Why the sign at a hospital?

You’re anxious. You’re scheduled for surgery. You are greeted by the query “How are you today?” as you move to the number one position at the registration desk.

You monitor your response although you are panicking inside. Obviously, there are some who seek services at Upper Valley Medical Center who, for one reason or another, are not disciplined, thus, the large sign in the lobby: “This hospital has a ZERO tolerance policy towards aggressive behavior. Physical & verbal abuse towards our staff is unacceptable & will not be tolerated. It is also a criminal offense. Premier Health Upper Valley Medical Center.”

I recently used this information as a diversion as I met various medical center personnel beginning with the attendant at registration through the surgeon who was attending me to ask them how they deal with rude, hostile, out-of-control patients.

The registration attendant said, “I’m quiet, and I try to relate to the patient, to understand him or her.” Within a minute, I was being escorted to the next step in my journey by a health unit coordinator who responded, “ I’m patient and work through it. I’m kind and realize that this behavior is not a part of their normal self, that there’s a reason.”

A registered nurse was next on my trek, and her response was as follows, “I deal with each patient as they come to me. I talk with them about their concerns, talk them through their concerns, help them. I let them know that we will make their procedure as safe as possible.” Next, the anesthetist indicated that she uses her smile as a calming device as she details the processes that she will be using.

The physician’s assistant spoke with me next and with assurance said, “We are taught de-escalation techniques, to not get in a head-to-head battle with a patient. We use calming words, avoid accusational phrases, and identify common ground. I say, ‘I’m sorry this is happening to you. What can we do to make you feel better?’”

A longer conversation was with the chaplain who detailed some of the causes for behaviors that are aggressive: drugs, alcohol, self –harm inclinations, and recent loss.

My final query was of my attending surgeon, Dr. Stewart Lowry, who said that he first assesses the situation to determine the safety of the health care workers and others. He then makes a determination of interventions. Should he intervene and use steps to de-escalate the situation? Should security be called?

Lowry indicated, “You never know when aggressive behavior will occur. There was a case in which a patient woke up from anesthesia and was just wild. His nurse suffered broken ribs. At times a physician must just say, ‘Stop. I’m not going to help you.’”

In conclusion, patients have responsibilities as a collaboration is essential for the wellness we seek as parts of our body need medical attention. Patients who have scheduled surgery need to spend time in getting prepared. This involves getting paperwork in order, planning for absence from work, planning for assistance at home, and handling spiritual/religious, psychological issues. And we all need to master stress- reduction techniques for a variety of times in our lives, and hospitalization is certainly one of the times we need to use them.

Vivian B. Blevins. Ph.D., teaches telecommunication employees from around the country and students at Edison State Community College and works with veterans. You may reach her at 937-778-3815 or [email protected].