Someone once was quoted as saying “You can’t control what happens to you. You can only control how you react to it.” This statement couldn’t be more true… but especially when it comes to clinicians, working with those who have sustained a neurological injury.
Controlling your reactions is easier said than done. To stay calm at work requires not only patience, but also some intense self-reflection. It is very easy to get wrapped up in your emotions when you are working in a high pressure, high stress environment (i.e., healthcare). Not only do you have to manage the patients and their families, but there is also schedules, equipment, co-workers, deadlines… the list goes on. The question that probably always crosses your mind is “How do I maintain my composure when something intense is happening?”.
Suppressing your emotions is any given situation is not healthy, but it is important to remember that there is a time and a place for everything… emotions included.
Our priority should be facilitating a calm environment filled with mutual respect and support for our patients as they recover. At the end of the day, that is why we are all in healthcare, right? Modulating our own behavior can have a positive effect on our patients, especially those who are having difficulty regulating their own behavior.
So how can we maintain a calm, cool, and collected demeanor in the face of adversity? The Crisis Prevention Institute (CPI) is a really great resource regarding verbal de-escalation techniques and management. CPI was founded in 1980 to give people the tools to better manage conflict, and they believe that empathy, compassion, and meaningful connections are powerful tools to maintain a safe working environment.
CPI suggests the following as being the “Top 10” De-escalation Tips:
- Be empathetic and nonjudgmental
- Respect personal space
- Use nonthreatening nonverbal
- Keep your emotional brain in check
- Focus on feelings
- Ignore challenging questions
- Set limits
- Choose wisely what you insist upon
- Allow silence for reflection
- Allow time for decisions
The tips listed above are really great actionable items you can use to stay calm at work, when someone becomes agitated, confrontational, or upset (these can also be useful outside of work as well!). We need to keep in mind that our patients are probably experiencing the worst time in their lives – we are unfortunately meeting them when they are not at their best, and are probably going to be unable to reason and regulate their own behavior/reactions to things. It is up to us, the professional, to take a step back and have empathy for our patients (and their families!).
In addition to those things from CPI that can be done in the moment when things are escalating, there are also other things we can be doing at work to ensure we will stay calm and be ready to implement our training when needed:
Get training… often.
A ‘one off’ training focusing on de-escalation is not sufficient. A training like CPI is a great tool to have in your toolbox, but it is just that… one tool in your toolbox. There are other programs out there as well such as Handle with Care, and NAPPI. You have to choose the training that is being going to fit the needs of your team, and your patient population. Also, consider how you learn best. Some people enjoy going to a live, in person seminar while others prefer a self-paced course that can be completed on their own time at home. There is not one ‘magic training’ that is going to be a one size fits all and it is very important you do your homework to see what is going to fit you best. Lastly, make sure the ongoing education needed is something that is going to be feasible for you and your team/facility. You do not want to set yourself up to fail with something that is not going to fit into your schedule well.
Function as a team.
Management of crisis situations should not and cannot fall onto one person. It truly does ‘take a village’ to be successful and ensuring all members of your team are adequately trained and comfortable with your facility’s plan is paramount to success. If you see a colleague in situation that appears it is going to escalate, hang around and hang back. Stay within an earshot so that way you are able to assist if needed. Try and let your colleague know that you are there for them to increase that overall feeling of security. It can also help to have a designated group of staff that will respond to a crisis situation. There truly is safety in numbers and knowing that your team has your back will enable you to more effectively manage that crisis situation.
Decompress.
It is important that you build in some time to decompress after a crisis situation. Emotions are running high, and there is a solid chance that your heart is beating in over drive. Talk a walk outside, sit in a quiet space, or put on some comforting music so you are able to come down and refocus. The situation that you just handled did not go from 0 to 100 in .2 seconds, and you are not expected to come back to zero instantaneously. It is more than ok to tell your work colleagues that you ‘need a minute’ to stay settled and calm, and that you will be available at a later time in the day.
Set aside time after you decompress from the crisis situation to discuss why and how the situation escalated how it did. It is very important to talk through the good, the bad, and the ugly to further refine your process and response. Constructive criticism and feedback should be welcome and viewed as an opportunity for you to refine your skills and self-reflect instead of punishment. There is always going to be something that could have been better handled in each situation – no one is perfect (and that’s ok!)!
Self-care.
This term is a bit overused at times, but it is something that is vital for you to continue to be your best, calm self in the face of a crisis. Taking a break from your 9-5 can assist you with being fresh and positive at work. Self-care takes many forms, and can range from taking a short walk outside, to planning a relaxing vacation, to listening to some true crime podcasts in your down time. You are no good to your patients and colleagues if you are not being good to yourself first. You have PTO, USE IT!
As you can see, to stay calm in the face of a work crisis is so much more than just attending a one-time workshop on effective communication skills.
Getting training and education and just one piece of the self-regulation puzzle. Taking a step back and looking at the bigger picture for the patient is always necessary. Ask yourself “What am I doing to contribute to this person’s recovery? How can I better conduct myself to ensure a calm, safe environment?”. Remembering that it is not all about you, but the patient, can put things into a different perspective and assist you with how you can change your behavior. The best thing you can do is treat everyone you encounter with a mix of warmth, professionalism, and respect… Remember, people may forget what said… people may forget what you do… but people will never forget how you make them feel – Maya Angelou
