WE HAVE ALL HAD TO DEAL WITH DIFFICULT SITUATIONS that escalate quickly and without good reason. If a reason does exist, it most often resides in a failure to effectively communicate. I am sure that you and your staff have dealt with angry patients who feel that they have been mistreated. Often, the reality is that there was a breakdown in communication or a misunderstanding.

Patients might be upset about their underlying medical condition, such as an irregular cornea that has been challenging to fit. They might be in pain and frustrated with their treatment outcome, such as a dry eye patient for whom you’ve exhausted nearly all forms of treatment. Or they might be insecure in what they perceive is a power imbalance. Unfortunately, that situation sometimes turns into bullying, resulting in well-documented cases of workplace violence, compromised patient care, and issues with staff mental health and retention.

Why this discussion? I was recently in a medical setting with a well-documented/written zero-tolerance policy. I asked the technician if they had to use that tone with patients, and the answer was a resounding “Yes!” He went on to say that these incidents can no longer be viewed as “all hat, no cattle” situations when they escalate.

The term “workplace violence” brings up connotations of physical violence, but verbal abuse and intimidation are also highly damaging forms of aggression. What else can be done? De-escalation training, security measures, incident reporting, and leadership support come to mind.

Bullying can come in many forms in our professional lives. Here are some examples. I have had sponsors vaguely or directly threaten to pull their sponsorship when we could not publish an article because it did not follow Contact Lens Spectrum editorial policies. Usually there is a lack of awareness about said policies and communication solves the issue. I also have seen colleagues angered when their lecture or abstract was not accepted for presentation, absent an understanding that we use a rigorous and masked external peer review process to help make such determinations. Again, communication is key.

Any of these situations are damaging and, unfortunately, on the rise—particularly in health care settings. It is important that we deal with these issues directly with our staff to ensure that our key “frontline” individuals are equipped to de-escalate situations in the workplace.