Hospital Violence Reduction: Permission to Intervene
In some environments, there is sometimes still a question about whether a security officer or a nurse who uses force in a situation could rely on the backing of their management — and the backing of the hospital — if they intervene and are then challenged legally.
The intrinsic factors that influence use-of-force decision-making are absolutely fundamental to the success of any intervention. These are the emotional and psychological aspects of an individual’s response — and one of the most basic is what researchers describe as an expectation of personal gain or personal loss.
The Questions Staff Are Already Asking Themselves
Tacitly, staff at the hospital have already made decisions about whether the use of force to protect themselves, their colleagues, or the facility is personally acceptable. Does it carry too much risk to their own livelihood?
Am I willing to lose my job to protect my colleague?
Am I willing to face prosecution or loss of income if I intervene?
Would it be better to not get involved?
If I have been trained in effective techniques, will I get in trouble for using them?
Will my management support me if the subject of the intervention is injured?
⚠️ Critical insight: These questions are not hypothetical. Staff answer them every day — and their answers shape whether they act or stand by when violence unfolds.
Mental Models Shape Real-World Action
Theories of rapid decision-making have recognised the importance of mental models in forming action-scripts. Where the mental model does not support a successful outcome — one which protects the decision-maker from catastrophic results such as loss of job, loss of income, or loss of visa — then the resulting action-script will reflect this underlying belief structure.
The person’s action will reflect their mental model.
Expectations of non-support may understandably result in non-performance.
Permission Is as Important as Skill
In my team’s experience, these intrinsic factors are as important as the technical skills we impart to your team. Without permission from their leadership — without the explicit backing that says “we will support you if you act” — staff may still not work well together or bring effectiveness and functionality to the management of aggression.
✅ Action for leaders: Make your support explicit. Tell your team, in clear terms, that you will back them when they intervene to protect themselves and others. That conversation is as vital as any training course.
Gerard O’Dea is a conflict management, personal safety, and physical interventions training consultant. He is the training director for Dynamis, a specialist provider of personal safety and violence management programmes, and the European Adviser for ‘Verbal Defense and Influence’, a global programme which addresses the spectrum of human conflict.