Josh has 20 years in Public Safety
Currently doing crisis prevention instruction
We often don’t get any education in med school or PA school in how to communicate well with patients or how to de-escalate their behavior
Code greys are the behavior health emergency response; someone has some concern that a patient is escalating to potentially violent behavior and a team will respond
Staff safety is priority
We are there to provide excellent medical care, if it’s safe to do so
We recommend calling code greys earlier to avoid worsening scenarios
Code grey assures staff safety then de-escalation of the patient
Recognizing when you need help with patient interaction from some other staff member is important
Typically, negative behavior is a result of an unmet need or want
Rationally detach
Give people options, this helps give them a measure of control when they feel out of control
Get consent to do a physical exam, taking that extra few seconds to explain what you’re doing and getting that quick permission goes a long way
We forget that we ignore many social norms in the ED, patients may not be used to this
Always introduce yourself
A huge component to de-escalation of patients with negative and violent behaviors is that, if not done properly, they are a primary source of burnout. They become a huge negative experience that it sticks with you, not to even speak of the potential for an injury. Avoiding these negative experiences at all costs will be key to thriving in emergency medicine
Josh talks about a severe ankle injury he sustained and how he found a way to keep helping people anyway. He talks about how he strived to get the struggling people back connected to community. He helped them re-establish trust in others so that they could accept help
We talk about the resources available for financially struggling patients
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Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
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