Case 6 – De-escalation: Health
Note: Debriefing is done in role either in groups or as a whole class
- Did your team agree on each other’s suggestions? If not, why not?
- What were the pros and cons of each suggested technique?
- Based on your level of agreement were you able to complete the task?
- Is de-escalation possible in this scenario or should other measures be brought in?
- Explore the concept of zero tolerance.
- When would you consider de-escalation unsafe?
- What hospital staff should be involved in this type of de-escalation? Is it a nurse’s responsibility? If not, then whose?
- Suggest steps one could take on how to de-escalate including assessing the situation, how to approach, establishing rapport, when to walk away, etc.
- Would your suggestions to address the situation change, based on gender, sexual orientation, age and/or race of the characters?
- If the decision is to call security, but security takes 20-40 minutes to arrive, what do you do in the interim?
- See Scene 14 and Scene 18 from “Person-Centred Care: Finding Dignity within the Shadows”
- Is de-escalation always possible?
- How is abuse normalized; should it be?
The following suggestions could be undertaken either as a group or individually. They could be written as reflections, offered for discussion, or submitted as assignments for grading.
- Search “Hospital respect signs” on the web. Choose a few and discuss their tone and how effective they might be.
- Based on the above research, create your own respect sign for placement throughout the hospital. Debate the degree of regulation and the degree of call to respect. Annotate your rationale with footnotes.
- As a task force, research multiple sources to create your own a) hospital harassment policy and b) procedures on how to de-escalate and enforce these policies.
- Could de-escalation be considered a form of victim-blaming? Juxtapose the balance of responsibilities and rights of hospital staff.
- Brophy, J., Keith, M., & Hurley, M. (2019). Breaking point: Violence against long-term care staff. NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 29(1), 10–35.
- Harden, J. (1996). Enlightenment, empowerment and emancipation: The case for critical pedagogy in nurse education. Nurse Education Today, 16(1), 32–37.
- Hobbs, K. (2019). To Know Their Stories: Using Playbuilding to Develop a Training/Orientation Video on Person-Centered Care. Brock University.
- Kapoor, S & Grover, N. (2021). Strengthening contextual policy and training can empower nurses to reduce their sexual harassment. Evidence-based nursing 24(4), 139.
- Liu, J., Gan, Y., Jiang, H., Li, L., Dwyer, R., Lu, K., Yan, S., Sampson, O., Xu, H., Wang, C., Zhu, Y., Chang, Y., Yang, Y., Yang, T., Chen, Y., Song, F., & Lu, Z. (2019). Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occupational and Environmental Medicine, 76(12), 927.
- Lu, L, Dong, M, Lok, GKI, et al. (2020) Worldwide prevalence of sexual harassment towards nurses: A comprehensive meta-analysis of observational studies. Journal of Advanced Nursing 76: 980– 990.
- Magnavita, N., Heponiemi, T. & Chirico, F. (2020). Workplace Violence Is Associated With Impaired Work Functioning in Nurses: An Italian Cross-Sectional Study. Journal of Nursing Scholarship, 52(3), 281-291.
- Quinlan, E., Robertson, S., Urban, A.-M., Findlay, I. M., & Bilson, B. (2020). Ameliorating Workplace Harassment among Direct Caregivers in Canada’s Healthcare System: A Theatre-Based Intervention. Work, Employment and Society, 34(4), 626–643.