Professional Documents
Culture Documents
CRT Course Notes
CRT Course Notes
CRT Course Notes
1
In
partnership
with
POC
Management
Limited.
www.pocmanagement.co.uk
Foreword
In
April
2004
the
NaBonal
Health
Service
(NHS)
launched
the
biggest
training
iniBaBve
in
its
history,
with
the
aim
of
providing
a
minimum
standard
of
training
for
all
frontline
sta
(those
who
have
contact
with
paBents
and
the
general
public)
in
the
recogniBon,
prevenBon
and
management
of
violence,
aggression
and
challenging
behaviour.
2
IntroducBon
YOUR
ORGANISATION
NAME
have
provided
this
Workbook
which
is
now
your
property
to
keep,
as
such
it
has
been
designed
to
both
compliment
and
assist
in
todays
NaBonal
Syllabus
Course
on
Conict
ResoluBon.
Todays
course
is
to
provide
you
with
an
understanding
of
the
nature
of
workplace
conict,
and
the
environmental
and
human
factors
that
contribute
to
or
inuence
it.
Furthermore,
the
course
will
provide
an
understanding
of
the
impacts
and
eects
of
workplace
conict
on
individual
aVtudes,
behaviours
and
group
performance
both
in
and
outside
the
workplace
environment.
You
will
learn
how
our
communicaBon
paWerns
and
responses
to
conict
inuence
our
ability
to
resolve
conict
and
assist
others.
Through
the
use
of
communicaBon
models
and
the
applicaBon
of
contemporary
approaches
to
addressing
workplace
conict
you
will
experience
how
others
may
inuence
how
we
understand
and
act,
and
therefore
ulBmately
how
we
deal
with
conict.
Areas
are
provided
throughout
the
Workbook
for
you
to
make
your
own
notes,
should
you
wish
to
do
so.
The
workbook
contains
valuable
informaBon,
which
you
should
use
throughout
your
NaBonal
Health
Service
career
in
order
to
assist
you
within
your
chosen
workplace,
in
dealing
with
paBents,
visitors
and
also
colleagues.
3
Course
ObjecBves
The
aim
of
this
course
is
to
recognise
dierent
aspects
of
conict
that
delegates
may
encounter
and
to
understand
and
be
aware
of
dierent
methods
of
resolving
such
conicts.
At
the
end
of
this
course,
delegates
will
be
able
to:
1. Describe
common
causes
of
conict.
2. Describe
the
two
forms
of
communicaBon.
3. Give
examples
of
how
communicaBon
can
break
down.
4. Explain
three
examples
of
communicaBon
models
that
can
assist
in
conict
resoluBon.
5. Describe
paWerns
of
behaviour
they
may
encounter
during
dierent
interacBons.
6. Give
examples
of
the
dierent
warning
and
danger
signs.
7. Give
examples
of
impact
factors.
8. Describe
the
use
of
distance
when
dealing
with
conict.
9. Explain
the
use
of
reasonable
force
as
it
applies
to
conict
resoluBon.
10. Describe
dierent
methods
for
dealing
with
possible
conict
situaBons.
This
workbook
has
been
designed
to
complement
and
assist
with
todays
course.
4
Legal
DeniBons
of
Conict
VIOLENCE
-
Dened
as
a
physical
act
5
Common
Law
Common
Law
gives
each
and
every
individual
person
a
right
to
protect
themselves
from
being
aIacked
and
also
to
act
in
the
defence
of
others.
In
order
to
be
seen
as
lawful,
any
force
that
is
used
in
defence
of
an
aWack
must
be
reasonable
to
the
circumstances
and
proporBonate
to
the
actual
or
perceived
threat.
Circumstances
may
jusBfy
a
person
striking
rst
in
defence
of
an
aWack.
Common
Law
also
recognises
peoples
acceptance
and
use
of
force
against
each
other
as
say
a
sporBng
contest
rather
than
a
crime.
Common
Law
is
therefore
interpreted
according
to
the
following
guidelines:
If
force
is
used
it
must
be
reasonable
in
the
circumstances.
Any
force
that
is
used
must
also
be
proporBonate
to
the
threat.
Force
may
be
jusBed
in
the
prevenBon
of
serious
evil.
Force
can
be
used
in
defence
of
self
and
others.
Common
Law
also
places
responsibiliLes
onto
both
the
employer
and
the
employee:
Duty
of
Employer:
Employers
have
a
duty
of
care
to
others.
This
means
that
they
have
to
ensure
the
safety
of
anyone
who
has
access
to
their
premises,
as
far
as
is
reasonably
pracBcable.
This
means
that
there
is
a
duty
to
ensure
the
safety
of
members
of
the
public
and
to
ensure
that
they
are
not
put
at
risk
because
of
workplace
violence.
Duty
of
Employee:
Employees
must
take
care
for
their
own
safety
and
the
safety
of
others
who
may
be
aected
by
their
acBon
or
inacBon.
The
duty
of
employees
does
not
in
any
way
reduce
the
responsibility
of
employers
to
comply
with
their
duBes.
As
NHS
sta,
consideraBon
must
also
be
given
to
the
duty
of
care
towards
paBents.
6
Health
&
Safety
At
Work
(etc.)
Act
1974
Workplace
violence
is
dened
by
the
Health
&
Safety
ExecuBve
(HSE)
as:
Any
incident
in
which
a
person
is;
(Verbally)
Abused;
Threatened;
Assaulted;
in
circumstances
relaLng
to
their
work
There
is
no
special
law
relaBng
specically
to
workplace
violence
and
the
issue
is
dealt
with
under
the
Health
&
Safety
at
Work
(etc.)
Act
1974
(HASAW)
and
under
Common
Law
in
the
same
way
as
any
other
hazard
that
might
be
faced
in
the
workplace.
HASAW
Act
1974
lays
duBes
onto
both
employer
and
employee:
Duty
of
employers
(SecLon
2
HASAW
Act
1974)
To
ensure
the
health,
safety
and
welfare
of
their
sta,
as
far
as
is
reasonably
pracBcable.
To
do
everything
reasonable
and
pracBcable
to
eradicate
or
minimise
the
risks
of
harm
from
all
hazards
to
health,
including
violence.
Where
a
violent
incident
(a
hazard)
is
foreseeable,
an
employer
must
idenBfy
the
nature
and
extent
of
the
hazard
and
devise
measures
that
will
provide
a
safe
workplace
and
a
safe
system
of
work.
This
is
done
by
undertaking
risk
assessments
which
allow
employers
to
idenBfy
hazards,
how
severe
they
are
and
how
likely
they
are
to
occur
and,
having
done
this,
to
put
processes
and
procedures
in
place
to
eliminate
the
risks
or,
at
the
very
least,
minimise
them.
Duty
of
employees:
(SecLon
7
HASAW
Act
1974)
To
ensure
that
they
are
aware
of
the
risk
assessment
process.
To
follow
the
processes
and
procedures
put
in
place
by
their
employer
to
ensure
both
their
own
safety
and
that
of
their
colleagues.
7
Criminal
Law
SECTION
3
CRIMINAL
LAW
ACT
1967:
A
person
may
use
such
force
as
is
reasonable
in
the
circumstances
in
the
prevenBon
of
crime,
or
in
the
eecBng
or
assisBng
in
the
lawful
arrest
of
oenders
or
suspected
oenders
or
persons
unlawfully
at
large
s3
of
the
Criminal
Law
Act
is
always
considered
when
there
has
been
a
use
of
force
for
a
lawful
purpose.
As
with
the
Common
Law
use
of
force,
the
word
reasonable
is
used.
What
does
this
really
mean?
Make
notes
below
on
your
interpretaBon
of
the
word:
8
Other
LegislaBon
and
Guidance
THE
HUMAN
RIGHTS
ACT
1998
9
P.L.A.N
When
considering
a
use
of
force,
think
PLAN.
It
helps
you
to
ensure
your
acBons
fall
within
all
of
the
legislaBve
rules
and
guidance
surrounding
its
use.
Knowledge
of
your
basic
powers
under
the
law
is
an
essenBal
part
of
formulaBng
a
response
to
a
confrontaBonal
situaBon.
Using
the
minimal
amount
of
force
P
to
counter
the
aWack
or
threat.
The
way
to
remember
this
is
Dont
use
a
sledgehammer
to
crack
a
nut.
Is
the
use
of
force
legal?
For
L
LEGAL
example,
is
it
covered
by
Common
Law
or
s3
of
the
Criminal
Law
Act
1967?
If
not,
you
must
not
use
force.
Whenever
you
have
used
force,
A
even
if
you
think
nothing
of
it
at
the
Bme,
you
MUST
make
a
record.
Within
the
NHS
this
should
be
done
by
compleBng
an
incident
form.
Is
the
use
of
force
necessary?
Could
N NECESSARY
it
be
avoided
by
changing
tacBcs,
or
by
removing
yourself
from
the
situaBon.
This
is
always
the
preferred
opBon.
10
Causes
of
Conict
There
are
several
causes
for
conict
that
apply
to
the
NHS
arena:
Long
waiBng
Bmes
PaBents
being
refused
entry
to
NHS
sites
that
are
locked
down.
Slow
or
poor
service
(it
does
unfortunately
happen).
Drunk
or
otherwise
intoxicated
paBents.
EmoBonal
friends
and
relaBves
visiBng
paBents.
PaBents
being
asked
for
personal
informaBon
Misunderstandings.
Think
of
any
examples
of
when
you
have
had
to
deal
with
conict,
or
list
other
factors
that
may
lead
to
conict:
11
Dealing
with
Conict
PuVng
factors
such
as
long
waiBng
Bmes
aside,
how
can
you
prevent
conict
from
occurring
in
the
rst
instance,
or
deescalaBng
the
situaBon
if
it
has
occurred?
Use
the
box
below
to
list
methods
that
you
would
use
to
achieve
this:
12
Risk
ReducBon
Policy,
procedure
&
guidance
Physical measures
Training
Training
is
an
important
part
of
risk
reducBon,
which
is
why
you
are
taking
part
in
this
lesson!
Good Service
13
Basic
elements
of
communicaBon
CommunicaBon
is
basically
about
geVng
an
idea
from
your
head
into
another
persons
head.
This
seems
to
be
quite
a
simple
process,
but
it
can
be
very
dicult
to
convey
the
exact
idea
you
want
to
get
across
to
the
other
person.
The
diculty
comes
when
sending
the
message.
You
need
to
put
it
into
words
that
the
other
person
can
understand.
This
part
of
the
message
is
called
encoding.
You
then
actually
send
the
message.
This
is
typically
made
up
of
a
combinaBon
of
words,
tone
and
non-verbal
messages.
The
other
person
receives
the
message
and
then
has
to
decode
it
and
work
out
your
original
idea.
Misunderstandings
occur
for
many
reasons
most
of
them
are
related
to
the
fact
that
each
of
us
sees
our
world
in
a
very
dierent
way.
Consequently,
when
you
encode
your
message,
you
should
try
to
make
it
as
clear
as
possible,
and
most
importantly,
check
the
receiver
has
understood
the
message
as
you
intended.
14
Channels
of
CommunicaBon
In
conversaBon
the
message
is
passed
from
one
person
to
another
through
three
channels:
Channel
Percentage
of
meaning
Words
(verbal)
7%
Words
Tone
(verbal)
38%
Tone
Non-Verbal
CommunicaBon
55%
NVC
Many
studies
have
been
done
about
communicaBon
and
it
is
generally
accepted
that
in
a
face-to-face
situaBon
the
receiver
gains
the
meaning
of
the
message
as
shown
above.
We
can
easily
use
body
language
which
signals
anger,
frustraBon
or
aggression
without
realising
that
we
are
doing
so.
It
is
important
to
be
aware
of
our
stance,
posture,
eye
contact
and
gestures
to
avoid
giving
the
wrong
signals.
Similarly,
we
need
to
monitor
the
body
language
of
the
person
we
are
communicaBng
with
for
signs
of
aggression.
15
Blocks
to
CommunicaBon
A
number
of
things
can
get
in
the
way
of
eecBve
communicaBon.
These
are
termed
as
blocks.
A
block
is
anything
that
can
cause
the
communicaBon
between
two
people
to
break
down
or
become
dicult.
The
environment
The
environment
in
which
you
are
communicaBng
can
contain
things
that
will
have
an
eect
upon
the
success
of
the
communicaBon.
They
are
usually
obvious
although
you
do
not
always
recognise
the
eect
they
are
having.
They
include:
Loud
Noise
Lots
of
people
crowding
together
Physical
discomfort
feeling
hot/cold,
hungry,
Bred,
etc.
16
Blocks
to
CommunicaBon
Alcohol
and
Drugs
Alcohol
has
a
depressant
eect,
which
results
in
slower
reacBons
to
normal
sBmuli.
It
tends
to
reduce
peoples
inhibiBons
and
can
make
them
unreasonable
and
unpredictable.
Drugs
have
similar
eects,
and
can
also
induce
hallucinaBons
and
act
as
a
sBmulant.
When
you
are
communicaBng
with
a
person
who
is
under
the
inuence
of
alcohol,
or
drugs:
Talk
slowly
and
calmly.
Adopt
a
non-aggressive
stance.
Maintain
space
between
them
and
you.
17
Blocks
to
CommunicaBon
Mental
Health
Problems
A
person
may
behave
in
a
certain
way
because
of
mental
health
problems.
Mental
illness
can
take
many
forms,
and
most
people
with
mental
health
problems
will
not
be
problemaBc
or
a
threat
to
you.
It
is
important
to
be
aware
of
the
possibility
of
dealing
with
a
person
suering
from
mental
health
problems,
as
you
may
need
to
adapt
the
way
you
communicate
with
them.
A
person
who
is
very
unwell
could
become
aggressive
for
any
of
the
following
reasons:
Fear
and
confusion
(e.g.
caused
by
noise
or
people)
leading
to
desperaBon
and
the
feeling
that
the
only
way
out
is
to
ght.
Paranoia
(feelings
of
being
persecuted)
may
be
directed
towards
certain
groups
in
society,
for
example
NHS
employees
or
Police
Ocers,
and
could
have
been
caused
by
bad
experiences
with
them
in
the
past.
Anger
at
being
provoked
by
other
people.
When
dealing
with
people
who
have
a
mental
illness:
Give
them
plenty
of
space.
Talk
clearly
and
calmly
to
ensure
they
understand
you.
Make
sure
they
know
you
mean
them
no
harm.
Be
reassuring.
Tell
him
or
her
what
you
are
doing
and
why.
Keep
your
hands
open
and
in
full
view.
Reduce
distracLons
that
will
alarm
or
confuse.
If
you
are
with
a
colleague,
only
one
of
you
should
talk
to
the
person.
18
Blocks
to
CommunicaBon
People
with
disabiliBes
People
with
disabiliBes,
be
it
a
physical
disability
or
a
learning
disability,
experience
the
same
emoBons
as
other
people
and
may
become
upset
or
angry
when
they
are
in
an
unfamiliar
environment,
especially
when
in
pain
or
discomfort.
Things
to
remember:
Speak
clearly
and
do
not
over
complicate
language.
Be
sure
to
signal
non-aggression.
Consider
the
use
of
other
communicaBon
methods
i.e.
symbols/pictures,
wriWen
text
if
hearing
impaired
etc.
One
person
should
communicate
calmly
and
clearly
to
avoid
an
audience
or
crowd
that
may
confuse
or
anger
the
person.
Reassure
the
person
that
you
are
trying
to
help
them
remember,
to
them
you
are
a
stranger.
Empathise
and
be
sensiBve
to
their
needs.
Do
not
touch
the
person
unless
invited.
For
example,
if
someone
is
lost
and
scared
they
may
want
to
hold
onto
you,
whilst
others
may
not
welcome
physical
contact.
People
from
dierent
cultures/language
barriers
If
you
want
to
communicate
eecBvely
with
someone
who
is
from
another
cultural
or
ethical
background
to
yourself,
then
it
is
important
to
respect
the
values
of
that
culture
and
try
to
communicate
in
a
way
that
embraces
those
values
as
much
as
possible.
Dierent
cultures
hold
dierent
values
and
aVtudes
to
dene
the
way
they
live
and
interact
with
others.
There
are
no
rights
or
wrongs
where
culture
is
concerned
one
culture
is
not
beWer
than
another,
just
dierent.
When
communicaBng
consider:
Use
of
alternaBve
methods
of
communicaBon
i.e
symbols,
hand
signals,
using
other
speakers
of
their
language
as
interpreters
etc.
When
using
hand
signals
and
gestures,
consider
how
it
may
be
received.
In
come
cultures,
they
can
mean
something
very
dierent
to
your
own.
Remember
that
there
are
ouen
dierences
in
values
that
are
dicult
to
accept
for
some
people.
19
Blocks
to
CommunicaBon
Think
about
your
area
of
work
and
consider
the
cultural
and
diversity
issues
that
might
aect
you
when
trying
to
communicate
with
people.
20
Verbal
communicaBon,
TransacBonal
analysis
In
the
1950s,
a
great
deal
of
research
was
carried
out
by
psychoanalysts,
one
of
whom
was
Eric
Berne.
He
developed
a
theory
that
claimed
we
all
have
three
basic
ego
states
making
up
our
personality.
He
stated
that
each
Bme
we
interact
with
people,
our
ego
states
aect
the
way
we
act,
interact
or
react
in
any
situaBon.
The
ego
states
govern
our
personality
and
behavioural
paWerns.
Having
the
skill
to
recognise
these
dierent
ego
states
in
others
may
help
you
to
respond
appropriately
when
defusing
conict
situaBons.
It
is
important
to
note
that
this
theory
is
not
about
the
relaBonship
between
a
parent
and
their
child,
but
about
the
way
in
which
people
of
all
ages
adopt
certain
behaviours
(ego
states)
when
interacBng
with
others.
The
chart
on
the
next
page
gives
some
examples
of
the
comments
and
behaviours
that
are
typical
of
people
in
each
ego
state.
21
Verbal
communicaBon,
TransacBonal
analysis
EGO
STATE
TYPICAL
TYPICAL
TYPICAL
WORDS
BEHAVIOUR/
ATTITUDES
&
PHRASES
EXPRESSIONS
CRITICAL
Furrowed
Disgraceful
brow
Condescending
PARENT
Ought
to
PoinBng
Judgemental
Always
nger
NURTURING
Benevolent
smile
Caring
PARENT
Well
done
Pat
on
the
Permissive
back
ADULT
How?
When?
Relaxed
Open-minded
Where?
AWenBve
Interested
What?
22
IdenBfying
Non-Verbal
CommunicaBon
Enter
your
comments
below
23
CALM
model
of
CommunicaBon
The
following
is
a
model
of
communicaBon
that
can
be
used
to
avoid
conict
when
communicaBng
with
others,
and
can
also
be
used
to
de-escalate
situaBons
that
have
turned
into
conict.
C the Issue
24
PEACE
Model
of
CommunicaBon
Another
model
that
can
be
used
it
PEACE.
Discuss
what
each
leWer
may
represent
and
ll
it
in:
25
Proxemics
More
commonly
known
as
personal
space
or
distances
between
people.
Distances
are
used
to
allow
us
Bme
to
think
and
react,
in
certain
condiBons
it
would
be
natural
for
us
to
allow
some
people
closer,
while
we
will
keep
others
at
a
distance.
Performing
your
role
within
the
working
environment
can
be
the
excepBon
to
the
above
rule
as
condiBons
dictate
that
we
maintain
a
close
proximity
in
order
to
provide
quality
care
or
carry
out
a
necessary
procedure.
A
reacLonary
gap
is
the
name
given
to
the
distance
we
should
try
and
maintain
when
dealing
with
conict.
The
distance
for
this
is
just
outside
of
the
extremity
of
the
aggressors
reach,
which
includes
any
weapons
they
may
have!
26
EscalaBon
Understanding
how
violence
can
lead
to
aggression
Trigger
Trigger
The
next
level
is
a
deeper
level
of
emoBon
and
will
be
fairly
Anger
at
the
other
party
but
the
individual
will
be
less
raBonal.
Trigger
Most
and
this
forms
the
lowest
level
of
arousal.
It
may
FrustraBon
not
be
evident
or
obvious
and
the
individual
can
keep
it
very
much
under
control
27
Signs
of
Aggression
You
should
always
monitor
the
body
language
of
the
person
you
are
dealing
with,
looking
for
warning
signs
of
the
conict
escalaBng
into
physical
violence.
Below
are
lists
of
warning
signs,
showing
anger
and
aggression,
and
danger
signs,
which
suggests
a
physical
aWack
may
be
imminent.
In
this
case
posiBve
acBon
is
crucial
in
order
to
avoid
the
risk
of
injury.
Generally,
a
human
will
try
to
dehumanise
their
opponent
before
using
physical
violence,
and
the
danger
signs
below
give
an
indicaBon
that
this
is
happening.
Abrupt
stopping
and
starBng
of
nervous
Stance
changing
to
side
on
or
ghBng
stance
behaviour
such
as
tapping
of
ngers
Glancing
at
28
Reasonable
response
to
aggression
When
dealing
with
a
person
displaying
the
warning
signs
discussed,
you
must
ensure
that
you
maintain
your
self-control,
and:
Do
not
get
Angry
Manage
buse
A
4
As
Maintain
a
posiBve
A
Be
sserBve
AVtude
29
Signalling
non-aggression
The
importance
of
signalling
non-aggression:
This
is
one
of
the
most
important
areas
to
understand
when
defusing
a
situaBon
where
people
are
becoming
aggressive.
The
more
emoBonal
someone
is
becoming
the
less
they
can
hear
and
raBonalise
what
is
being
said
to
them.
However,
they
will
insLncLvely
respond
to
body
language
and
tone
of
voice.
Aggressive
signals
are
easy
to
spot.
As
someone
becomes
angrier
they
tend
to
turn
square
on,
stare
xedly
and
clench
their
sts.
When
they
are
about
to
resort
to
actual
violence,
they
will
then
move
to
avoid
eye
contact,
drop
their
chin,
and
dehumanise
you.
To
signal
that
you
are
not
aggressive,
do
the
opposite.
Turn
slightly
to
one
side,
one
shoulder
turned
away,
display
open
palms,
and
establish
and
maintain
a
normal
eye
contact.
The
AVtude
and
Behaviour
Cycle
People
Object
Place
31
Impact
Factors
Impact
factors
are
the
consideraBons
we
must
idenBfy
when
dealing
with
any
conict
like
carrying
out
a
mini
risk
assessment
of
the
situaBon
we
are
in.
You
must
assess
your
impact
factors
and
include
what
you
consider
the
other
persons
impact
factors
to
be.
For
example:
The
person
you
are
talking
to
is
tall,
appears
t
and
healthy
and
is
well-built.
He
is
becoming
agitated
and
louder.
You
are
much
shorter,
lighter
in
build
and
have
a
wrist
injury.
You
have
knowledge
of
marBal
arts.
If
the
situaBon
became
physical,
could
you
deal
with
it?
Are
you
the
best
person
to
deal
with
this
man?
Now
consider
that
this
person
is
on
crutches
with
a
plaster
cast
on
his
arm
and
leg.
Have
the
impact
factors
changed?
Could
you
now
deal
with
this
person?
32
Avoiding
Conict
Open
PALMS
Normal
contact,
L
and
listen
acBve
.
Maintain
a
comfortable
Make
distance.
33
Fight
or
Flight
This
is
the
name
given
to
a
to
a
danger
or
threat.
It
occurs
when
someone
is
frightened
or
angry.
It
is
the
bodys
way
of
for
signicant
muscular
eort,
by
releasing
a
massive
amount
of
adrenaline.
It
can
happen
for
the
following
reasons:
Their
personal
space
is
invaded.
They
feel
threatened.
They
have
no
means
of
escape
It
is
important
to
recognise
the
eects
the
adrenaline
rush
may
have
non-aggressive
body
language,
and
do
not
block
their
exits,
will
help
to
reduce
the
risk
of
this
happening.
34
Exit
strategies
Despite
all
of
our
best
eorts,
someBmes
conict
cannot
be
resolved,
and
the
situaBon
leads
to
a
point
where
for
your
own
safety
you
need
to
take
acBon
to
remove
yourself
from
the
incident.
GeVng
away
from
a
high
risk
situaBon:
When
you
are
in
a
situaBon
which
you
recognise
as
high
risk,
it
may
be
necessary
for
you
to
exit
from
the
situaBon.
This
will
take
you
out
of
immediate
danger
and
allow
you
to
think
raBonally
about
how
to
deal
with
the
incident.
People
ouen
nd
it
dicult
to
get
out
of
such
situaBons
without
losing
face
and,
therefore,
stay
longer
that
it
is
safe
to
do
so.
An
exit
strategy
is
a
pre-prepared
way
of
gehng
yourself
away
from
a
dicult
situaLon.
Have
a
ready
made
reason
to
exit:
An
exit
strategy
is
quite
simply
a
sensible
reason
for
leaving
the
situaBon
you
are
in.
You
need
to
have
a
reason
ready
so
that
it
comes
to
mind
quickly.
It
needs
to
be
something
that
will
not
make
the
situaBon
worse.
It
could
be
something
like
Im
afraid
I
cant
make
that
decision,
Ill
have
to
go
and
speak
with
my
manager
about
it.
Discuss
with
the
class
some
examples
of
exit
strategies
that
could
apply
to
your
parBcular
area
of
work:
35
Recording
Incidents
ReporBng
all
incidents,
however
minor
or
everyday
they
may
seem,
is
essenBal
in
order
for
the
NHS
to
protect
sta
against
risk
as:
The
NHS
relies
upon
quality
informaBon
to
establish
eecBve
strategies
and
training.
ReporBng
incidents
of
workplace
violence
is
a
duty
under
Health
and
Safety
legislaBon.
Under
reporBng
is
chronic
throughout
many
organisaBons,
and
the
NHS
is
no
excepBon.
There
are
a
variety
of
reasons
for
this,
but
the
main
factors
are
that
people
feel
there
is
a
lengthy
and
complicated
reporBng
procedure,
and
there
is
a
lack
of
understanding
about
what
should
be
reported.
For
the
Cluster,
the
DaLx
reporBng
system
is
designed
to
promote
reporBng
based
upon
the
two
reasons
above.
It
is
a
structured,
simple
form
to
ll
out,
which
should
not
take
long.
Any
incident
which
felt
out
of
the
norm
should
be
reported.
Ensure
that
you
know
how
to
access
this
system.
It
can
ouen
be
found
via
a
link
from
the
Intranet
page.
There
are
guides
available
to
help
you
use
the
system,
as
well
as
sta
members
such
as
your
LSMS,
or
the
Risk
Team,
who
can
also
assist.
An
example
of
the
guide
can
be
found:
When
compleBng
any
incident
form,
ensure
that
you
give
precise
details,
including:
Facts
about
yourself
and
any
other
parLes
involved
Background
informaLon
DescripLon
of
behaviour
Level
of
force
used
Simply
staBng
that
the
person
was
abusive
or
violent
is
not
enough,
use
specics,
including
the
exact
words
and
movements
involved.
36
Knowledge
Check
1.
Non
verbal
communicaLon
is
a
key
element
of
how
we
communicate,
but
what
percentage
of
our
message
does
it
form?
7%
38%
55%
93%
2.
Which
of
these
could
lead
to
a
breakdown
in
communicaLon?
Stress
Cultural
Dierences
Alcohol
All
of
these
3.
What
are
the
missing
words
from
SecLon
2
of
the
HASAW
Act
1974:
It
shall
be
the
duty
of
every
employer
to
ensure
as
far
as
reasonably
pracLcable
the
health,
at
work
of
all
his
employees.
Safety
and
welfare
Safety
and
wellbeing
Security
and
welfare
Security
and
wellbeing
4.
What
does
the
S
stand
for
in
the
SAFER
risk
assessment
model?
Safety
Send
for
help
Security
Step
back
5.
Which
ONE
of
the
following
is
the
MOST
appropriate
non-verbal
behaviour
used
to
confront
unacceptable
behaviour?
Open
Hands
Loud
Voice
Strong
eye
contact
Head
juVng
forward
6.
To
defend
yourself,
the
law
states
that
you
can
use
as
much
force
as
is
in
the
circumstances.
RaBonal
Responsible
Respectable
Reasonable
7.
The
3
ego
states
in
transacLonal
analysis
are
Parent,
,
Child?
Carer
Grown-up
Adult
Mature
9.
Which
of
the
ve
dierent
ego
states
is
this
comment
indicaLve
of:
Can
we
try
to
avoid
any
misunderstanding?
Adult
CriBcal
Parent
Adapted
Child
Free
Child
10. From the PALMS model of avoiding conict, what does the M represent?
As
a
nal
exercise,
go
back
to
the
start
of
the
workbook,
and
look
at
the
personal
example
you
gave
of
dealing
with
conict.
Would
you
change
the
way
you
dealt
with
the
situaBon
with
the
knowledge
you
have
gained
today?
How?
We
hope
you
have
enjoyed
the
course,
and
gained
new
skills
and
knowledge
that
you
can
apply
to
your
work
environment
and
even
your
home
life.
Thank
you
for
your
parBcipaBon
today.
38
References
&
Further
reading
NHS
Security
Management
Service:
Conict
ResoluBon
Training
ImplemenBng
the
NaBonal
Syllabus
SMS
Ref:
SMS/VAS/01/04
hWp://www.nhsbsa.nhs.uk/Documents/crt_implemenBng_syllabus.pdf
Your
local
NHS
Managing
Violence
&
Aggression
in
the
Workplace
Policy
A
safer
place
to
work:
ProtecBng
NHS
hospital
and
ambulance
sta
from
violence
and
aggression.
hWp://www.publicaBons.parliament.uk/pa/cm200203/cmselect/cmpubacc/641/641.pdf
NHS
CFSMS:
A
professional
approach
to
managing
security
in
the
NHS.
hWp://www.nhsbsa.nhs.uk/Documents/sms_strategy.pdf
NHS
SMS:
Conict
ResoluBon
training
workbook
Created by John Lambert, Senior Consultant & Trainer - POC Management Limited.
39