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Ep. 35: Good Speak: Non-Escalation Strategies for Healthcare
16 Plays27 days ago
Summary:
In healthcare, the words you choose can mean the difference between connection and confrontation. In this episode of Confidence in Conflict, Marcus (former healthcare security director) and Natalie (nurse practitioner and clinical team leader) explore “Good Speak”—the use of verbal and non-verbal communication as proactive tools to prevent conflict before it starts. Together, they unpack Vistelar’s Beyond Active Listening framework and the six C’s of Conflict Management, showing how simple, structured communication habits can keep interactions calm, respectful, and safe.
Some key takeaways from the discussion include:
- How “Peace Words” reduce tension and promote psychological safety
- Seven components of Beyond Active Listening every provider can use
- Non-verbal strategies that signal empathy and professionalism
- Ways to handle difficult patients, families, and coworkers without escalation
- How staying in the “Blue Zone” helps staff manage stress and preserve teamwork
From emergency departments to long-term care units, this episode offers practical language and mindset shifts that turn daily challenges into opportunities for trust, healing, and safety.
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Transcript
Introduction: Importance of Conflict Management
00:00:00
Speaker
Welcome to another edition of Confidence in Conflict. I'm Marcus, and whether you're starting your shift in the emergency department, making rounds on a busy medical floor, or managing the complexities of healthcare care security, you know that challenging conversations are part of your daily reality.
00:00:14
Speaker
Today, we're diving deep into something that can transform how you handle those moments before they become problems. And I'm Natalie. Marcus, what I love about today's topic is that it's truly preventive medicine for conflict.
00:00:28
Speaker
We're talking about peace words, those verbal and nonverbal communication strategies that can prevent conflict from starting. As someone who spent years in clinical settings, I can tell you that the most powerful intervention is often the one that prevents escalation in the first place.
00:00:46
Speaker
These healthcare workplace violence solutions help teams create safer environments for staff and patients alike. Exactly right, Natalie. And I think our listeners will appreciate that we're not just talking theory here.
00:00:58
Speaker
We're talking about practical, immediately applicable techniques that you can use whether you're dealing with an anxious family member in the waiting room room, a frustrated colleague during a difficult shift, or a patient who's frightened or anxious.
00:01:09
Speaker
These methods are a core part of hospital de-escalation training and nurse safety training programs across the country.
De-escalation Techniques and Tools
00:01:16
Speaker
Before we dive in let's set the stage with something that probably resonates with everyone listening.
00:01:21
Speaker
Picture this. It's been a long day, the unit is understaffed, and you walk into a patient room where someone is clearly upset. Maybe they've been waiting for hours. Maybe they're in pain.
00:01:32
Speaker
Maybe they're scared about a diagnosis. In that moment, your first few words and your body language can either diffuse the tension or pour gasoline on the fire.
00:01:43
Speaker
In healthcare, care those first words are part of clinical de-escalation techniques that can determine how the rest of the encounter unfolds. That's such a perfect example because it highlights something fundamental about healthcare conflict management.
00:01:56
Speaker
Every interaction happens in a high-stress environment. People are vulnerable, worried, and often not at their best. As healthcare care professionals, you're managing your own stress while trying to provide excellent care.
00:02:08
Speaker
Understanding how to use communication as a preventative measure in these moments isn't just helpful, it's essential.
The 6Cs Framework Explained
00:02:14
Speaker
And that's where Vistalar's approach really shines. The framework gives us concrete tools, not just good intentions.
00:02:23
Speaker
When we talk about non-escalation strategies, we're talking about systematic approaches that are easy to learn, teach, remember, and deploy consistently.
00:02:33
Speaker
Even when you're tired, even when you're stressed, even when you're dealing with your fourth difficult interaction of the day. This approach aligns perfectly with medical staff communication training programs and behavioral health crisis intervention strategies used in hospitals nationwide.
00:02:51
Speaker
So let's start with the foundation. Natalie, when we talk about peace words, what do we mean exactly? Great question, Marcus. In communication, our words and nonverbal behavior function the same way.
00:03:05
Speaker
They can diffuse negative emotions, protect relationships, and create psychological space that allows everyone to stay calm and focused on solutions. When healthcare professionals master these clinical de-escalation techniques, they not only prevent conflict, but also strengthen trust between staff and patients.
00:03:26
Speaker
And I think it's important to emphasize that this isn't about manipulation or being fake. This is about genuine, strategic communication that serves everyone's best interests. It's genuine because no provider wants to experience conflict on the job if they can avoid it.
00:03:40
Speaker
Non-escalation is about the avoidance of conflict. This is medicine practiced in good faith because the end goal is best outcomes for our patients and safety for everyone. Absolutely. It's about being authentic while also being intentional.
00:03:53
Speaker
When we use VistaLar's non-escalation techniques, we're operating from what they call the blue zone of the six C's of conflict management. This is that space where we're focused on context, contact, and closure.
00:04:06
Speaker
Basically, preparation, engagement, and follow-through, all with the goal of keeping interactions safe and constructive. Let's break that down for our listeners. The 6Cs framework gives us a way to analyze any interaction and determine the right approach.
00:04:21
Speaker
The blue zone, context, contact, and closure are the phases where we have the most control over preventing present and future escalation. Exactly. And the beauty of this framework is that it acknowledges reality.
00:04:34
Speaker
Sometimes, interactions do escalate into the red zone, conflict, crisis, or combat. But the goal is always to stay in the blue zone, entering the red only when absolutely necessary.
Active Listening and Communication Techniques
00:04:48
Speaker
By staying calm, applying structured communication, and using proven health care conflict management practices, we protect everyone involved. So let's get practical.
00:04:59
Speaker
What does this look like at the point of contact? That moment when you first engage with someone, whether or not they might be anxious or agitated? This is where the magic really happens. At the contact phase, we're focused on engagement considerations with the goal of non-escalation.
00:05:16
Speaker
One of the most powerful tools here is what Vistalar calls beyond active listening. This isn't just nodding your head and saying, uh-huh. It's a systematic approach to gathering information while simultaneously calming the situation.
00:05:32
Speaker
Can you walk us through what beyond active listening looks like in practice? Sure. Beyond Active Listening has seven components, and each one serves a specific purpose. The first is clarify.
00:05:45
Speaker
You ask open-ended or opinion-seeking questions, but you keep them simple and ask only one at a time. For example, instead of saying, what's wrong with you today, which sounds judgmental, you might say, help me understand what's concerning you.
00:06:02
Speaker
That single adjustment is a cornerstone of medical staff communication training because it immediately changes the tone of the interaction. I can see how that changes the entire tone of the interaction right from the start.
00:06:15
Speaker
Exactly. And you pause to give them ample time to respond. In health care, we're often in a hurry, but that pause is crucial. It shows respect.
00:06:26
Speaker
It gives people time to collect their thoughts, and it prevents them from feeling rushed or pressured. What's the second component? Paraphrase. You use simple language and even gestures to be as clear as possible.
00:06:40
Speaker
This isn't about showing off your medical vocabulary. If a patient says, I'm angry because nobody cares, you might paraphrase back, it sounds like you're concerned that you're being ignored. Is that right?
00:06:53
Speaker
You're reflecting back what they said in a way that shows you understood. That's interesting because it serves three purposes. It demonstrates that you're actually listening, and it gives them a chance to correct you if you misunderstood.
00:07:05
Speaker
It also allows them to self-reflect and communicate more freely. Exactly right. The third component is reflect, and this is one place you can include what Vistalar calls safety statements.
00:07:18
Speaker
You might say something like, you seem frustrated because you've been waiting, but I'm here now and I want to help you. You're acknowledging their emotion while also reassuring them that they're safe and cared for.
00:07:33
Speaker
I imagine that safety component is particularly important in health care settings where people are already feeling vulnerable. Absolutely. People come into health care environments often feeling scared, out of control, or dependent on others.
00:07:48
Speaker
When we include safety statements in our reflections, we're addressing that fundamental need for security. The fourth component is affirm, using simple statements that validate their feelings.
00:08:01
Speaker
I can tell you're worried, and that makes complete sense given what you're going through. Now some people might worry that affirming someone's anger or frustration will make them more angry or frustrated.
00:08:12
Speaker
How do you address that concern? That's a great question, and it gets to a common misconception about validation. When you affirm someone's feelings, you're not saying their behavior is appropriate or that their anger is justified.
00:08:27
Speaker
You're simply acknowledging that they're experiencing that emotion, which is always valid. There's a big difference between saying, you have a right to be angry, and you have a right to yell at me.
00:08:40
Speaker
We will get to that part in the final step. That's a crucial distinction. What are the remaining components of beyond active listening? The fifth is mirror, subtly adopting their voice volume, tone, and speed, and even their body language to increase their comfort level.
00:08:56
Speaker
That is provided that their communication is appropriate. We shouldn't mirror yelling or cursing, for instance. Instead, we should model appropriate communication.
00:09:07
Speaker
However, if they're speaking quietly, you should match that. If they're more animated, you might be slightly more expressive to match their appropriate level of urgency. No one wants to have their pain or anxiety trivialized.
00:09:21
Speaker
The key word is subtly. You're not mimicking them. You're finding a middle ground that feels comfortable. That sounds like it requires some skill and practice. It does.
00:09:31
Speaker
And that's why Vistalar emphasizes training and practice with these techniques.
Nonverbal Communication Strategies
00:09:36
Speaker
The sixth component is advocate. You always communicate that you're there to help. I'm here for you.
00:09:43
Speaker
I'm going to stay with you. We're going to work through this together. In healthcare, care this aligns perfectly with our caregiving mission. And the seventh component?
00:09:54
Speaker
Summarize. Keeping it simple and brief. You might even consider providing a written checklist if appropriate. Okay, so you're concerned about the wait time, you're worried about your test results, and you want to make sure your family knows what's happening.
00:10:09
Speaker
Let's address each of these. Summarizing also allows you to set limits on inappropriate behaviors. For example, Okay, great. Thank you. I'll take care of that right now.
00:10:21
Speaker
And to recap, you agreed not to yell or curse anymore. Please just ask the triage nurses for updates or to report any changes in how you are feeling.
00:10:33
Speaker
Finally, summaries should always be followed up with a good closure. Well, that started out tense, but I'm glad you spoke up. I'm going to check on when we might have a room available, and I'll be right back to update you.
00:10:47
Speaker
I can see how this systematic approach would be incredibly helpful in high-stress situations, where it's easy to get overwhelmed or forget the basics. That's exactly right. And Vistalar emphasizes being careful not to make what they call listening mistakes.
00:11:02
Speaker
Things like advising, complimenting inappropriately, excessive querying, dismissing, or identifying too much with their situation. The focus has to remain on the other person, not shift to you.
00:11:16
Speaker
Let's talk about the nonverbal side of this. We know that communication is much more than just words. What does it look like when using nonverbal communication as good speak? Nonverbal communication is absolutely crucial, and often it's where we either build trust or create defensiveness without even realizing it.
00:11:34
Speaker
This ties into their principle of being alert and decisive, being aware of your surroundings and ready to take appropriate action. Can you break down what that looks like in terms of body language and spatial awareness?
00:11:47
Speaker
Sure. Let's start with positioning. When you approach someone who might be upset, approach from the side rather than directly head-on. A direct approach can feel confrontational or threatening.
00:12:00
Speaker
Maintain about a five-foot distance, close enough to show engagement, far enough to respect personal space, and avoid feeling invasive. That makes sense from a security perspective, too.
00:12:12
Speaker
You're maintaining what we call safe positioning. Exactly. And always ensure the person has an escape route. Never position yourself between them and the exit.
00:12:24
Speaker
This isn't just about physical safety. It's about psychological comfort. When people feel trapped, they're more likely to escalate. You should also give yourself an out, making sure the individual isn't between you and an escape route.
00:12:40
Speaker
What about posture and body positioning? Keep your posture open and non-threatening. Uncrossed arms, relaxed stance, hands open and visible. Avoid sudden movements.
00:12:51
Speaker
Everything should be slow and predictable. Your facial expression should be calm and appropriate, not overly smiling, which can seem fake, but not stern either. Patients want to see confidence and empathy from their providers, not pity, judgment, or detachment.
00:13:08
Speaker
And eye contact. Maintain appropriate eye contact without staring. You want to show you're engaged and present, but constant eye contact can feel aggressive or intimidating.
00:13:19
Speaker
It's okay to look away occasionally. It can actually make people more
Practical Applications in Healthcare
00:13:23
Speaker
comfortable. Let's talk about voice volume and tone. How do these function as non-escalation skills?
00:13:30
Speaker
Your voice is incredibly powerful in setting the tone for the entire interaction. Speak slowly and clearly. When people are upset or stressed, they have a harder time processing information quickly.
00:13:42
Speaker
Keep your volume soft but audible. If someone is yelling, the natural tendency is to raise your voice to match theirs. But that just escalates the situation. So you're essentially modeling a calm demeanor to invite them into a calmer space.
00:13:57
Speaker
That's beautifully put. The first step in both non-escalation and de-escalation is modeling. Providers must model the energy they want to create for all their interactions and avoid any language that sounds threatening or aggressive.
00:14:11
Speaker
No medical jargon that might confuse them further. Keep explanations clear and simple. Now let's talk about some specific scenarios. What does this look like when you're dealing with an anxious family member in a waiting room?
00:14:25
Speaker
Great example. Let's say a family member approaches you, clearly agitated, saying something like, we've been waiting for hours and no one will tell us anything about my mother's condition.
00:14:37
Speaker
Your initial response sets everything in motion. So walk me through how you'd apply these techniques. First, I'd approach at an angle to avoid confronting them. Head on, maintain a safe distance, and use a calm, clear voice.
00:14:52
Speaker
I can begin clarifying while delivering my universal greeting, Hello, I'm Natalie and I'm a nurse here in the emergency department. I am here to help. Help me understand what specific information you're looking for about your mother's care.
00:15:07
Speaker
This way I'm showing respect and gathering information at the same time. And you're not getting defensive about the wait time or making excuses. Exactly. Then I might paraphrase, so you've been waiting several hours and you're concerned because you haven't received an update about your mother's condition.
00:15:24
Speaker
I'm showing I heard them accurately. Then I'd reflect with a safety statement. I can see how worried you are. That's completely understandable, and I want to help get you the information you need.
00:15:37
Speaker
That's already a completely different dynamic than what often happens in these situations. Right. Then I'd affirm, anyone would be concerned in this situation, and you have every right to want updates about your mother's care.
00:15:50
Speaker
I'm validating their feelings without accepting inappropriate behavior. Finally, I'd advocate, I'm going to find out exactly what's happening and make sure you get the information you need.
00:16:02
Speaker
Let me go check on that right now. And if they're still agitated at that point? That's where you might use some mirroring. If they're speaking with some urgency, I might increase my pace slightly while keeping my volume calm.
00:16:16
Speaker
And then I'd summarize. Okay, so I'm going to find the nurse caring for your mother, get an update on her condition, and come right back to you with that information. You can wait right here, and I'll be back in just a few minutes.
00:16:30
Speaker
I can see how this approach would be so much more effective than either dismissing their concerns or getting into an argument about hospital procedures. Exactly. And notice that throughout this interaction, I'm staying in Vistalar's blue zone.
00:16:43
Speaker
I'm not getting pulled into conflict. I'm using my communication skills to prevent escalation while still addressing their legitimate concerns. Let's try another scenario.
00:16:54
Speaker
What about dealing with a colleague who's frustrated or overwhelmed during a difficult shift? This is so common, and it's where these skills can really strengthen working relationships. Let's say a colleague snaps at you, I can't handle another admission.
00:17:09
Speaker
This is insane, and nobody cares that we're drowning out here. In that moment, it would be easy to either take it personally or respond defensively. Absolutely.
00:17:19
Speaker
But instead, I might clarify. It sounds like you're feeling overwhelmed with the current patient load. What's the most pressing concern right now? I'm not taking the bait about nobody caring.
00:17:33
Speaker
I'm focusing on what might actually help. and you're treating their outburst as information rather than as an attack. Exactly. Then i might reflect, you're managing a lot right now, and it feels unsustainable.
00:17:47
Speaker
Let me see how I can support you. I'm acknowledging their stress while positioning myself as an ally, not an adversary. What if they continue venting or become more agitated?
00:17:59
Speaker
I'd continue to affirm, you're absolutely right that this is a challenging situation and it makes sense that you're feeling stressed. Then I'd advocate, we're a team and I want to figure out how we can make this more manageable for everyone.
00:18:14
Speaker
Finally, I might summarize. So you're concerned about the patient load, you're feeling unsupported, and you want to make sure we can provide good care. Let's talk about what options we have.
00:18:27
Speaker
I noticed that in both scenarios, you're not trying to solve every problem immediately, but you're creating space for problem solving to happen. That's a key insight, Marcus. Sometimes the best intervention is simply demonstrating that you understand the problem and you're willing to work on solutions.
00:18:43
Speaker
People often escalate when they feel unheard or dismissed. When you show genuine engagement with their concerns, that alone can defuse a lot of tension.
00:18:54
Speaker
Now let's talk about patient interactions. These can be particularly challenging because patients are often scared, in pain, or facing difficult diagnoses. How do these techniques apply in direct patient care?
00:19:06
Speaker
Patient interactions require extra sensitivity because you're dealing with people who are often at their most vulnerable. Let's say you walk into a room and a patient immediately says, the nurse from the last shift was terrible.
00:19:20
Speaker
She didn't listen to me and I didn't get my pain medication on time. I want to file a complaint. That's a situation where it would be tempting to either defend your colleague or dismiss their concerns.
00:19:31
Speaker
Right, but neither of those approaches helps anyone. Instead, I'd start with clarification. Tell me more about what happened with your pain management.
00:19:43
Speaker
I'm gathering specific information rather than getting into general complaints about staff. And you're focusing on their current need rather than re-litigating the past. Exactly.
00:19:54
Speaker
Then I might paraphrase, so you're saying you didn't receive your pain medication when you expected it, and you felt like your concerns weren't being heard. I'm reflecting back on what they said without making any judgments about whether they're right or wrong.
00:20:09
Speaker
What would reflection look like in this situation? I might say, you're clearly uncomfortable right now, and that's the most important thing we need to address. I'm here to make sure you get the care you need.
00:20:20
Speaker
I'm acknowledging their current state while reassuring them about my commitment to their care. An affirmation? It makes complete sense that you'd be frustrated if you felt your pain wasn't being managed properly.
00:20:32
Speaker
Pain management is a priority, and you deserve to have your concerns taken seriously. I can see how that would completely change the patient's attitude towards you, even if they had a negative experience with someone else.
00:20:47
Speaker
That's the power of validation. When people feel heard and understood, they're much more likely to work with you collaboratively. Then I'd advocate, I'm going to review your pain management plan and make sure we're doing everything we can to keep you comfortable.
00:21:02
Speaker
We'll also look at what happened earlier so we can prevent it from happening again. And summarize? Okay, so my priorities right now are to assess your current pain level, review your medication schedule, and make sure you understand how to communicate with us if you're not getting relief.
00:21:19
Speaker
Does that sound right to you? I notice you ended with a question that gives them some control over the conversation. That's crucial, especially with patients. They often feel like everything is being done to them rather than with them.
00:21:33
Speaker
Giving them a voice in the process, even in small ways, can significantly reduce anxiety and defensiveness. Let's
Overcoming Communication Obstacles
00:21:42
Speaker
talk about some of the challenges that come up when trying to use these techniques.
00:21:45
Speaker
What are the most common obstacles healthcare professionals face? Time is the biggest one. Everyone feels like they don't have time for extended conversations, especially when they're dealing with multiple priorities.
00:21:57
Speaker
But here's what I've learned. Taking two minutes on the front end to prevent escalation often saves you 20 minutes on the back end dealing with complaints, incident reports, or trying to repair damaged relationships.
00:22:09
Speaker
That's such an important point. This isn't just about being nice. It's about being efficient. Exactly. Another challenge is emotional management. When someone is angry or aggressive toward you, it's natural to want to defend yourself or respond in kind.
00:22:26
Speaker
That's your amygdala, your fight or flight response, kicking in. But Vistalar teaches us to respond rather than react. Can you explain that distinction? When you react, you're responding emotionally and automatically.
00:22:40
Speaker
When you respond, you're making a conscious choice about how to engage. Vistalar's approach helps you develop what they call a decision mindset. The ability to assess a situation quickly and choose the most appropriate response.
00:22:55
Speaker
That sounds like it requires practice. It absolutely does. Like any skill, these techniques become more natural and effective with practice. That's why Vista-Lar emphasizes training and ongoing development.
00:23:09
Speaker
You can't just learn these concepts intellectually. You need to practice them until they become second nature. What about cultural considerations? Healthcare environments are incredibly diverse.
00:23:22
Speaker
How do these techniques adapt across different cultural contexts? That's a really important question, Marcus. The principles remain the same. Respect, validation, safety.
00:23:33
Speaker
But the expression might vary. Eye contact norms are different across cultures. Some cultures are more direct, others more indirect. Physical space preferences vary.
00:23:45
Speaker
The key is being observant and responsive to individual cues while maintaining the core principles of non-escalation. So it's about being culturally responsive while staying true to the fundamental approaches.
00:23:58
Speaker
Exactly. And remember, Vistalar's Beyond Active Listening approach emphasizes gathering information. Part of that information includes understanding how someone prefers to communicate and what makes them feel respected and heard.
00:24:14
Speaker
Let's talk about language barriers. How do these techniques work when you're communicating across languages? Language barriers add complexity, but the nonverbal elements become even more important—your tone, body language, facial expressions.
00:24:29
Speaker
These communicate volumes even when words aren't understood. And when you do use words, keep them simple and clear. Use translators when available, but remember that your demeanor and approach are being translated, too.
00:24:44
Speaker
What about situations involving colleagues who might be resistant to these approaches? Not everyone is immediately on board with conflict management techniques. That's a reality we have to acknowledge. Some people see these approaches as soft or time-consuming.
00:24:58
Speaker
The best way to address that is through modeling and results. When people see that these techniques actually work, that they reduce complaints, improve relationships, and make work more pleasant, they become more receptive.
00:25:12
Speaker
And I imagine that leadership support is crucial. Absolutely. When leadership models these behaviors and creates expectations around professional communication, it changes the entire culture.
00:25:24
Speaker
It's not just about individual skills. It's about creating an environment of care where respectful and non-escalating communication is the norm. Let's discuss some advanced applications.
00:25:36
Speaker
What about situations where someone is under the influence of substances or experiencing mental health crises? These situations require extra care and often additional resources, but the fundamental principles still apply.
00:25:49
Speaker
Actually, they become even more important. People who are impaired or experiencing mental health crises are often more sensitive to threat and less able to process complex information.
00:26:01
Speaker
So the clarity and calm approach becomes even more critical. Exactly. Keep your language very simple. Move slowly and predictably. Reduce the environmental stimulation and use one, voice-only one person communicating with the individual in crisis.
00:26:18
Speaker
Give them extra time to process what you're saying. And always have backup. These situations might require additional team members or specialized interventions. What about dealing with grief?
00:26:31
Speaker
Healthcare professionals often encounter people who are dealing with loss or bad news. Grief is its own category, and it requires tremendous sensitivity. People experiencing grief might cycle through anger, denial, bargaining, and sadness rapidly.
00:26:46
Speaker
The key is not to take any of it personally and to provide consistent, calm support throughout all of those stages.
Emotional Resilience and Self-care
00:26:54
Speaker
Can you give an example of how these techniques might look with a grieving family member?
00:26:58
Speaker
Let's say a family member who just received bad news about their loved one says, this is all your fault. If the doctors had caught this earlier, this wouldn't be happening. Perhaps I'd begin with reflecting.
00:27:12
Speaker
You're devastated by this news, and you need answers. That's completely understandable. I'm acknowledging both their emotion and their need to make sense of the situation.
00:27:23
Speaker
What would affirmation look like here? Everyone struggles with news like this. You're angry, and it's natural to want to understand what's happening when someone you love is suffering.
00:27:34
Speaker
I'm validating their feelings without accepting responsibility for things that may not be anyone's fault. And then advocacy and summary? I'd advocate. I want to make sure you have all the information you need and that your loved one gets the best possible care moving forward.
00:27:52
Speaker
Then summarize. So you want to connect with the physician so you can get the answers you need and deserve. I can see how that approach honors their grief while still keeping the conversation constructive.
00:28:04
Speaker
Exactly. You're not being defensive, minimizing their pain, or dismissing their concerns. But you're also not allowing the conversation to become destructive or accepting blame.
00:28:16
Speaker
Let's talk about self-care. Using these techniques day after day, especially in high-stress environments, can be emotionally demanding. How do health care professionals maintain their own well-being while consistently applying these approaches?
00:28:29
Speaker
That's such an important question, and it ties into Vistalar's concept of self-compassion. You can't pour from an empty cup. Taking care of yourself isn't selfish.
00:28:41
Speaker
It's essential for being able to take care of others. What does self-compassion look like in practice? Let's face it, nursing is physically and emotionally demanding work, and the stakes are high for everyone.
00:28:53
Speaker
So it starts with recognizing that dealing with sickness, injury, conflict, and difficult emotions all day is genuinely challenging work. It's normal to feel drained or frustrated sometimes.
00:29:06
Speaker
Self-compassion means treating yourself with the same kindness you'd show a colleague who was struggling. That's key. Would you tell a peer to suck it up and move on if they were struggling?
00:29:17
Speaker
Of course not. But it's what we often say to ourselves. And what are some practical strategies for maintaining emotional resilience? Regular debriefing, either formally or informally with trusted colleagues.
00:29:30
Speaker
Taking real breaks when possible, even if it's just stepping outside for a few deep breaths. Developing rituals that help you transition between work and home. And recognizing when you might need additional support, whether that's employee assistance programs, counseling, or just talking with a friend.
00:29:49
Speaker
What about in the moment? If you find yourself getting triggered during an interaction, what can you do? Vistellar teaches the importance of staying in what they call the decision mindset, rather than slipping into reaction mode.
00:30:03
Speaker
Take a breath. Remind yourself that their behavior isn't about you personally. Focus on your goal, keeping everyone safe and finding solutions. If you need a moment to collect yourself, it's okay to say, i want to make sure I can give you my full attention.
00:30:19
Speaker
Let me just take a moment to review your chart, and then I'll be right back with you. That gives you a brief reset while still showing care for the other person.
Enhancing Team Communication and Culture
00:30:28
Speaker
And know your limits. Recognize when it's time to talk with supervisors and peers about your needs in the moment.
00:30:33
Speaker
This is another case where we judge ourselves harshly. We wouldn't turn away a colleague who said they needed time and attention to process their stress, but we usually judge ourselves as weak or incompetent when we need the same grace.
00:30:45
Speaker
Openly talking about these dynamics with coworkers can change that equation for everyone, thereby strengthening the environment of care for the better. Exactly. Asking for help isn't a sign of weakness.
00:30:56
Speaker
It's actually a sign of experience and maturity. In high-stakes professions like healthcare, it's also a sign of professionalism, such as when a pilot self-reports they are too tired to fly safely.
00:31:09
Speaker
If an interaction is escalating beyond your comfort level, bringing in a colleague or supervisor is the best choice for everyone involved, including your patients. Let's talk about team dynamics.
00:31:21
Speaker
How can these individual skills translate into better team communication and culture? When team members consistently use these approaches with each other, it creates a ripple effect throughout the entire unit.
00:31:33
Speaker
Conflicts get resolved more quickly, communication becomes clearer, and people feel more supported. It's not just about patient interactions. It's about creating a work environment where everyone can feel safe, actually be safer, and do their best work.
00:31:49
Speaker
Can you give an example of how this might look in a team setting? Sure. Let's say during a team meeting someone says, I'm tired of covering for people who call in sick all the time.
00:32:00
Speaker
Some of us are doing all the work while others get away with everything. Instead of letting this turn into gossip or blame, a team leader might use these techniques. How would that look? They might clarify, it sounds like you're concerned about workload distribution and fairness.
00:32:17
Speaker
Can you help me understand what specific situations you're referring to? They're gathering information rather than allowing general complaints. And then? Paraphrase.
00:32:28
Speaker
So you're feeling like the workload isn't being shared equally and you're concerned about burnout. Reflect. That kind of imbalance can be really frustrating, and it's important that we address it so everyone feels supported.
00:32:42
Speaker
Affirm. You have a right to expect fairness in how work is distributed. And then move toward solutions? Exactly. Advocate, I want to make sure we have a sustainable system that works for everyone.
00:32:56
Speaker
Summarize. So we need to look at our coverage policies, make sure expectations are clear, and figure out how to handle staffing challenges more fairly. Let's put together a plan for addressing these issues.
00:33:09
Speaker
I can see how that approach would prevent the meeting from turning into a complaint session while still addressing legitimate concerns. right? And it models the kind of communication we want to see throughout the team.
00:33:20
Speaker
When leaders consistently use these approaches, team members start adopting them too. What about measuring success? How do you know if these techniques are working in your organization? There are several metrics you can track.
00:33:32
Speaker
Patient satisfaction scores, particularly related to communication. Staff satisfaction and retention rates. Incident reports related to verbal conflicts or aggressive behavior.
00:33:45
Speaker
Workers' compensation claims related to workplace violence. But honestly, the most immediate measure is often just the feel of the unit. Are people more relaxed?
00:33:55
Speaker
Are conflicts resolving more quickly? Do people seem to enjoy coming to work? Those qualitative measures are often just as important as the quantitative ones. And don't forget patient satisfaction scores, because the link between staff and patient satisfaction is indisputable.
00:34:10
Speaker
Absolutely. And remember, the goal isn't to eliminate all conflict. That's unrealistic in any workplace, especially health care. The goal is to reduce unnecessary conflict and manage unavoidable conflict more effectively so it doesn't escalate unnecessarily, damage relationships, or compromise patient care.
00:34:33
Speaker
Let's talk about implementation. If a healthcare professional or team wants to start incorporating these techniques, where should they begin? Start with self-awareness. Begin paying attention to your own communication patterns.
00:34:46
Speaker
Do you tend to interrupt? Do you get defensive when criticized? Do you rush through explanations? Just becoming aware of your current habits is the first step toward changing them.
00:34:57
Speaker
And then? Practice the beyond active listening techniques in low stakes situations first. Use them with colleagues, with family members, in everyday interactions.
00:35:09
Speaker
Get comfortable with the approach before you need to use it in a crisis. What about team-wide implementation? That's where formal training becomes valuable. Vistalar's conflict management programs provide systematic training in these techniques, along with opportunities to practice in realistic scenarios.
00:35:28
Speaker
But even without formal training, teams can start by committing to basic principles, really listening to each other, validating concerns before jumping to solutions, staying curious rather than judgmental.
00:35:41
Speaker
Are there any common mistakes people make when they're first learning these techniques? The biggest one is being too mechanical or artificial. These techniques work because they demonstrate genuine care and respect.
00:35:53
Speaker
If you're just going through the motions, people will sense that. The goal is to internalize these approaches so they become natural expressions of your professional values.
00:36:04
Speaker
What about the mistake of believing these techniques guarantee positive outcomes in all cases? That's a great point. Sometimes people think that if they use the right words or techniques, they can guarantee a particular outcome.
00:36:17
Speaker
But that's not how it works. These approaches increase the likelihood of positive outcomes, and experience has shown that they will. but you can't always control other people's responses.
00:36:28
Speaker
The goal is to do your part as trained to keep interactions safe, respectful, and constructive.
Communication in High-pressure Environments
00:36:35
Speaker
In this way, you will increase the probability of better outcomes and place yourself in a better position to explain and defend your decisions and actions when questioned.
00:36:46
Speaker
Let's talk about some specific challenges that come up in different health care settings. Emergency departments, for example, have their own unique pressures. Emergency departments are incredibly challenging environments for these techniques because everything is urgent, emotions are high, and time is limited.
00:37:03
Speaker
But that's also where they're most needed. In the ED, you might have to compress the entire beyond active listening process into just a few minutes. Can you give an example of how that might look?
00:37:16
Speaker
Let's say a patient comes in clearly agitated saying, I've been in pain for hours and the triage nurse barely looked at me. You might quickly clarify, OK, I'm glad you told me.
00:37:27
Speaker
Tell me about your pain. Paraphrase. So you're having significant pain and you're frustrated about the wait. Reflect. That combination of pain and waiting must be really difficult.
00:37:39
Speaker
I'm here to help. Affirm. Pain is always concerning and you were right to come in. And then quickly move to action? Right. Advocate. Let me assess your pain and see what we can do to help you feel better.
00:37:54
Speaker
Summarize. So I'm going to examine you. We'll get some more information about your pain, and then we'll determine the best way to address it. Does that sound okay?
00:38:05
Speaker
The entire process might take two minutes, but it completely changes the dynamic. Exactly. And in the ED, that can be the difference between a patient who cooperates with treatment and one who becomes increasingly difficult throughout their visit.
00:38:19
Speaker
What about long-term care settings, where relationships are ongoing rather than brief? Long-term care has its own challenges and opportunities. The advantage is that you have time to build relationships and really understand individual residents' communication, preferences, and triggers.
00:38:36
Speaker
The challenge is that conflicts can fester over time if they're not addressed well. So the investment in good communication pays off over months and years rather than just during a single visit.
00:38:48
Speaker
Absolutely. In long-term care, you might encounter a resident who becomes agitated every time they need assistance with personal care. Using these techniques consistently over time can help you understand what's driving that agitation and find ways to make the experience more comfortable for them.
00:39:06
Speaker
What about outpatient settings? Outpatient settings often involve frustrated patients who feel like they can't get appointments when they need them, or who are dealing with insurance issues, or who are managing chronic conditions that affect their quality of life.
00:39:22
Speaker
These techniques are incredibly valuable for building trust and maintaining therapeutic relationships over time. Let's address something that might be on our listeners' minds. In healthcare, care there are times when you have to deliver news that people don't want to hear or enforce policies they don't like.
00:39:38
Speaker
How do these techniques apply when you can't give people what they want? That's where these skills really prove their value. You can't always give people what they want, but you can always treat them with respect and dignity.
00:39:51
Speaker
Let's say a patient wants a prescription for a medication that's not appropriate for their condition. You can't prescribe it, but you can validate their desire to feel better and work with them to find alternatives.
00:40:03
Speaker
Can you walk through how that might sound? Sure. They might say, I need you to prescribe this medication. It's the only thing that helps. Instead of just saying no, you might clarify, help me understand what symptoms you're hoping to address with that medication.
00:40:19
Speaker
Paraphrase. So you're looking for relief from these specific symptoms, and you've had some success with this medication in the past. Then what? Reflect. It's frustrating when you know what has helped you before and you want to get back to feeling better.
00:40:35
Speaker
Affirm. You're absolutely right to want relief from these symptoms. Then advocate. I want to help you feel better too. Let me explain why this particular medication might not be the best choice right now.
00:40:49
Speaker
And let's talk about other options that might be even more effective. So you're not just shutting them down. You're redirecting towards solutions. Exactly. And summarize. So we both want you to feel better.
00:41:02
Speaker
I can't prescribe that specific medication for medical reasons, but let's work together to find something that will help with your symptoms safely. That approach honors their concerns while still maintaining appropriate medical standards.
00:41:15
Speaker
Right. People are much more likely to accept limitations when they feel heard and when they understand that the limitation is in service of their well-being, not just an arbitrary policy.
00:41:27
Speaker
What about situations involving safety concerns? Sometimes in healthcare, people want to do things that aren't safe, or they resist necessary safety measures? Safety concerns require clear boundaries, but these techniques can help you enforce those boundaries in a way that maintains dignity and cooperation.
00:41:46
Speaker
Let's say a patient wants to get up and walk around when they're a fall risk. You can't let them do that unsupervised, but you can validate their desire for mobility and work together on safe alternatives.
00:41:59
Speaker
How would that conversation go? You might start with clarification. Help me understand what you're hoping to accomplish by getting up without assistance. They might say they're restless or they need to use the bathroom or they just want to feel more independent.
00:42:14
Speaker
Then you can paraphrase. So you're feeling restless and you want to move around a bit. Reflect. It's hard to be stuck in bed when you're used to being active. And then work towards safe solutions?
00:42:26
Speaker
Exactly. Affirm. Wanting to be mobile and independent is completely normal. Then advocate. I want to help you be as active as possible while keeping you safe.
00:42:38
Speaker
Summarize. So let's figure out how we can help you get some movement and address your restlessness without risking a fall. That's so much more effective than just saying, you can't get up and leaving it at that.
00:42:50
Speaker
Right? And it often leads to creative solutions that meet everyone's needs. Maybe you can arrange for supervised walks or physical therapy visits, or even just helping them move to a common area for a change of scenery.
00:43:03
Speaker
As
Building a Culture of Safety and Efficiency
00:43:04
Speaker
we start to wrap up, let's talk about the bigger picture. How do these individual communication skills contribute to the overall culture of safety and health care? Communication is actually at the heart of most safety issues in healthcare.
00:43:18
Speaker
When people don't feel comfortable speaking up about concerns, when information isn't shared clearly, when conflicts interfere with teamwork, these communication breakdowns can directly impact patient safety.
00:43:30
Speaker
So improving communication skills isn't just about being nicer. It's about creating environments where people can do their best work. Exactly. When people feel heard and respected, they're more likely to follow safety protocols, more likely to report near misses, more likely to ask for help when they need it.
00:43:49
Speaker
All of these behaviors directly contribute to safety and better patient outcomes. And these skills help with staff retention too, which is crucial in today's healthcare care environment. Absolutely.
00:44:00
Speaker
People don't leave jobs because of the work itself. They leave because of how they're treated. When healthcare care organizations invest in communication skills and conflict management, they're investing in their people.
00:44:13
Speaker
And in healthcare, care your people are your most important asset. What would you say to someone who's listening and thinking, this all sounds great, but I barely have time to eat lunch, let alone have extended conversations with every upset person I encounter?
00:44:28
Speaker
I'd say I understand that concern completely, and it's exactly why these skills are so valuable. When you prevent escalation on the front end, you save enormous amounts of time on the back end.
00:44:40
Speaker
One two-minute conversation using these techniques can prevent hours of dealing with complaints, incident reports, or damaged relationships. And these approaches often make interactions more efficient, not less.
00:44:54
Speaker
Right? When people feel heard quickly, they cooperate better, they provide better information, and they're more likely to follow instructions. All of that actually saves time.
00:45:05
Speaker
What's your advice for health care leaders who want to implement these approaches in their organizations? Start with modeling. Leaders need to demonstrate these communication skills in their own interactions with staff.
00:45:17
Speaker
You can't expect frontline workers to use respectful, de-escalating communication with patients if leadership isn't using the same approaches with them. And then provide training and support.
00:45:29
Speaker
Vistalar's conflict management programs are designed specifically for health care environments, and they provide both the theoretical framework and practical skills that people need. But even beyond formal training, create opportunities for people to practice these skills and discuss challenging situations.
00:45:47
Speaker
What about accountability? Make professional communication an explicit expectation, not just a nice-to-have. Included in job descriptions, performance evaluations, and promotion criteria.
00:45:59
Speaker
Recognize and celebrate examples of excellent conflict management, not just clinical excellence. Before we close, let's talk about hope. Healthcare care can be challenging, and conflict is inevitable.
00:46:13
Speaker
But what gives you hope about the potential for these approaches to make a real difference? What gives me hope is seeing how quickly these techniques can transform individual interactions and, over time, entire unit cultures.
00:46:27
Speaker
I've seen emergency departments go from chaotic, stressful environments to places where people actually enjoy working. I've seen patient satisfaction scores improve dramatically.
00:46:38
Speaker
I've seen staff turnover and injury rates drop significantly. And on
Ethical Commitment and Summary
00:46:43
Speaker
an individual level? On an individual level, I've seen health care professionals rediscover why they went into health care in the first place.
00:46:52
Speaker
When you're not constantly dealing with conflict and drama, when interactions with patients and families are more positive, when you feel competent in handling difficult situations, that's when you can focus on the healing work that drew you to health care.
00:47:08
Speaker
That's beautiful. And I think our listeners should remember that every expert in these techniques started as a beginner. These skills can be learned, and they get easier with practice. Absolutely.
00:47:19
Speaker
And remember Vistalar's core principle. We cannot control the outcome of every interaction, but we can always manage the process. When you focus on managing your part of the process well, using respectful communication, staying calm, looking for solutions, you're doing everything within your power to create positive outcomes.
00:47:42
Speaker
And no one can question that. That's such an empowering way to think about it. You can't control other people's behavior, but you can control your response, and your response has tremendous power to influence the direction of any interaction.
00:47:55
Speaker
Exactly. And in health care, where you're dealing with people at their most vulnerable moments, that power comes with real responsibility. Using good speak isn't just a communication technique.
00:48:08
Speaker
It's an ethical commitment to treating every person with dignity and respect, even in difficult circumstances. Well said. I think our listeners have gotten a comprehensive look at how to use verbal and nonverbal communication as shields in healthcare environments.
00:48:22
Speaker
We've covered the theoretical framework, practical techniques, specific scenarios, and implementation strategies. And we've emphasized throughout that these aren't just soft skills.
00:48:33
Speaker
They are practical safety and treatment techniques. This podcast uses synthetic voices to share Vistalar's training and communication strategies.