Author: Claire Adams

Being in the Emergency Department is an emotional experience for patients and their families. Working as a Nurse in the ED its inevitable you will come across angry or aggressive patients and family at some point for several different reasons. That’s why is good to know some essential de-escalation tips….



Listen- Identify why the person is angry- is may be that the patient is in pain or there has been poor communication regarding the patient plan or department flow. Use open-ended questions. Try to do it in a private or quieter area.

Be Aware- being aware of your body language, aggressive or passive reactions may escalate the situation further. Use eye contact, your posture should be open and non-threatening. Be aware of the persons body language, there may be signs of the situation escalating. Be aware of your surroundings and people around you.

Be Calm- talk to the person in a calm, honest, assertive manner. Apologise to the patient or family if something has happened.

Offer- can you resolve this situation easily by offering a simple solution? For example, analgesia if a patient is in pain or a trolley to lie down on.

Plan- Implement the plan you have came up with patient or family. If you haven’t been able to come to a conclusion, ask for help. Don’t feel bad we can’t do everything and make everyone happy all the time.

Ask for Help- getting the Nurse in charge or the Doctor looking after the patient to speak to the patient or family is always useful. This shows that you acknowledge the significance of the situation and they may be able to offer something you are unable to.

Documentation- Remember to document everything in the patient’s notes.

Reflection- can you do anything to prevent this situation in the future? If you have been upset by this situation it’s ok to talk to your colleagues and manager. We have all been there at some point.


Listen, be aware, be calm, offer, plan or ask for help and document!

Hannah Bell