Department Education of Disruptive Patient Behavior

[miller22time]

Hello all-

I work in a pediatric ED and as you can imagine we come across our fair share of angry parents.

This past weekend we had a significant event that is causing our department and system to look at how we handle disruptive behavior.

I just wanted to reach out and see if there are any suggestions or good ideas other facilities are doing around preparing and educating staff on how to handle, intervene, etc with disruptive behavior and threatening staff.

thank you for taking the time!

[Crush]

Any threats to staff = calling security. Not putting up with that.

Interventions would be listening. Not only to the words but with parents, listen to the emotion or reason behind the anger. Are they really upset because of their child's diagnosis and not really at staff? Do they need emotional support? Finding a way to address the root cause may be a good thing to explore. For training of staff maybe get the chaplain and SW involved for some input as well.

https://store.samhsa.gov/shin/content/SMA11-4634CD-DVD/EBPsPromisingPractices-IDBD.pdf

https://ctafp.org/wp-content/uploads/2015/08/Session-2B-How-to-Deal-with-the-Difficult-Patient.pdf

[JKL33]

I would enocourage looking at interventions that involve individuals not responsible for the nursing care of the child. Someone has to provide the care, excellent care, and the bottom line is that person should not be bullied or threatened while doing so, nor should they be solely responsible for trying to pacify these situations while trying to provide excellent care. Part of the problem is that various menacing/threatening behaviors have been tolerated even as they have become worse over time. I'm not sure why we don't recognize this as being every bit as dangerous as a patient who thought about harming themselves (suicidal ideation - and will require a sitter for that fact).

This is about patient safety. It is an interference with safe patient care, and we must think of it as such instead of telling nurses all the reasons why people might act this way. We all should be both understanding and intolerant of interference with safe care.

[Crush]

I would enocourage looking at interventions that involve individuals not responsible for the nursing care of the child. Someone has to provide the care, excellent care, and the bottom line is that person should not be bullied or threatened while doing so, nor should they be solely responsible for trying to pacify these situations while trying to provide excellent care.

Exactly, I know the OP was asking about facility staff training but this brings up a good point. We are never alone on the floor. If this type bullying behaviors are happening, notify your charge nurse so other staff are aware. Depending on what is going on you could enlist the chaplain or SW. Notify the House Supervisor or security depending on the type/level of the behavior. Certainly any threats ( IMO ) is to call security. Safety first always. Check with your facilities SOP on what policies your facility has in place.

Our facility has verbal de-escalation training at the annual job fair.