I’ve witnessed conflict levels so stressful in our program that I sometimes feared actual violence was going to erupt. What can we do when things escalate to such a point?

The workplace is becoming more violent. Over 1 million workers are assaulted each year in the US workplace, and the health care industry is no exception to this frightening statistic.

Violent incidences have been reported between physicians, as the changing pattern of medical practice creates enormous stress on both work and family. If the warning signs are not heeded, disastrous consequences can occur. The signs of impending violence include verbal threats, profanity, belligerence, and intimidating statements. Threats should always be taken very seriously. Physical signals of a violent confrontation are the gripping of fists, agitated movement, speaking through clenched teeth, and a paranoid stare. The leader should try to defuse the situation by being non-threatening and by taking verbal control: using a calm, controlled voice, he/she should be very clear and respectful.  The leader should take a nonaggressive posture–by not cornering the individual or getting into his or her “space,” by allowing a buffer zone to exist, and by always staying at least an arm’s length plus 1-inch distance! The leader should ensure that no objects that could be used as weapons are readily available. When a threatening situation appears to be developing, the leader should take it very seriously and summon help.  Also, an adequate security system or systems should be seriously considered.