Joel Lashley

Preventing Healthcare Violence – Joel Lashley

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In “Preventing Healthcare Violence,” Bill returns to the topic of healthcare security with his guest, Joel Lashley. Joel is the author of “Confidence in Conflict for Healthcare Professionals: Creating an Environment of Care that is Incompatible with Violence” and is a certified Verbal Defense and Influence instructor.

As we mentioned in our conversation with Dick Sem, healthcare is by far the most violent profession. Nearly seven in every ten non-fatal assaults on American workers that force the victim to take time off work are perpetuated against healthcare workers.

You’ll really enjoy Bill’s chat with Joel and will gain further insight into the silent problem of violence affecting healthcare professionals everyday.

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Healthcare Myths 4 0f 7 – People behave badly because they are sick

Healthcare providers deal with conflict a lot on the job, and sometimes that includes rude, obnoxious and even threatening patients and visitors.  Part of the reason people can behave badly in a hospital or clinic is no doubt because they or a loved one is sick or injured.  But is that the only reason?  Are there things we could be doing as providers that could reduce the levels of stress and effectively set limits on challenging behaviors?  Can an “environment of care” be made incompatible with anti-social and threatening behavior?  Absolutely, once we understand that the major element of the “environment of care” is its people!

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What are your thoughts?  Do you agree or disagree with Joel’s observations?   Let us know what you think in the comments section.

If you want more more information about healthcare issues, concerns and solutions, make sure to check out Joel Lashey’s new book,  Confidence in Conflict for Healthcare Professionals.

http://www.amazon.com/Confidence-Conflict-Health-Care-Professionals/dp/0990910911

 

Point-of-Impact Crisis Intervention Instructor Training conducted at the Camden County PD

Hello.

This is Gary Klugieiwicz.

Joel Lashley and I just completed a three day Point-of-Impact Crisis Intervention (P.I.C.I.) Instructor Training Class for the Camden County Police Department.  There were thirty-one instructors in the class from the CCPD and other local agencies.  The purpose of the training was to train instructors to train local police department officers in how to recognize, respond to, and manage persons in crisis.   A unified approach was developed to respond to the three types of persons in crisis:  persons in short term crisis, persons under the influence of drugs & alcohol, and persons with mental health illness or brain-based disorders, such as Autism & Alzheimers.  This program was part of ongoing series of training programs provided by Jack Hoban, president of Resolution Group International (http://www.resgroupintl.com) that incorporates ethics training along with verbal and physical tactics.

In the Verbal Defense & Influence program, we explain the 5 C’s of Communication, i.e. (Initial) Contacts, (Verbal) Conflict, (Verbal) Crisis, (Physical) Combat, and Closure (After Contact).   The beauty of the P.I.C.I. Program is that it applies basic VDI Tactics to crisis management.   The instructors in the class learned the importance of utilizing the Universal Greeting to initiate a non-escalative approach to all contacts – even when the person is exhibiting all the signs & symptoms of being in crisis.   Redirection is used to “Interrupt the Person’s Pattern of Behavior.”  The Persuasion Sequence is used to persuade the person in crisis of ways to return to more safer behavior.   Ethical Intervention is used to keep a “Caring Watch” over each other to prevent the intensity of the situation of getting out of hand for the care-givers who are there to bring order out of disorder.  While all the 5C’s apply to all potential conflicts, the emphasis of the P.I.C.I. Program is crisis management.

On day one, I introduced the Basic VDI Concepts to the class providing focused activities on the ten components of the Communication Under Pressure (CUP) Card.  On day two, Joel Lashley introduced his “Managing Brain-based Disorders” Program along with Special Needs Strategies that included how to reduce stimulation to the person in crisis, how to separate & support the person in crisis.  how to use adaptive communication to “communicate” with different types of persons with special needs, and how to meet a persons in crisis urgent unmet needs.   Day three consisted of the development of courseware for their classes that included crisis intervention management demonstrations videos and videos documenting the instructor’s personal peace stories managing a person in crisis.

We were assisted at this training by Joe Potterton, a nationally known healthcare trainer, crisis intervention specialist, and VDI Instructor.

Joel Lashley and I would like to thank the instructors who attended the class for their contribution of both their experiences and time-tested expertise to the success of this class.

For more information about the Vistelar training programs, check out  http://vistelar.com/training-calendar/

Healthcare Myths Video 2 of 7: If you say something, you will make it worse

Healthcare Myth Video 2 of 7: If you say something, you will make things worse.

Joel Jashley, a Vistelar Trainer and nationally known healthcare expert, explains the second the myth concerning violence in healthcare that “If You Say Something, You Will Makes Things Worse.”

When faced with disrespectful or threatening language, the silence of onlookers is loaded with meaning. Usually, their silence means their afraid or unsure of what to do. Yet silence is usually how we answer anti-social and even threatening behavior in the public setting. Does our silence make us safer? Is it the right response? Does allowing people to “vent” really de-escalate them? In truth, when people are behaving badly, the last thing we may want to be is silent. And when people in crisis, silence might be saying, “I don’t care.”

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Watch for the next six of these cutting-edged videos.

Make sure to comment below on your thoughts, feedback, and experiences with this second myth.

Healthcare Myths Video 1 of 7: Killing Them with Kindness

Joel Lashley, a Vistelar Trainer and nationally known healthcare safety expert, explains the Seven Myths surrounding Violence in Healthcare.  Here is the first video that explores the myth the if you Kill them with Kindness, you will be safer on the job.

“Kill them with kindness”—does that really work?

If you’ve been a nurse for any length of time, you’ve probably been given that advice. The reasoning behind it being, if we lavish extra attention on people who treat us disrespectfully, they might start to like us and stop treating us badly. That approach rarely ever works. In rare cases, it might work for you. But the aggression is usually just redirected towards someone else, like another provider. In that case you become the bully’s ally, simply legitimizing their aggressive behavior towards others.

We wouldn’t advise our kids to be subservient to their bullies, would we? Why not? Though the goal may be to win the bully over, the goals of a bully are simply to dominate, control, and objectify. We instinctively know that bullies cannot be placated by killing them with kindness. Yet it’s often the approach we take in healthcare, usually because we are unsure about what to do. When we are unskilled at setting limits, offering solutions, or making amends when we are truly in the wrong, we are almost assured of negative outcomes.

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Watch the video and share your thoughts, comments, and experiences in the comment section.

 

Healthcare Myths Video 3 0f 7: Violence is just part of the job

This is Joel Lashley’s third installment of his Seven Healthcare Myths Video Series entitled “Violence is just a part of the Job.”

Have you ever been told that violence is just part of the job?  What would your spouse, parent or child think if you went home and told them that accepting violent assaults on your job was a work requirement?  Does being accepting of violence keep people safer? If we accept violence into our lives we’re bound to get plenty of it. Violence is always unacceptable no matter where we work and we have to make that clear to everyone – patients and staff alike.

 

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What are your thoughts on this video?  Do you agree with its findings?  Comment below.

Healthcare Myth 1 – “Kill them with kindness”

“Kill them with kindness”—does that really work?

If you’ve been a nurse for any length of time, you’ve probably been given that advice. The reasoning behind it being, if we lavish extra attention on people who treat us disrespectfully, they might start to like us and stop treating us badly. That approach rarely ever works. In rare cases, it might work for you. But the aggression is usually just redirected towards someone else, like another provider. In that case you become the bully’s ally, simply legitimizing their aggressive behavior towards others.

We wouldn’t advise our kids to be subservient to their bullies, would we? Why not? Though the goal may be to win the bully over, the goals of a bully are simply to dominate, control, and objectify. We instinctively know that bullies cannot be placated by killing them with kindness. Yet it’s often the approach we take in healthcare, usually because we are unsure about what to do. When we are unskilled at setting limits, offering solutions, or making amends when we are truly in the wrong, we are almost assured of negative outcomes.

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Instead, we should learn to discriminate between service recovery situations and anti-social or threatening behavior. We also need to be skilled at identifying people in genuine crisis. When people are cursing or yelling at us, or calling us names and otherwise treating us disrespectfully, simply lavishing extra attention on them sends the wrong messages. Messages such as, “It’s okay to treat us that way”, or worse yet, “Disrespecting me gets you what you want.” Perhaps the most dangerous message of all is, “I’m afraid and you can use that to control me.” This is the same sort of cycle that is present in all inter-personal cycles of violence, whether it’s a bullying situation or a domestic violence relationship. And when people are in crisis, we need to offer them privacy and support that is trauma informed and focused on our patients. That is perhaps the kindest thing we can do for them.

-Joel Lashley, author of Vistelar’s new book focused reducing violence and conflict in the healthcare environment. To get your own copy of the book, check it out on Amazon: http://amzn.com/0990910911

healthcare book

 

 

Great New Book for Healthcare Ethical Protectors & Caregivers

Hi Everyone. Robert Whiteside here.

Yesterday I arrived home, and was greeted by a package. Opening it, I found the new book entitled, Confidence in Conflict for Healthcare Professionals, by Joel Lashley. I can’t read it fast enough!

CinC-Healthcare-Pros_cover (2)-1Joel has worked in Public Safety for over 3 decades and in healthcare security since 1991. He really knows his stuff, and this new book is outstanding. We highly recommend it for all of our healthcare security colleagues, clinical caregivers, and indeed any role which exists in healthcare facilities.
The book contains chapter after chapter of stories (which are so very effective in conveying teachings) as well as practical strategies, tactics, and tools including the Five Maxims, the Universal Greeting, Beyond Active Listening, Bystander Mobilization, and much more.
Joel mentions regulatory/accrediting agencies which, for those of us in healthcare security management, oversee our operations. These include The Joint Commission, OSHA, and the CDC. This is important, as any healthcare professional knows that our operations must meet various (often quite challenging) regulatory guidelines.
Another aspect of Joel’s book which we very much like is the presence of quotes at the beginning of each chapter. Individuals as varied as Aleksandr Solzhenitsyn, Edmund Burke, Mahatma Ghandi, and Gary Klugiewicz are represented. What a table of folks with whom to have a conversation about getting along well with our fellow human beings!
This book is great. Every page gets better. It is a tool which will assist any healthcare professional to create (as Joel states), “environments of care that are less compatible with anti-social and aggressive behaviors, but also more compatible with patient collaboration and better patient outcomes.”
Obtain this book; implement its teachings; and improve the atmosphere and safety of your healthcare facility!

Pick up a copy of our new book on Amazon today! http://amzn.com/0990910911

Milwaukee County Sheriff’s Office To Host Wisconsin Jail Association Worship On Verbalization, Proxemics, Bystander Mobilization and Crisis Intervention Strategies

The Wisconsin Jail Association is conducing an eight (8) hour workshop on Friday, November 6, 2015 at the Milwaukee Country Sheriff’s Office Training Academy (9225 South 68th St, Franklin). Instructors for the workshop are from Vistelar, a Milwaukee-based conflict management training company, and will include Gary Klugiewicz, Joel Lashley, Pete Jaskulski, Mike Mastaw, Derrick S. Washington, Sr, Jill Weisensel and Bob Willis. Online registration is at http://www.wjawi.org.

Gary Klugiewicz, Director Training at Vistelar, said, “We are excited to be putting on this workshop for Wisconsin correctional professionals.  This cost effective, information packed, training event will provide valuable additions to the attendee’s tactical tool belt while introducing them to the valuable resources provided by the Wisconsin Jail Association.”

Here is just some of what attendees will learn:

  • Staying safe and defending your verbal and physical response in a video rich world
  • Communicating with, persuading, and non / de-escalating people who are different from you
  • Utilizing Point-of-Impact Crisis Interventions (P.I.C.I.) tactics that reduce conflict and promotes safe resolution
  • Developing your tactical verbal response and translating it into your verbal testimony and written reports
  • Mastering tactics for controlling distance, relative positioning, and proxemics to stay safe in close quarter encounters.
  • Using Bystander Mobilization to get people to intervene before things get out of hand.
  • Keeping everyone safer with RIPP restraints during non-cooperative prisoner escort / transportation.

The normal cost of the workshop is $35.00 but it’s free for those who attended the 2015 Wisconsin Jail Association Annual Conference. Refreshments and lunch will be provided.

The Wisconsin Jail Association is a nonprofit organization dedicated to supporting those who work in and operate Wisconsin Jails. Vistelar is a global consulting and training organization focused on preventing and managing conflict at the point of impact (www.vistelar.com).

How Much Danger Am I In?

Though it rarely occurs to anyone entering the healthcare field that they might experience high levels of conflict and violence, soon after beginning their clinical training, providers are taught to accept a culture of violence. That’s because the culture of healthcare embraces the belief that violence is part of the job.  From one certainly tragic point of view, the people who embrace this notion are absolutely right.  Violence is a day-to-day reality in healthcare.

How bad is the problem?  Among the ranks of risk management professionals, workplace violence is a much talked about issue. But is workplace violence an even larger issue in healthcare? If the federal government’s own statistics, from sources such as the Bureau of Labor Statistics are to be believed, healthcare is the most violent profession.  In fact, people who work in healthcare are at least seven times more likely to be assaulted on the job than average.   That’s higher than any other profession, including law enforcement and corrections.

One of the more prevalent misperceptions is that these grim statistics include numbers of minor assaults, such as shoves or spitting incidents.  Nothing could be further from the truth.  In order to qualify for the government’s statistics, workers must have suffered enough of an injury to miss time from work.  We can place these numbers into an even clearer perspective, by accepting the following reality.  None of these statistics represent all of the so called “minor” assaults, such as slaps, shoves, unwanted sexual touching, spitting, verbal threats, and other assaults that do not result in time off from work.  This represents an even greater number of uncounted assaults, because healthcare workers are notorious for accepting and under-reporting violent incidents. Police officers and prison guards are not so forgiving and rightly so.

In their groundbreaking surveys between 2009 and 2012, the Emergency Nurses Association discovered that half of all emergency department nurses surveyed have been the target of violence and threats on the job. Also, half of those who reported said they had experienced twenty or more violent and/or threatening incidents, during their last three years on the job.  Overall, even according to the government’s statistics, which are limited to assaults resulting in injury, around 20,000 registered nurses are assaulted annually and over 40,000 nursing assistants! Physicians, respiratory therapists, hospital security officers, x-ray technicians, social workers, and many others are also assaulted at unusually high rates.

The loss of quality healthcare workers, due to violence related turnover and the hundreds of millions of dollars lost annually from injuries are devastating.  In a very real way, violence in healthcare has become one of the medical profession’s biggest problems and can no longer be contained as one of its dirty little secrets.

The following story is a blatant example—albeit an all too familiar one—of a level of acceptance that is perhaps unique to healthcare.  While merely engaged in a casual conversation, a law enforcement professional asked a healthcare professional how her day was going. She related that moments earlier she had almost been physically and sexually assaulted. This Nurse Practitioner was able to escape from the situation by having done an appropriate assessment and using some evasive tactics.

After escaping the potentially catastrophic attack, she told the shocked police officer that the police were not contacted and that she simply went to a location where others were present and waited for her attacker to leave the scene.  She did say that she notified her supervisor and documented the incident in the patient’s medical record.  The scariest part of the whole interaction was that not only didn’t she feel the need or the right to access the criminal justice system, but that she did, in fact, report the incident to her employer and no law enforcement action was deemed necessary.

To make things perhaps even worse, due to a general misunderstanding of HIPAA and other laws  governing patient confidentiality, she did not feel that she was able to notify the police.  She also told the officer that all her previous training as a nurse caused her to accept that “these things just happen” and that they must be accepted as “part of the job”.  She also believed that if she were to pursue an investigation of the incident, it was quite possible that she would lose her job.

In her interpretation of her role as a provider, she believed that there was actually no recourse for her as a victim.  In her mind, her position as a provider denied her not only  access to the criminal justice system, but even to a reasonable expectation of safety.  There was no system in place, set by the employer, to protect her from any future occurrence.  Instead, there was a professional culture in place to protect the offender from prosecution.  Obviously, the environment of care in which she was working was compatible with violence; furthermore, her acceptance of risk for violent behavior was an expectation of employment.  But is that reasonable or even uncommon?

Before we even begin to consider our rights under the law, our beliefs should always be subjected to the smell test of reasonable expectation.  It’s time we ask ourselves, would she have adopted the above belief system if she were a waitress or a police officer?  The answer seems obvious, doesn’t it?  Then why is it okay to sexually assault a healthcare provider?  If she asked a peer or her boss, if this was an acceptable risk, perhaps they might have answered yes.  But what if she asked her mother or her husband?  What would any of their perceptions have been?  In all likelihood, they wouldn’t have been as accepting as someone who works in the healthcare field.

This scenario and many like it also begs the question, what if her attacker had just been a visitor or a relative of her patient?  What if he had been a fellow employee or just some courier delivering a package to the clinic?  The relationship between patient and provider is special, but is culpability for violent behavior really just a matter of context?  Do any solid lines exist that no one may cross in the patient-provider relationship?  That blurry line is at the heart of the problem of violence in healthcare.  Providers cannot begin to protect themselves from violence in their profession, if they cannot first agree that they are entitled to their own personal safety and basic human dignity.