Does Zero Tolerance Leave Room for Life Saving Negotiations?
Mel Cortez
Always Innovating to Reduce Violence in Healthcare & Schools | Non profit Founder | Author | Keynote Speaker | Security is not the absence of threat, but presence of connection.
The most dangerous negotiation is the one that you didn't know you were in. - Chris Voss
When I began my journey 4 years ago to finding better solutions for workplace violence, like many students of security, I learned from Chris Voss. His book, "Never Split the Difference" is a must read for anyone, especially those working in a customer service based industry that has now become the most violent place to work, second only to an underground mine.
When I explain to organizations why A Zero Tolerance policy in healthcare is a bad idea, I reference Chris Voss's theories on trust and negotiation. In this article I will reference this thought leader and explain why Zero Tolerance creates challenges for nurses when dealing with patients.
I dive more into these concepts and theories in detail in my ebook, A Nurses Guide to Healing Workplace Violence in Healthcare. ORDER PART 1 HERE.
1. Building Trust:
????- Effective negotiation relies heavily on building trust and establishing rapport. Voss emphasizes the importance of creating a safe environment where the other party feels heard and understood, which is essential for cooperative problem-solving.
????- A zero tolerance policy can undermine trust because it removes the opportunity for nuanced, empathetic responses to patient behavior. Patients who sense a rigid, punitive approach may feel alienated, defensive, and less likely to engage openly with healthcare providers.
2. Empathy and Understanding:
????- Voss advocates for tactical empathy—understanding the emotions and perspectives of the other party to build rapport and influence outcomes. This involves active listening and validating the other person’s feelings.
????- Zero tolerance policies do not allow for the empathetic engagement that Voss recommends. They enforce a strict, one-size-fits-all response that can prevent nurses from addressing the underlying causes of a patient’s behavior, such as pain, fear, or mental health issues.
3. Flexibility and Adaptation:
????- Successful negotiators must be flexible and adaptive, tailoring their strategies to the specific situation and individual they are dealing with.
????-A zero tolerance policy is inherently inflexible. It mandates a predetermined response regardless of context, preventing nurses from adapting their approach to de-escalate situations or address unique patient needs.
4. Creating Safety:
????- Creating psychological safety is crucial for productive dialogue. Voss argues that people are more likely to cooperate when they feel safe and respected.
????- Zero tolerance policies can create an environment of fear and uncertainty, both for patients and staff. Patients who fear punitive measures may become more agitated or uncooperative, making it harder for nurses to manage situations calmly and effectively.
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5. Communication and Negotiation Skills:
????- Effective communication is key to negotiation. Voss highlights the importance of clear, calm, and strategic communication to guide the other party towards a desired outcome.
????- These policies limit the scope for communication and negotiation. When nurses are required to follow strict disciplinary measures, their ability to use negotiation skills to de-escalate and resolve conflicts is significantly reduced.
Practical Implications for Nurses:
- Patient Relationship: Nurses may find it harder to establish positive relationships with patients who exhibit challenging behaviors, as these patients might perceive the healthcare environment as hostile or unaccommodating.
- Conflict Resolution: The ability of nurses to resolve conflicts through dialogue and understanding is hampered by the inflexible nature of zero tolerance policies.
- Care Quality: The overall quality of care may decline if nurses are unable to employ personalized approaches to manage and treat patients exhibiting disorganized or violent behavior.
-Physical Safety: The nurses ability to gain trust, and remain on the "side of the patient" will keep them safe and can potentially reduce their likelihood of becoming a target of a weapons related event.
Ethical Considerations:
- Duty of Care: Nurses have an ethical duty to provide compassionate care to all patients, including those who might exhibit challenging behaviors. Zero tolerance policies can conflict with this duty by leading to exclusion rather than engagement and support.
- Professional Integrity: Such policies can also impact the professional integrity of nurses, who are trained to use their judgment and skills to manage complex patient interactions.
In summary, while zero tolerance policies aim to create safer work environments, they often conflict with the principles of trust, empathy, and flexibility that are central to effective negotiation and patient care. This can make it more difficult for nurses to manage patient behaviors constructively and ethically.
To work with Mel to create sustainable and profitable strategies to keep your patients, staff and visitors safe, book a FREE consultation here!
Nurse. Innovator. Author. Speaker. LinkedIn Top Voice, First Nurse Featured on Ted.com, Forbes Business Council, President Emeritus: SONSIEL, Chief Nursing Officer
9 个月Great article Mel Cortez !!! Keep educating and advancing the need for better safety and training protocols for nurses - you are making a difference!!!
Nationally Recognized Security Leader & Speaker
9 个月As more hospitals begin to adopt Workplace Violence Prevention Programs, it has become a common tagline to say "We have zero tolerance toward violence." A poster on the wall is not enough. The reality as you point out is often quite different - because a lot of violence often IS tolerated. This could be by uninformed/overwhelmed leadership (it's not a big deal) or adopting explanations as excuses (the patient has behavioral health issues). I tend to prefer the "Not Zero Tolerance, Zero Incidents" approach adopted by a number of organizations. The overarching goal becomes driving a safety culture where 'NO ONE GETS HURT'
Hawaii's Top Cop, Former Hostage Negotiator, Human Interaction Expert, Hall of Fame Speaker. Using the Power of Respect to Transform Chaos to Calm and Improve the Bottom Line,
9 个月Mel Cortez you bring forth really great and useful points; and while all of them are of equal validity and importance, a common thread that binds them together is respectful communication in their application. Effective Communication is a two-way flow of information and as you point out, Zero Tolerance is a one-sided, predetermined response that does not allow for true communication to take place. Thank you for sharing this great information that is not only applicable to the nursing profession, but ito all business.
Personal Safety & Violence Reduction Specialist
9 个月Would like more information to buy this and mr Voss books
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9 个月A great work. Thank you for this perspective post.