Violence is part of the job?
Joel Lashley from Vistelar
Another myth that gets us in so much trouble is the myth that violence is part of the job in health care. From a certain point of view, that’s absolutely true. I mean, health care providers are five to seven times more likely to experience a nonfatal assault at work than the average person. Health care and social work are the two most dangerous professions in the private sector for a nonfatal assault. If we keep telling ourselves that it’s part of the job, if we’re accepting of that much violence, then what countermeasures are we going to introduce into the professional relationship to keep us safe from all that violence? The first step is to not accept it.
Being exposed to threatening and violent behaviour should not be a condition of employment. And if there’s steps that we can take to make a relationship and environment less compatible with that sort of behaviour, threatening and violent behaviour, we’ll see less of it. We’ll get better outcomes for ourselves and we’ll get better outcomes for our patients.
So how do we manage the myth, the pervasive myth in health care that violence is part of the job? We see more violence in health care, but part of it is because of that belief that it’s acceptable. To begin not accepting so much violence in our environments, we have to adopt a broad and clear definition of what violence is and adopt a zero tolerance policy in our hospitals and facilities for violence. That doesn’t mean that we throw everybody out who drops and “F-bomb”.
What it means is that we consistently address gateway behaviours when we see them … Cursing, yelling, threatening. Because if we can manage the lower behaviours, they don’t build into the bigger, more violent behaviours. We have to train to do that. We have to train to persuade people and set up those social contracts early on. When people are yelling and cursing, we have to introduce ourselves: “Hi, my name is Jill. I work here in the hospital. The reason I’m here is because I can hear that you’re really upset and I want to help.”
And then we have to set limits specifically on those violent behaviours.
Can I ask you please not to yell or curse? We have patients around who are very sick and you’re disturbing them. And if they say, “I don’t care about that” and continue yelling and cursing, we have to present them with their options. We have to give them choices to say, “We have a couple good choices. If you stop yelling and cursing, I can help you. We can go into this conference room here, we can talk. I genuinely want to help you with what has you angry. I’m not going anywhere until we figure it out. But if you insist on yelling and cursing, we’ll have to ask you to leave.”
Their response might be, “You can’t separate me from my wife.” “Sir, I don’t want to. She needs you here. But because your wife is sick doesn’t mean that you can yell and curse and disturb the other patients. They need their rest and she needs her rest. So if you insist on doing that, you will have to leave. But I don’t want you to leave. I want you to stay here. I also want to help you with your issue. So if you can tell me calmly and quietly what has you angry, I am going to help address that issue.”
Team Dynamis Ltd. is the UK representative for Vistelar Conflict Management Training since 2014.
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