Kristine Powell, MSN, RN, CEN, TCRN, NEA-BC, FAEN
A violent incident in the emergency department can escalate in an instant. That’s why managing the response as it’s happening, as well as before and after, are critical for keeping everyone safe and preventing such episodes from happening again.
“What we do in the moment affects what happens next,” said Kristine Powell, MSN, RN, CEN, TCRN, NEA-BC, FAEN, director of emergency services at Baylor Scott & White Health.
During her session, “De-escalating the Escalating: Readiness in the Moment for Workplace Violence” at Emergency Nursing 2025, Powell will review de-escalation strategies to help keep ED nurses safe and ready. She’ll also discuss the important components and infrastructure for an effective organizational workplace violence program.
“How can we prepare organizations and individuals to manage the moment?” Powell said.
While organizations should provide education, tools, resources and environmental design to mitigate workplace violence, nurses have a role to play, too.
“I also expect individuals to prepare themselves. It can’t all be organizational,” she said. “It must be a combination of organizational and individual preparedness. That’s really what’s going to help in the moment.”
Comprehensive Strategies
During her session, Powell will review early recognition of aggressive behaviors from patients, such as raising their voices, standing up or getting close to someone’s face. She’ll also discuss how to intervene and calm those tense situations as the aggressive behavior continues to escalate and provide mnemonic tools for attendees to take back to their organizations and share with their colleagues.
“It’s truly recognition and response, and how do we de-escalate situations?” Powell said. “The earlier we can respond, the better able we are to affect the outcome of that interaction.”
In addition to sharing strategies for handling the moment itself, Powell will also discuss ways organizations can prepare themselves for violence before it happens, including implementing a workplace violence program, performing a gap analysis, providing education and training for staff, and applying other Joint Commission standards.
She’ll also offer tactics for nurses after the violence occurs, such as how to continue communicating with and caring for an aggressive patient, as well as the importance of team debriefs, huddles and discussing what could be done better next time.
Workplace violence in the ED isn’t a problem that’s going away, but Powell believes with preparation, strength, determination and advocacy, nurses can successfully manage and mitigate violent incidents, not only for themselves, but for patients, family members and others.
“Workplace violence poses a danger to everyone in the emergency department,” she said. “It is truly a safety issue.”