- Some suggestions that can be used by nurses to de-escalate client responsive behaviours and implement client-preferred interventions to assist them to cope.
- De-escalation tips:
- Always identify yourself.
- Talk and think calm.
- Ask patients how they are doing, or what’s going on.
- Ask patients if they are hurt (assess for medical problems).
- Ask patients if they were having some difficulty or what happened before they got upset.
- Remember why the patient is in the hospital.
- Find a staff member that has a good rapport/relationship with the patient and have him or her talk to the patient. Let the patent know you are there to listen.
- Offer medication if appropriate.
- Help patients remember and use coping mechanisms they identified on the Patient reported Therapeutic Interventions Survey.
- If a patient screams and swears, reply with a calm nod, okay, don’t react.
- Use team or third-party approach. If patient is wearing down one staff, have another take over (10 minutes of talking might avoid a restraint incident).
- Reassure patients and maintain professional boundaries (tell patients you want them to be safe, that you are here to help them).
- Allow quiet time for patents to respond – silent pauses are important.
- Ask the patient if she/he would be willing, could try to talk to you (repeat requests, persistently, kindly).
- Respect needs to communicate in different ways (recognize possible language/ cultural differences as well as the fear, shame, and embarrassment the patient may be experiencing).
- Empower patients. Encourage them with every step towards calming themselves they take.
- Make it okay to try and talk over the upsetting situation even though it may be very painful or difficult.
- Acknowledge the significance of the situation for the patient.
- Ask the patient how else we can help.
- Ask the patient’s permission to share important conversations with other caretakers for on-going discussion
Promoting Safety: Alternative Approaches to the Use of Restraints
Point of Care Resources