A tragic incident we call all learn from

I want to share something serious with you. A real-world event that is a harsh reminder of why managing distance and positioning is so important in our daily work as healthcare security professionals. After reading an article about a tragic incident, I couldn’t stop thinking about how it could have been prevented.

A healthcare professional was recently assaulted by a patient. The attack happened so fast that he didn’t have a chance to respond. He was kicked in the groin, and sadly, he died just a few days later. The autopsy results are still pending, but the fact remains, he was attacked, and that attack cost him his life. (reference below)

For those of you who have ever been kicked in the groin, you know how devastating it can feel. In that moment of impact, it’s not just pain; it’s a full-body shock that can make you feel like you’re dying. My heart goes out to his family, and my deepest condolences are with them.

This tragic event is a powerful reminder that distance and positioning are not just part of our training, they are the keys to our survival. If you give up distance and fail to control your positioning, you are essentially giving up your ability to manage your safety. That’s why I want to talk about some basic threat indicators that can help keep you safe.

These indicators go beyond active listening skills. They are tools that help us navigate communication and maintain safety during every contact. By recognizing and responding to these threat indicators, you can protect yourself and others.

In my experience over the last 10 years in healthcare, many healthcare professionals who face assaults often lose their personal space during interactions with patients. While maintaining some distance may not always be possible, there are several steps you can take to better manage your safety during these encounters.

The 10-5-2 Safety Rule

We follow what we call the 10-5-2 Safety Rule. This rule helps us maintain a safe distance during every contact:

1. At 10 feet, you observe the situation. Look for signs that everything is safe before moving closer.
2. At 5 feet, you engage in verbal interaction. This is where you assess their body language, tone of voice, and hand movements.
3. At 2 feet, you enter the personal space where physical contact could happen. This is where your awareness must be at its highest.

If something feels off at any point, whether it’s their body language, tone, or positioning—you must regroup, exit, or change how you handle the interaction. Trust your instincts. If safety is compromised, it’s better to step away and let someone else take over, or at least create a little distance during that moment..

5 Basic Threat Indicators

1. Distance

Distance is a major factor in keeping yourself safe. It’s only natural to let people you trust stand closer to you. But when you’re dealing with someone unpredictable, managing that distance becomes critical.

Example: You’re talking to someone, and they keep stepping closer, invading your personal space. No matter how you try to maintain distance, they keep closing the gap. This is a red flag. It means they might be testing your boundaries or preparing to act aggressively.

2. Positioning

Positioning shows respect—or disrespect. When someone stands slightly off to the side, it’s usually a sign of respect. But when they stand directly in front of you, “in your face,” it’s often a sign of aggression or dominance.

Example: During a conversation, you adjust your position to create a safer angle, the person moves right back in front of you. This behavior can indicate they are trying to intimidate or control the interaction.

Remember this,” When you cannot manage your distance you need to manage POSITIONING!”?

3. Tone of Voice, Repetition, and Word Choice

A person’s tone of voice tells you about their emotional state. If their voice is too loud, they’re likely frustrated or excited. If their voice is too soft or controlled, they might be trying to suppress their emotions.

Excessive repetition is another sign of trouble. When someone repeats the same comments or questions over and over, it often means they’re losing control. If they start to curse, they are losing their ability to express themselves.? Their word choice can also reveal their intentions—insults, threats, or aggressive language should never be ignored.

Examples:

• Tone: "What took you so long to get here? This is crazy!" (yelling)
• Repetition: "I told you already! Do I have to repeat myself again?"
• Word Choice: "You’re an idiot! You have no idea what you’re doing!"

4. Hand Movements

A person’s hands often reveal their intentions before they act. Clenched fists, cracking knuckles, or stretching can indicate they’re getting ready for physical action. Even subtle movements like adjusting their shirt or removing a watch can be warning signs.

Example: You’re talking to someone, and you notice they’re loosening their tie, untucking their shirt, or cracking their knuckles. These small actions may be their way of preparing for a physical confrontation.

5. Eye Focus

The eyes tell a story. When someone is focused on you, they’re engaged in the conversation. But if their eyes are darting around, looking at specific objects or scanning the area, they may be planning their next move.

Example: You’re speaking with someone, and you notice their eyes keep shifting toward the exit or a specific object, like your ID badge or radio. This behavior could mean they’re considering an escape or trying to grab something.

Putting It All Together

It’s hard to know how an assault starts just by reading about it or watching a video. But managing distance and positioning—along with these other threat indicators—can give you an edge. Your goal is to recognize the signs early and adjust your approach before things escalate.

If you lose control of these indicators, it’s time to step back, regroup, and decide on your next move. Sometimes, that means exiting the situation altogether. Other times, it may mean calling for backup or letting someone else take over.

Why Awareness Matters

Every contact is different. The person you’re dealing with might be calm one moment and agitated the next. That’s why staying aware and managing these indicators is so important.

We don’t train because we’re looking for trouble—we train because trouble might find us. By paying attention to distance, positioning, tone, hand movements, and eye focus, we give ourselves the best chance to stay safe.

Final Thoughts

Being aware of these threat indicators can save your life. Always trust your instincts. If something feels wrong, it probably is. Take control of the situation early, and don’t be afraid to back off if safety becomes an issue.

Your safety is not negotiable. Remember—stay safe, stay ready, and stay aware.

Feit, N. (2022, June 6). SC woman hit a hospital employee in the groin and he died. It’s a homicide, officials say. Yahoo News. https://www.yahoo.com/news/sc-woman-leaving-hospital-fought-201058419.html