilized setting is total self-sabotage. People want to feel as if they are in control, and usually, people know that turning to violence is an admission of already losing it, and an attempt to regain it using underhanded means. Hence the implied threat of violence, instead of actual violence. At least for a start, if a person is backed into a corner using words, they may lash out physically exactly because they feel they must regain control at all costs.

If there's a way to effectively de-escalate, it's often only possible to identify by intuition, and an attempt to execute may as likely set off another fuse. But usually it involves appealing to something the person out of control cares about, something that throws them off the track of hot rage and onto something calmer. Instead of "you are scaring me" you might say "you are scaring your family". But, when even people experienced with the person in question are at a loss and are doing nothing, the behaviour is either an exception they've not dealt with before, or the norm, which they've no clue what to do about.

When dealing with groups of irate people, there's a bit of mob mentality involved. If there's no clear "head" on the mob it can be quite easy to give it one, by asking only one of the people in the group a question, or forcing them to organize with something like "I can't hear all of you at once".

But you can't talk down a storm. The best way is to find shelter and wait, give the person out of control time to sit with their thoughts and let them spin down as they tire out. If a group is involved they can talk each other up and get even more mad, so if you have a way to prevent them from speaking to each other for a bit, use it, let their trains of thought diverge even a little and they'll have to put energy into coming back to agreement. Rage burns calories like few other things. It's possible to do these things while standing right there, but it's difficult and seldom more than an unnecessary risk.

If you feel that closure is important (and possible), a calm moment much, much later, is the best time IMO.

If the person seems the type to accept some calm words once their head has cooled, not hold a grudge (and are still within speaking distance), I make an effort to achieve some kind of a reconciliation. Something like "I realize you had a lot on your mind at the time, and felt things that aren't meant to be controlled, but the way you behaved insert situation was not fair. It made the situation worse, and added to everyone else's burden. I would like you to apologize in some way to insert relevant parties, they were deeply affected by having to deal with this." Being too "blamey" can spark a hot guilt that flames into another outburst, so I try to allow them to save as much face as I can stomach. Besides, a forced apology is no apology at all.

Again, it can depend, but I like to go with treating their behaviour as somewhat inevitable, and that making up for it now is the logical next phase. Not all people are open to feedback on their character, and how to grow. Even people who are, can still get pissed when told off, before privately coming around while mulling it over, long after parting with you.

Even if the offender learns nothing, getting an apology out of them can do a lot for the people they hurt, and is worth some effort as long as they are likely to never have to deal with the same individual again.

If no apology occurs. Voice your discontent, even if only to the party that most deserves an apology. Such solidarity does wonders to quell the self-doubt a situation like this can provoke. The target of their ire, the female nurse in your experience, is likely to be asking herself how she could have dealt with the situation better. Even if she could have, it's a travesty that she was forced into a situation where such skills would have been useful. She did not put herself there, the patients family did. In general, discussing such experiences with your peers can be extremely cathartic and helpful.

When it comes to whether you should pull the heat onto yourself to keep it off others, here I don't agree. When someone is "under attack" and I feel I could help, I try to "join" the fight, not "take over". A joint front is three times as strong as one of two fighting alone. If you pull all the heat onto yourself, you'll still be just one person against a storm. An individual is easy to single out, even if that individual is swapped out for another. But being angry at two people at the same time, takes twice the effort at least.

By all means, step in to take a punch someone else cannot. But when it comes to words, we all hurt the same, and taking them together halves the pain.

At our hospital we have vocera badges for voip. If you double tap the call button it will call security for you and give them your location, they come running.

I’m sorry this happened to your colleague and you. Unfortunately healthcare takes a lot of abuse

We’ve had similar situations at the health system I work for. Your hospital should have a clear procedure for how to deal with violent guests and it sounds like yours does not. I’d call your union and express your concerns. We trespass guests that are aggressive and send their info to the local PD.

First, ask your boss for your employer's policies on handling these situations.

Second, ask your boss for de-escalation training. If you've already gone through this training, a refresher will still be good.

Third, you mentioned a union. Ask them for recommendations and resources.

Fourth, if your concerns feel unaddressed, contact whomever would be your HR department. Know that HR is not there to help or protect employees, but there to keep the organization from being sued.

Fifth, do right by yourself. You're obligated to your own safety. Healthcare is an emotionally charged environment with clients who are almost never there for good reasons. These high level emotions will cause intense feelings and scenarios. People can react irrationally during such situations.

Over the past decades I've had several different women (girlfriends, mother-in-laws, coworkers) complain that I "acted too softly" in some situation or another, saying I should have raised my voice or made threats or stuff like that. If I could go back in time I wouldn't act differently in any of those situations.

In your case I would probably complain to someone about security not showing up though. In a hospital setting it is their responsibility.

So do not say to them I'll talk to you when you're acting like an adult. Patronizing a patient or family member will always end up badly. Just like it is not your responsibility to go into a burning room to save a patient, it is not your responsibility to endure physical and sexual abuse. Unfortunately, physical and sexual abuse is rampant in the healthcare sector and is something that every health care professional needs to learn to work with. That said, your facility should have a policy in place for just such an occasion. They should have educated you on it and you should never have any worries about when you use it. You should talk to your supervisor, the senior nurses, or your union rep so they can show you what to do. You shouldn't be making decisions when that happens, you should be just following protocol.

Ah, hospitals. I feel for you.

I haven't read the comments here yet, but scenario 1 and a modified scenario 2 in combo sound like the best approach. DO NOT TELL PEOPLE TO CALM DOWN, IT WILL ALWAYS MAKE THEM ANGRIER. The best way to do it IMO is to model the behaviour you want to see - remain calm. Explain (to the degree that you're authorized to as a nurse) why they can't do the thing, and the potential outcome of doing the thing. While trying to calm them down, have the more vulnerable target disengage and make the call to security. Remember that your duty is to your patients' health and safety - make it as clear as possible that you're not doing this to be a power-tripping douchebag, but to make sure their father gets the best possible care they can so they can go home ASAP.

My work experiences are not exactly the same, but similar in some respects. I've found it useful to consider the following - in a healthcare-related scenario, the person who is super pissed and aggressive is usually more scared/freaked out than angry. If you address the fear they will usually calm down pretty quick (or at least the anger turns to other, less dangerous expressions of fear).

Does your hospital/union offer any training on descalation techniques? They're not a cure-all but it's vital stuff to know in a high-tension environment like a hospital.

Edit: Misread the OP and thought patient was the daughter of the aggressors, fixed to say 'father'.

OP, my partner works with the public (education) and they have regular de-escalation training sessions to know how to respond to similar situations. He says it’s very helpful.

If you do not currently have the option to take something like that, could you request that it be offered to you and your colleagues?

If you are offered it and have taken it, could you reach out to the instructors asking about your specific situation here?

I’m sorry I don’t have better advice. My partner routinely has to break up fights, calm people down (adults and minors), police are often involved, and he brings up that training a lot when he tells me the story and how he handled the situation.

the man told her in a very aggressive way he would be waiting for her when she finishes her shift

What kind of coward threatens a diminutive woman like he's the school bully setting up a fight like it's 3 O'Clock High? Guess i answered my own question with the bully observation, but like seriously, did he feel like a big man afterwards? What a bitch-made mofo.

All of the other comments are right, security should have thrown these dumb asses out and trespassed them as soon as they starting issuing threats, hospital staff have far more than enough shit to deal with than some yokel shitheads throwing childish tantrums cause they couldn't get their way.

There are already a lot of good tips, I just want to add that telling people to calm down never works. They are upset for a reason, even if it's a nonsensical one.

If you happen to become the lighting rod for someone else's anger it helps to remind yourself that they are not actually upset with you personally. You just happen to be caught in it.

Sometimes it is possible to use empathy to align yourself with them by agreeing that this situation is upsetting, validating their feelings. In the end they will have to deal with their feelings, you can't do that for them. All you can do is move out of the way and maybe redirect it. In this situation you could say: yes this sucks. I'm very sorry, I wish I could help you, but I will lose my job if I try. These regulations are there to protect our patients, but sometimes they get in the way. Unfortunately I cannot do anything about that. If I could I would.

In the end this might or might not work to redirect their anger. How they deal with their anger is out of your control. That also means it is not your responsibility and you don't need to take it to heart personally.

First off, Midas (or whatever your facility's equivalent is) this event, get eyes on it. Patients and families getting violent is a safety event.

De-escalate however you can, but it should be stated that you're in a place of healing and anyone preventing the necessary care for the patient is not to be allowed in your facility.

Staff and patients need to feel safe.

If someone gets unreasonably confrontational over something like that then you are in a pretty shit situation. There isn't much you can beyond looking out for your safety and then your colleagues safety.

When I worked retail I would manage aggressive customers by pretending I was about to bend the rules to get them what they want. I'd first explain the policy reasons why they cannot have what they want. Then after they got upset I'd give them a bit and then say look I know it's annoying/unreasonable give me a few minutes and I'll see what I can do.

Then I'd come back with security and the manager and get them kicked out. Unfortunately this probably won't work since they will return to see their family and you'll be fucked.

If you're average sized guy 5'8 - 5'10 then taking up MMA will give you the confidence to stand up knowing that you can protect yourself if someone tried to get physical. Even smaller guys can get this benefit but they will probably still get pushed around by massive size differences.

Welcome to life in American medicine, there's basically nothing you can do because administration doesn't really care, and anythingyou do will likely be viewed as wrong. These situations are a when, not if in the current landscape. You find a way to deal or you leave medicine.

I'd like to be more optimistic, but the system is broken and it's going to take something significant to create the will to fix it.

You and your first colleague did all what probably could've been called the best case scenario. I would then go on to say I wouldn't blame the hospital for banning the family. Would that not be the preferable next step?

Because what the medical care system needs is more trauma for its workforce and more people leaving front line services. What reprehensible people.

you dont do anything. if you have security, it's their job. if you dont have security, quit immediately

From what I learned from my life is to keep quiet till person stops talking/blowing up, give them a few seconds to breath/cool off, then with a poker face tell them the facts in a way that can make them regret their actions if they don't follow your advice. They may continue yelling but giving no reaction makes people cool off faster.