Responding to Abusive Patient Behavior: 10 Ways to Defuse Incidents

Here are 10 tips on managing abusive individuals discusses how staff members can take action to prevent or mitigate dangerous behavior.

Responding to Abusive Patient Behavior: 10 Ways to Defuse Incidents

7. Permit Verbal Venting When Possible
It is often the safest and best alternative to let a person shout, removing others from the area when feasible. Allow the person to release as much energy as possible by venting verbally. As a person is venting, there will be peaks and valleys in the outburst, as the person’s energy expenditure rises and falls. If you cannot allow the person to continue venting, state the directives and reasonable limits during the “valleys” in the venting process.

8. Identify Real Reason for the Behavior
Even in the midst of an angry tirade, there is useful information to be gained about what a person is thinking and feeling. The real reason for a person’s outburst is often not what it seems to be. Anxious patients and family members can be highly critical of hospital staff for reasons that are much more related to the fear and helplessness they are experiencing than to the ways staff members are performing their duties. Try to listen for the real message — the feelings behind the facts. Restate the message you think you have received in order to determine if you correctly understood the person’s intent.

9. Stay Composed, Avoid Overreacting
It’s hard not to take things personally, especially since angry people often say very personal things. But it is essential to do your best to remain calm and professional — at least on the outside. Your composed, rational response can go a long way toward influencing the person’s behavior in a positive way.

10. Use Physical Techniques Only as a Last Resort
Physical restraint should be used only when people’s behaviors are dangerous to themselves or others. Physical intervention itself always carries some risk of injury to staff or to the person being restrained. Such interventions should be used, therefore, only when it is more dangerous NOT to intervene. Furthermore, physical interventions should be used only by competent staff members who are trained to use the safest, least restrictive methods of intervention possible and who are well-versed in any applicable regulations or laws pertaining to restraint use in their facilities.

Prevention Promotes Culture of Caring
Not every crisis situation can be successfully de-escalated, but trained staff members who know these key principles are much more likely to influence behavior in a positive way, defusing potential crisis situations before they become dangerous. Prevention is the best way to promote a culture of caring and a safe and respectful workplace for everyone.

Judith Schubert is president of the Crisis Prevention Institute (CPI). For additional information on CPI, please visit The information above was adapted from “10 Tips for Crisis Prevention,” by CPI ©2002 and is provided with permission.

This article was originally published in 2007.

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