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Spotlight on Walden // Nov 19, 2015

Mastering Crisis Management

A man paces anxiously. He’s waiting for news about his sister, whose illness has brought her to the emergency room. The stakes are high: Not only is he concerned about his sister’s health, but he’s also worried about his own future—as someone with cognitive challenges, he depends on her as his sole caregiver. What will happen to him if she dies? Soon, he becomes more aggressive and angry.

Then a nurse approaches him reassuringly. “You must be really scared for your sister,” she says calmly. His expression changes and he begins to relax. The night passes without incident.

This real-life scenario is just one example of how nurses (in fact, anyone) can defuse tense situations, says Suzanne Casella ’14, a nurse and clinical educator at Chambersburg Hospital in Pennsylvania. She knows the dangers well. Casella personally experienced workplace violence early in her career when she was attacked as she blocked an exit to keep a patient from leaving a locked psychiatric ward.

What’s more, she’s not alone in her experience. According to research published in the Journal of Emergency Nursing in May 2014, 76% of nurses reported experiencing verbal or physical abuse on the job within the past year. Indeed, healthcare workers experience more nonfatal workplace violence than any other profession.

Now, Casella is invested in sharing simple approaches to help others deal with such situations. “I knew I had two choices back then,” she explains. “I could run and quit—or I could learn how to alter the course of future situations so they didn’t become violent.”

Although she always had an interest in nursing, Casella pursued a career in behavioral health before deciding to earn her Master of Science in Nursing (MSN) at Walden. She says her experience at the university changed the way she thinks about nursing and healthcare. “Instead of looking for quick fixes to problems, I now consider ways to improve the entire process.”

This shift in thinking has already borne fruit. As part of a course at Walden, Casella began to explore techniques that help employees prevent workplace violence. With the encouragement of her professor, Dr. Anna Valdez, she authored an article describing these approaches, which was published in the May 2015 issue of the Journal of Emergency Nursing. Here are a few suggestions from her article about stopping violence before it starts:

Lend a hand. Greeting a patient or family member with a warm handshake can go a long way in expressing concern and fostering a feeling of safety. The intimacy of this simple—yet professional—act has more positive implications than you may realize.

Talk about it. If a patient or family member seems stressed, have a seat. You want to be on the same eye level so you will be perceived as an equal, rather than someone talking down to him/her. Encourage the person to talk about how he/she is feeling so you can identify what’s causing anxiety.

Stay cool. Frustrated patients and families may be hot under the collar—literally. When people are anxious, their heart rate and temperature go up. A cold drink can help them cool down and give them something else to focus on. This tactic often leads to calmer conversations, allowing you to pinpoint how you can help.

Know the signs. “If someone is already threatening and violent, take the threat seriously and call for help,” Casella says. “But if you can recognize cues along that path, such as anxiety, defensiveness, and anger, and understand where that person is coming from, you may be able to intervene before the situation becomes a crisis.” —Jessica Cerretani