Please see this valuable article about violence in healthcare. It’s a useful article in that it highlights the growing violence which healthcare professionals must face every day. Healthcare in the present era is not the healthcare of our parents and grandparents. Most nurses today experience levels of anxiety and aggression in patients and visitors that simply did not exist years ago to the scale it does today.
In this article is a quote by Michelle Mahon, a representative of a labor group (National Nurses United): “There’s a lot of focus on de-escalation techniques,” Mahon added. “Those are helpful tools, but oftentimes they are used to blame workers.”
This quote reflects an unfortunate misunderstanding of the real nature of so-called de-escalation. I’ll go ahead and say up front that I have long used the term de-escalation. Now, however, I’m moving away from it, choosing, instead, terms like conflict communication, tactical communication, civil communication, and/or the philosophy of civil communication. I am moving away from the term de-escalation precisely because of how I’m now seeing it, more and more, being dwarfed in its fullest scope such as is visible in the quote above.
It’s vital to remember that so-called de-escalation is a term that really should be pointing to the fullness of an actionable philosophy of how to create a non-escalating environment, that is, an environment in which all people are treated with dignity and respect (along with all the other measures to create safety in an environment). De-escalation should not be reduced (but nowadays it frequently is) to meaning merely a collection of techniques. It does, of course, include techniques of defusing fear, anxiety, anger, and rage. What is vital to know, however, is that there must be a cohesive glue (so to speak) that binds all the so-called techniques into a full, practical, and actionable approach. In their contextualized fullness, so-called de-escalation techniques are adaptive actions in a moment in time which are part of a much greater holistic approach to communicating civilly, and safely, with all people. Any decent training program should emphasize just such a sophisticated, holistic, approach, that is, if one wishes for one’s non-escalatory and de-escalatory efforts to actually be effective, retainable, and transformative of the environments in which they’re lived.
What I’m describing is not unlike how one trains in the martial arts. It’s the simpleton who looks for techniques and makes collections of them. The sophisticated, and more effective, practitioner, on the other hand, bases her training on concepts, principles, and theories. They are the glue that holds the entire discipline together and gives it shape and effectiveness. The so-called techniques, then, which are always embodied as spontaneous, extemporaneous expressions (i.e., using what is needed in the moment), grow out of this foundation of concepts, principles, and theories.
The greats of conflict communication, such as the late Dr. George Thompson, creator of Verbal Judo, knew just how sophisticated can be the approach we use to get along well, and safely, with other people. Early on, he emphasized principle after principle after principle, all of which connected with the other, to create an entire, teachable, actionable, philosophy of civil communication. It should be no surprise that he originally based his Verbal Judo on principles from the peace-keeping martial arts.
Do yourself and your organization a great service by refusing to depreciate just how much you can create climates of dignity, respect, non-escalation, and persuasive presence. Don’t buy into the “Let’s learn de-escalation techniques” syndrome. Provide your staff with quality training.