Workplace Violence: Don't Risk It, De-escalate It

Leah Curtin, RN, ScD(h), FAAN


Am Nurs Today. 2019;14(5):72 

In This Article

Abstract and Introduction


Know the warning signs and stay calm.

Whether you're a certified nursing assistant, licensed practical nurse, registered nurse, or nurse practitioner, you'll likely deal with patients who are feeling pain, have lost their independence, or are experiencing stress and anxiety—and they will sometimes lose control of their emotions. These angry and upset patients or family members can test your compassion, communication skills, and patience. They even may resort to violence.

Workplace violence is a serious and growing threat. And it's not confined to patients and families; it also may include your co-workers. When faced with threats of violence from a subordinate, co-worker, patient, or visitor, the first order of business is to consciously calm yourself before interacting with the person. If you're upset, it's only going to escalate the situation. Calm down and begin to look at the situation and how you can intervene safely. Take a deep breath.

Then, what do you do? The short answer is:

  1. Give them space. Stand 2 to 3 feet away if possible.

  2. Monitor your voice tone. Keep it measured and calm.

  3. Know how to retreat. Have a planned escape route.

These techniques may help, but how do you know, unless it's patently obvious, that you are—or may be—facing violence? Warning signs of potential violence from patients, families, or coworkers include:

  • intimidating, harassing, bullying, or other belligerent and aggressive behavior

  • numerous conflicts with patients, families, coworkers, or supervisors

  • comments that indicate approval of using violence to resolve a problem

  • comments that indicate desperation over family, finances, or other personal problems

  • inappropriate references to guns or idle threats about using a weapon to harm someone and, of course, bringing a weapon to the workplace.