Security in Healthcare: A Shift from Violence Reduction to Clinical Security

In healthcare, we often find ourselves reacting to crises—workplace violence, escalating patient confrontations, or unforeseen threats. But what if we changed our approach? What if we focused not just on reducing violence but on building something far more integral to our daily lives in healthcare? That's what I call, Clinical Security.

As a nurse, I’ve seen firsthand the pressure we face in fast-paced, high-stress environments. The nature of our work exposes us to physical, emotional, and mental risks. Yet, for too long, security has been treated as something that happens outside our clinical responsibilities, something separate from patient care.

I believe in the idea that security is not the absence of threat but the presence of connection. We are not just victims in the environments we work in. We have the power, through preparation and connection, to create safer spaces—not just for ourselves but for our patients and colleagues too.

Clinical security is about bringing security into the fabric of healthcare itself. It’s not a one-size-fits-all solution or something we can leave to security officers and cameras alone. It’s a proactive approach that integrates safety with clinical care—understanding the unique risks of our environments and building the skills, policies, and mindset needed to prevent crises before they happen.

Changing the Approach

What does it mean to shift from violence reduction to clinical security? It means recognizing that we can’t just react to incidents—we need to get ahead of them. It’s about creating connections between staff, understanding the dynamics that lead to tension or aggression, and having the tools and confidence to address these situations.

In my work, I’ve developed a model of tactical healthcare, which means equipping healthcare professionals with practical, real-world skills that enable them to act decisively in high-stakes situations. This includes the use of resonate language, which connects with people on an emotional level and ensures communication is effective in reducing tension, and tactical empathy, the skill of understanding the underlying needs and emotions driving behavior in a crisis to facilitate an end positive patient goal. These are not just soft skills but essential tools for building trust and safety in healthcare environments.

Instead of focusing on de-escalation, I advocate for what I call counterbalance—a method of shifting the dynamics in tense situations, not by merely calming things down, but by applying equal measures of empathy and authority. Counterbalance acknowledges that there’s often more than one issue at play and that by addressing both the emotional and practical needs of a situation, we can prevent things from getting worse. The word de-escalation is dismissive and often a buzz word that is used to placate poor training and high dollar amounts not suitable for a clinical environment.

When we shift our focus to clinical security, we also shift from a mindset of fear and helplessness to one of control and connection. We take ownership of our environments, understanding that we have the tools to keep ourselves, our patients, and our colleagues safe.

A Proactive, Tactical Mindset

I’ve always believed that preparation is power. Part of my approach includes training healthcare professionals to develop a tactical mindset—thinking strategically about safety while delivering patient care. This doesn’t mean being hypervigilant at all times, but it does mean being prepared and having protocols that integrate seamlessly with our clinical workflows.

We’re not helpless in these situations. We’re highly capable professionals, and when we’re trained to think about security proactively, we can prevent so many of the incidents that leave lasting impacts on our teams and patients.

This approach includes things like situational awareness, emotional regulation and safe distance training that help clinicians understanding the triggers of violence. The training should align security protocols with our clinical responsibilities. When everyone is on the same page, from the front desk to the clinical floor, we create an environment where threats are minimized because we’re all part of the solution.

Connection is the Key

The heart of clinical security is connection. It’s about creating environments where people feel safe because we understand the threats and have built systems to manage them. It’s not about isolating or separating security from patient care—it’s about integrating the two in a way that makes everyone feel valued and protected.

Healthcare security shouldn’t feel like an afterthought, and it definitely shouldn’t be something that falls entirely on our shoulders after an incident happens. It should be something we prepare for, build into our teams, and see as an integral part of delivering quality care.

What Can We Do Together?

I believe that by taking a proactive approach and embracing clinical security, we can change the narrative. We are not victims in this environment—we are empowered professionals who can make a real difference in the safety and wellbeing of our healthcare spaces.

If you’re a leader in healthcare, whether you’re a Chief Nursing Officer, a manager, or a frontline clinician, I encourage you to think about how your team approaches safety. How connected do your staff feel to the systems in place? How prepared are they for the unpredictable?

If you’re ready to explore these questions and learn more about how we can integrate security into your healthcare practice, I’d love to connect. Let’s build a safer, more secure future for everyone in healthcare—together.