Personal Safety Issues

Certain health care groups are at increased risk of violence in the workplace, for example, those working in the custodial environment (27) or accident and emergency services (28).

There are numerous strategies for interviewing a difficult patient (29), which include being fully aware of the person's history (be prepared) and considering how the person sees you (as uninterested or hostile), being polite and respectful, avoiding confrontation, using appropriate eye contact, keeping calm, and showing interest. Look for signs of tension and find out why tension may be increasing. Finally, be ready to leave if necessary and consider the need to have a chaperone (appropriately trained in restraint techniques) of the same sex as the patient.

Accurate assessment regarding the possibility of violence will reduce the danger, but it should never be assumed that there is no risk, and every clinical situation should be categorized as high risk owing to an obvious risk or unknown risk resulting from undiscovered factors (30).

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