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Presented By: Presented By: Steve Wilder, BA, CHSP, STS Steve Wilder, BA, CHSP, STS Sorensen, Wilder & Associates Bourbonnais, IL.

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Presentation on theme: "Presented By: Presented By: Steve Wilder, BA, CHSP, STS Steve Wilder, BA, CHSP, STS Sorensen, Wilder & Associates Bourbonnais, IL."— Presentation transcript:

1 Presented By: Presented By: Steve Wilder, BA, CHSP, STS Steve Wilder, BA, CHSP, STS Sorensen, Wilder & Associates Bourbonnais, IL

2   An employee enters the facility carrying a brown paper bag. The employee doesn’t say anything to anyone, and is wearing camouflaged clothing. The employee has been acting strange the past few weeks, making threats to his supervisor and fellow employees, and making comments about “getting even” What Would You Do If…

3   An employee comes into work, and tells you that he/she is going to commit suicide  A co-worker comes into the employee lounge while you are in there, stating “I’ve had it with that )#&*% and if she doesn’t watch out, she’s gonna be one sorry SOB” What Would You Do If…

4   An employee starts crying once or twice every shift, for no apparent reason, and without provocation  A female co-worker, going through a divorce, gets a call from her estranged spouse, and hangs up the phone and tells you “he says he’s coming here to kill me” What Would You Do If…

5   A co-worker can’t seem to stay awake, and keeps complaining that her paycheck isn’t enough to make ends meet.  A co-worker returns from lunch daily with a detectable odor of alcohol on his breath What Would You Do If…

6   Like every other catastrophic event that we have faced (mass casualties, staffing shortages, lack of supplies, fires, loss of utilities, etc.) episodes of Workplace Violence tax our resources, place our people at risk, and jeopardize our ability to care for those who need us most. Each Of These Scenarios Are Indicative Of A Potential Incident Of Workplace Violence.

7  Incidents of Workplace Violence are equally catastrophic in nature, but can be avoided, if we understand the issues, and know what to look for.

8   Nearly 1/3 of all Americans are victims of crime each year  3 people die of violent acts in the workplace everyday  90% - 95% of acts of violence are against women  Workplace violence is the leading cause of female deaths in the workplace The Impact of Violence in the Workplace

9   43% of healthcare managers have reported a violent incident in their workplace in the last 3 years.  25% of healthcare workers have experienced acts of Workplace Violence against them.  Violence in the workplace is the #1 security threat.  Approximately 900 deaths and 1.7 million non fatal assaults occur in the work place a year.  15% of all work-related fatalities that occurred in the US in 2007 were due to violent acts. Facts

10  Always RememberAlways Remember Incidents of Workplace Violence can be avoided, if we understand the issues and know what to look for.

11  What Constitutes Workplace Violence ? In simplest terms: Any incident in which an employer or employee is threatened, intimidated, physically or verbally attacked, harassed, injured or killed

12  THE GOLDEN RULE: IN EVERY HEALTHCARE FACILITY, THE RISK OF VIOLENCE SHOULD ALWAYS BE RECOGNIZED, BUT CAN ALWAYS BE AVOIDED OR MITIGATED THROUGH PREPARATION WORKPLACE VIOLENCE PREVENTING WORKPLACE VIOLENCE

13  To increase safety and lessen your chances of being injured, follow some simple guidelines:  Limit physical interventions  Use adequate number of staff  Develop and train Emergency Response Teams  Provide training to all employees  Train using role playing, situations, and mock drills Responding To A Violent Situation

14  Male 80%Probability Caucasian 75% Probability Working Age 90% Probability Characteristics of the Potentially Violent Person

15  90% Will Display One Or More Of The Following Characteristics of the Potentially Violent Person Pathological Blaming Depression Personality Disorder History of Violence

16  90% Will Display One Or More Of The Following Characteristics of the Potentially Violent Person Erotomania Interest in weapons Chemical Dependence Alcohol dependence

17  90% Will Display One Or More Of The Following Characteristics of the Potentially Violent Person Elevated Frustration Levels Impaired Neuro Functions Evidence of Psychosis

18  Recognizing and Avoiding Potentially Violent Behavior The Aggression Continuum: Six Steps from Calm to Violent

19  The Aggression ContinuumThe Aggression Continuum The continuum can best be thought of as a six foot step ladder. The closer the aggressor gets to the top rung, the more likely the risk of violent behavior.

20  The Aggression ContinuumThe Aggression Continuum Remember what the sticker on the top step says: DANGER Do Not Stand Here

21  The Aggression ContinuumThe Aggression Continuum STEP 1: the Person is Calm

22  Step 1: Calm and Non-Threatening  Persons Action:  Presents In A Calm Manner  Not Agitated  Presence Is Not Threatening  Is Just “Another Person Functioning In Society” The Aggression ContinuumThe Aggression Continuum

23  Step 1: Calm and Non-Threatening  Your Response:  Respect Person Dignity  Listen to Person Concerns  Be Compassionate and Caring  Focus on Persons Needs The Aggression ContinuumThe Aggression Continuum

24  STEP 2: the Person is Verbally Agitated Calm

25  Step 2: Verbally Agitated  Persons Actions:  person expresses verbal anger  the anger is not directed at any specific person or object  the person is no threat to you The Aggression ContinuumThe Aggression Continuum

26  Step 2: Verbally Agitated  Your Response:  Listen To The Person  Respect The Person  Save The Person’s Self Esteem  DO NOT Give Orders The Aggression ContinuumThe Aggression Continuum

27  STEP 3: the Person is Verbally Hostile Verbally Agitated Calm

28  Step 3: Verbally Hostile  Persons Actions:  behaviors very similar to being “verbally agitated”  person is oblivious to efforts to calm him The Aggression ContinuumThe Aggression Continuum

29  Step 3: Verbally Hostile  Your Response:  Maintain non-threatening body posture  Respect the “personal zone”  Allow the person to vent anger  Keep your instructions minimal The Aggression ContinuumThe Aggression Continuum

30  STEP 4: the Person is Verbally Threatening Verbally Hostile Verbally Agitated Calm

31  Step 4: Verbally Threatening  Persons Actions:  Begins to focus anger on specific person(s)  Makes demands for action  Makes threats of consequences if demands are not met The Aggression ContinuumThe Aggression Continuum

32  Step 4: Verbally Threatening  Your Response:  Maintain eye contact  Avoid cornering the person  Give person options  ANTICIPATE VIOLENCE The Aggression ContinuumThe Aggression Continuum

33  To corner the person means to trap the person. To remember the dangerous methods of cornering, remember the acronym C-A-P-E: C - Contact Cornering A - Angular Cornering P - Psychological Cornering E - Exit Cornering CORNERING

34  The Aggression ContinuumThe Aggression Continuum STEP 5: the Person is Physically Threatening Verbally Threatening Verbally Hostile Verbally Agitated Calm

35  Step 5: Physically Threatening  Persons Actions:  Takes stance that suggests violence  May scan area for potential weapons  May make aggressive moves against you The Aggression ContinuumThe Aggression Continuum

36  Step 5: Physically Threatening  Your Response:  Must recognize this is the critical point  Maintain defensive posture  Look for strong side/weak side indicators  Be prepared for physical attack The Aggression ContinuumThe Aggression Continuum

37  Physically Violent Physically Threatening Verbally Threatening Verbally Hostile Verbally Agitated Calm STEP 6: the Person is Physically Violent

38  Step 6: Physically Violent  Persons Actions:  Physically attacks you in some form The Aggression ContinuumThe Aggression Continuum

39  Step 6: Physically Violent  Your Response:  Change to self defense/survival mode The Aggression ContinuumThe Aggression Continuum

40  Watch for non-verbal clues :  Sudden Movements Toward You  Tightening Of Small And Large Muscle Groups  Twitching Of Facial Muscles  Darting Eye Movements  Fixed Staring Additional Key PointsAdditional Key Points

41  Watch for non-verbal clues :  Glancing For Weapons  Shifting Balance  Raised Voice Pitch And Increased Volume  Changing Stances  Increased Breathing Rate Additional Key PointsAdditional Key Points

42   DON’T Give Orders Instead Of Choices  DON’T Project A “Don’t Give A Damn” Attitude  DON’T Over Stare  DON’T Make Threats Or Lie To The Individual  DON’T Argue  DON’T Turn Your Back Or Walk Away  DON’T Become Emotional  DON’T Corner The Individual, Or Invade His Space The DON’T List of Aggression Management

43   DO Monitor Your Own Status  DO Demonstrate Self Confidence  DO Stay Calm And Relaxed  DO Keep Voice Pitch/Volume Down  DO Offer Honest Options  DO Allow Individual To Make Choices  DO Allow Individual To Save Self Esteem  DO Maintain Safe Personal Distance  DO Position Yourself On Individuals Weak Side  Do Take Your Time The DO List of Aggression Management

44   Most Men Carry Pens/Pencils/Cigarettes on Weak Side  Most Men Carry Their Wallets On The Strong Side  The Tip Of The Belt Usually Points To The Weak Side  Most Women Carry Purse Over Strong Side Shoulder  Most Men Part Their Hair On The Weak Side Strong Side / Weak Side Indicators

45   Most People Wear Their Watch On The Weak Side  Most People Stand With Strong Side Shoulder Dipped Lower  Most People Will Stand With Weak Side Foot Forward  Most People Carry Pagers, Phones, Etc. On Strong Side Strong Side / Weak Side Indicators

46  1.Commitment To Outcome 2.Pay Attention 3.Know The Aggression Continuum 4.Assessing The Cause 5.Avoid Ego Battles Ten De-Escalants To ApplyTen De-Escalants To Apply

47  6.Monitor Status 7.Monitor The Environment 8.Offer Options / Choices 9.Avoid Cornering – I.E. C.A.P.E 10.Establish Leadership (Who’s In Charge) Ten De-Escalants To ApplyTen De-Escalants To Apply

48  THE BUDDY SYSTEM: When responding to a situation that you know may become violent or involve aggressive behavior, always use a buddy system. A minimum of two people, but 3 or more is even safer. Responding to Potentially Violent Incidents

49  Triangle Approach Back Up #1 Back Up #2 In Charge Aggressor

50  Triangle Approach Back Up #1 Back Up #2 In Charge Aggressor

51   First, obtain any necessary medical attention you may need.  Report the incident to your supervisor  Complete a Violent Incident Report Form and turn it in to your supervisor IfYou Are Involved In A Violent Situation If You Are Involved In A Violent Situation

52   Talk about it!  Watch for signs of Post Traumatic Stress Disorder  Utilize CISD Teams  Utilize EAP programs  Utilize Crisis Intervention Teams  Critique each session from Quality Improvement perspective If You Have An Incident…If You Have An Incident…

53 QUESTIONS / COMMENTS Steve Wilder Sorensen, Wilder & Associates Bourbonnais, IL (cell)


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