long post:
I'm a male nurse and 3 days ago, my female colleagues had to deal with an asocial, violent family: the patient's daughter, her very big and tall husband and 4 other family members that weren’t that aggressive, but said nothing and did nothing to stop the violent family members.
Cardiac unit, they wanted to take the patient for a walk, except that the patient was under monitoring, meaning you cannot.
The nurse in charge, a small woman told the family they couldn't take the patient out of the unit and the daughter and her husband lost it. Literally. They turned to pure karen mode, started yelling and insulting my colleague, words I'm not going to repeat but it was very denigrating and happened repeatedly, like they were trying to elicit an aggressive response from my colleague so they would have an excuse to get physical, they got 3 inches off her face, the man told her in a very aggressive way he would be waiting for her when she finishes her shift, the woman told her if her father dies, she would hunt her down, also insulted her some more.
All my colleague did was telling them that the patient is under monitoring and cannot leave the unit. My colleague tried to calmly repeat the same line another 2 times, but these 2 people just wouldn't listen, they started being that aggressive directly.
Security was called, but they never reached the unit on time, cops were not called, a doctor was called as well who came running, repeated what my colleague said, the doctor informed the family the patient could leave against medical advice, the patient refused, the family left, complaining about my colleague, didn't apologize to her, my colleague needed 30 minutes alone to cry.
Now I'm a male and I have no idea how to react, should that happen during my shift. I have the feeling my female colleagues expect me to intervene, because I'm a man, but I’m not a strong person and I don't know how to react when an intimidating and aggressive, bigger man than could easily punch me unconscious tells me 3 inches from my face he is going to wait for me when I finish my shift.
I have thought about several scenarios:
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I simply say 'I'll call the doctor', disengage, call security, call the police saying I fear for my security and for my patients' security and ignore them till they come. Then I tell security and the cops to escort the violent family from the unit. Document. Call the union.
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I confront the violent family: 'Im not gonna talk to you unless you behave like an adult, call me when you're ready to do that'. I disengage, call security and the cops and ask for them to come silently because, even though there is no violence, the situation can escalate very quickly and unpredictably and I fear for my safety, my coworkers' safety and that of my patients. Document, call the union.
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I try calming the violent family: 'calm down, you don't let me talk, repeat that twice at most. If they don't behave, I stop engaging, call security and the cops, because I fear for my safety. Document, call the union.
I also don’t know what could I say or do if they keep pestering and goading me when I disengage. Do I try to ignore that? Tell them to stop, looking them in the eye? Repeat ‘I’ll only talk to you when you act like an adult? Repeat ‘leave me alone’? Say ‘I don’t want any trouble with you, but if you attack me I’m going to defend myself?
I also need help to stay safe for the 10 minutes our internal security sometimes need to reach our unit and whatever time the police needs to reach us. Do I make the aggressive person focus on me so my female coworkers are safer? Do I ignore them? This must be one of the creepiest experiences a person has to live.
thank you for your help
As a nurse, you can think about it physiologically. What happens when a person is in fight or flight mode but then finds nothing in their environment to fight against? After the adrenaline dump, they become tired. Probably the most useful de-escalation technique I use in these situations is to recognize that time is on my side. Of course, we always want to stop a stressful situation as quickly as possible. However, if you stay calm and just let the person rant, they will run out of steam much more quickly than you will. Just remaining calm and staying on message without arguing will almost always work. Again, don't argue, just stay physically present with a neutral expression and remain firmly on message using as few words as possible. Get your colleagues to do the same. This is your space and your expertise, not his. Own it. He'll run out of steam.
Calling the doctor, in addition to security, is also a great idea because doctors have a lot of built-in social authority.
And finally, if you have a husband and wife both going at you together, try to separate them and speak to them individually. In many relationships, there is a subconscious dynamic where the couple engages in a positive feedback loop of escalation. You slowly take the husband aside and have a female nurse take the wife aside, if you can. Even if only a little ways apart. Divide their attention between you to short-circuit the feedback loop.