+ Prevalence of confrontation
- The patient care environment is prone to high stress situations with opportunity for miscommunication and conflict.1,8
- Data from family medicine in Canada suggest that medical professionals can expect to deal with confrontational encounters at some point during their career.2
+ Dealing with confrontation
- When encountering outward frustration, be open and honest about the problem – this can sometimes help to diffuse the situation:3,4
- Give complete attention to the concern being expressed
- Allow for full explanation and ask questions to ensure full understanding of concerns
- Ensure body language demonstrates respect – understanding that ideal body language may vary depending on culture and background (e.g., relaxed stance, arms uncrossed, eye contact)3-5
- Permit verbal venting to help diffuse frustration
- Allow the individual to identify what a successful resolution of their concern would be -- for example ask "What would you need to feel the situation is resolved?"
- Stay calm and composed during the interaction
- If a patient and/or family member, or another healthcare professional wishes to carry through on making a complaint, assure them that the appropriate action will be taken and provide them with the necessary information to proceed with their concerns
+ Dealing with escalation
- On occasion, these techniques do not elicit the desired response, and frustration may escalate to abusive and even violent behaviour.
- Taking into account provincial regulations, laws and facility policy, a plan is put in place for abusive situations before they arise.6
- In the case of confrontation, help is sought before the problem escalates.6
- In potentially dangerous situations, have another technologist or staff member stay during the procedure/treatment as a preventative step and involve the supervisor or manger when appropriate.
- If a confrontation escalates to violence in a hospital setting, hospital security is notified and it may be grounds to initiate a code (e.g., Code White, or appropriate code for your institution).
- Education is obtained in preparation for abusive situations before they arise.
- Education designed to prepare healthcare professionals to address conflict situations may be available through one's institution6
+ Documenting confrontation
- All factual details of confrontations or abusive situations are documented, including:7
- Names of those involved
- Date and time
- Nature of the situation
- Steps taken in response to the situation
- The presence of witnesses and who they were
- MRTs should be familiar with the specifics of facility policy regarding the documentation of confrontation.
- Gurley LT, Callaway WJ. Introduction to Radiologic Technology, 7th Ed. Maryland Heights, MO: Mosby; 2011.
- Miedema B, et al. Prevalence of abusive encounters in the workplace of family physicians: a minor, major, or severe problem? Can Fam Physician 2010;56(3):e101–e108.
- Schubert J. Hospital Security: Responding to Abusive Patient Behavior (Part II of III): 10 Ways to Defuse Incidents. Campus Security 2007.
- Difficult Patients. Patient UK website. Available at: http://www.patient.co.uk/doctor/Difficult-Patients.htm. Accessed March 22, 2011.
- Galanti GA. An introduction to cultural differences. West J Med. 2000;172(5):335–336.
- Ehrlich RA, Daly JA. Patient Care in Radiography. With an Introduction to Medical Imaging. 6th Ed. St. Louis, MO: Mosby; 2004.
- Canadian Centre for Occupational Health and Safety. Violence in the Workplace: Prevention Guide. 2014. Available at: http://www.ccohs.ca/oshanswers/psychosocial/violence.html. Accessed November 19, 2015.
- Beech B, Leather P. Workplace violence in the health care sector: A review of staff training and integration of training evaluation models. Elsevier. 2006;11:27-43.