Good Speak: Non-Escalation Strategies for Healthcare—Podcast

“Good Speak: Non-Escalation Strategies for Healthcare” — Episode 35

Co-host: Marcus—former healthcare security director

Co-host: Natalie—nurse practitioner and clinical team leader

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In healthcare, the words you choose can mean the difference between connection and confrontation. In this episode of Confidence in Conflict, Marcus (former healthcare security director) and Natalie (nurse practitioner and clinical team leader) explore “Good Speak”—the use of verbal and non-verbal communication as proactive tools to prevent conflict before it starts. Together, they unpack Vistelar’s Beyond Active Listening framework and the six C’s of Conflict Management, showing how simple, structured communication habits can keep interactions calm, respectful, and safe.

Some key takeaways from the discussion include:

• How “Peace Words” reduce tension and promote psychological safety

• Seven components of Beyond Active Listening every provider can use

• Non-verbal strategies that signal empathy and professionalism

• Ways to handle difficult patients, families, and coworkers without escalation

• How staying in the “Blue Zone” helps staff manage stress and preserve teamwork

From emergency departments to long-term care units, this episode offers practical language and mindset shifts that turn daily challenges into opportunities for trust, healing, and safety.

MARCUS: Welcome to another edition of Confidence in Conflict. I'm Marcus, and whether you're starting your shift in the emergency department, making rounds on a busy medical floor, or managing the complexities of healthcare security, you know that challenging conversations are part of your daily reality. Today, we're diving deep into something that can transform how you handle those moments before they become problems.

NATALIE: And I’m Natalie. Marcus, what I love about today’s topic is that it’s truly preventive medicine for conflict. We’re talking about Peace Words – those verbal and non-verbal communication strategies that can prevent conflict from starting. As someone who’s spent years in clinical settings, I can tell you that the most powerful intervention is often the one that prevents escalation in the first place. These healthcare workplace violence solutions help teams create safer environments for staff and patients alike.

MARCUS: Exactly right, Natalie. And I think our listeners will appreciate that we’re not just talking theory here. We’re talking about practical, immediately applicable techniques that you can use whether you’re dealing with an anxious family member in the waiting room, a frustrated colleague during a difficult shift, or a patient who’s frightened or anxious. These methods are a core part of hospital de-escalation training and nurse safety training programs across the country.

NATALIE: Before we dive in, let’s set the stage with something that probably resonates with everyone listening. Picture this: it’s been a long day, the unit is understaffed, and you walk into a patient room where someone is clearly upset. Maybe they’ve been waiting for hours, maybe they’re in pain, maybe they’re scared about a diagnosis. In that moment, your first few words and your body language can either defuse the tension or pour gasoline on the fire. In healthcare, those first words are part of clinical de-escalation techniques that can determine how the rest of the encounter unfolds.

MARCUS: That’s such a perfect example because it highlights something fundamental about healthcare conflict management – every interaction happens in a high-stress environment. People are vulnerable, worried, and often not at their best. As healthcare professionals, you’re managing your own stress while trying to provide excellent care.
Understanding how to use communication as a preventative measure in these moments isn’t just helpful – it’s essential.

NATALIE: And that’s where Vistelar’s approach really shines. The framework gives us concrete tools, not just good intentions. When we talk about non-escalation strategies, we’re talking about systematic approaches that are easy to learn, teach, remember, and deploy consistently – even when you’re tired, even when you’re stressed, even when you’re dealing with your fourth difficult interaction of the day. This approach aligns perfectly with medical staff communication training programs and behavioral health crisis intervention strategies used in hospitals nationwide.

MARCUS: So let’s start with the foundation. Natalie, when we talk about peace words, what do we mean exactly?

NATALIE: Great question, Marcus. In communication, our words and non-verbal behavior function the same way: they can defuse negative emotions, protect relationships, and create psychological space that allows everyone to stay calm and focused on solutions. When healthcare professionals master these clinical de-escalation techniques, they not only prevent conflict but also strengthen trust between staff and patients.

MARCUS: And I think it’s important to emphasize that this isn’t about manipulation or being fake. This is about genuine, strategic communication that serves everyone’s best interests. It’s genuine because no provider wants to experience conflict on the job if they can avoid it. Non-escalation is about the avoidance of conflict. This is medicine practiced in good faith because the end goal is best outcomes for our patients and safety for everyone.

The Blue Zone: Staying Ahead of Escalation 

NATALIE: Absolutely. It’s about being authentic while also being intentional. When we use Vistelar’s non-escalation techniques, we’re operating from what they call the blue zone of the six C’s of Conflict Management. This is that space where we’re focused on Context, Contact, and Closure – basically, preparation, engagement, and follow-through – all with the goal of keeping interactions safe and constructive.

MARCUS: Let’s break that down for our listeners. The six C’s framework gives us a way to analyze any interaction and determine the right approach. The blue zone – Context, Contact, and Closure – are the phases where we have the most control over preventing present and future escalation.

NATALIE: Exactly. And the beauty of this framework is that it acknowledges reality. Sometimes interactions do escalate into the red zone – Conflict, Crisis, or Combat. But the goal is always to stay in the blue zone, entering the red only when absolutely necessary. By staying calm, applying structured communication, and using proven healthcare conflict management practices, we protect everyone involved.

MARCUS: So let’s get practical. What does this look like at the point of contact – that moment when you first engage with someone, whether or not they might be anxious or agitated?

NATALIE: This is where the magic really happens. At the Contact phase, we’re focused on engagement considerations with the goal of non-escalation. One of the most powerful tools here is what Vistelar calls Beyond Active Listening. This isn’t just nodding your head and saying “uh-huh.” It’s a systematic approach to gathering information while simultaneously calming the situation.

MARCUS: Can you walk us through what Beyond Active Listening looks like in practice?

The Seven Components of Beyond Active Listening 

NATALIE: Sure. Beyond Active Listening has seven components, and each one serves a specific purpose. The first is Clarify – you ask open-ended or opinion-seeking questions, but you keep them simple and ask only one at a time. For example, instead of saying, “What’s wrong with you today?” – which sounds judgmental – you might say, “Help me understand what’s concerning you.” That single adjustment is a cornerstone of medical staff communication training because it immediately changes the tone of the interaction.

MARCUS: I can see how that changes the entire tone of the interaction right from the start.

NATALIE: Exactly. And you pause to give them ample time to respond. In healthcare, we're often in a hurry, but that pause is crucial. It shows respect, it gives people time to collect their thoughts, and it prevents them from feeling rushed or pressured.

MARCUS: What's the second component?

NATALIE: "Paraphrase." You use simple language and even gestures to be as clear as possible. This isn't about showing off your medical vocabulary. If a patient says, "I’m angry because nobody cares," you might paraphrase back, "It sounds like you're concerned that you’re being ignored, is that right?” " You're reflecting back what they said in a way that shows you understood.

MARCUS: That's interesting because it serves three purposes – it demonstrates that you're actually listening, and it gives them a chance to correct you if you misunderstood. It also allows them to self-reflect and communicate more freely. 

NATALIE: Exactly right. The third component is "Reflect," and this is one place you can include what Vistelar calls safety statements. You might say something like "You seem frustrated because you've been waiting, but I'm here now and I want to help you." You're acknowledging their emotion while also reassuring them that they're safe and cared for.

MARCUS: I imagine that safety component is particularly important in healthcare settings where people are already feeling vulnerable.

NATALIE: Absolutely. People come into healthcare environments often feeling scared, out of control, or dependent on others. When we include safety statements in our reflections, we're addressing that fundamental need for security. The fourth component is "Affirm" – using simple statements that validate their feelings. "I can tell you're worried, and that makes complete sense given what you're going through."

MARCUS: Now, some people might worry that affirming someone's anger or frustration will make them more angry or frustrated. How do you address that concern?

NATALIE: That's a great question, and it gets to a common misconception about validation. When you affirm someone's feelings, you're not saying their behavior is appropriate or that their anger is justified. You're simply acknowledging that they're experiencing that emotion, which is always valid. There's a big difference between saying "You have a right to be angry" and "You have a right to yell at me." We will get to that part in the final step. 

MARCUS: That's a crucial distinction. What are the remaining components of Beyond Active Listening?

NATALIE: The fifth is "Mirror" – subtly adopting their voice volume, tone,  and speed, and even their body language, to increase their comfort level. That is provided that their communication is appropriate. We shouldn't mirror yelling or cursing, for instance. Instead, we should model appropriate communication. However, if they're speaking quietly, you should match that. If they're more animated, you might be slightly more expressive to match their appropriate level of urgency. No one wants to have their pain or anxiety trivialized. The keyword is "subtly." You're not mimicking them; you're finding a middle ground that feels comfortable.

MARCUS: That sounds like it requires some skill and practice.

NATALIE: It does, and that's why Vistelar emphasizes training and practice with these techniques. The sixth component is "Advocate" – you always communicate that you're there to help. "I'm here for you." "I'm going to stay with you." "We're going to work through this together." In healthcare, this aligns perfectly with our caregiving mission.

MARCUS: And the seventh component?

NATALIE: "Summarize" – keeping it simple and brief. You might even consider providing a written checklist if appropriate. "Okay, so you're concerned about the wait time, you're worried about your test results, and you want to make sure your family knows what's happening. Let's address each of these." Summarizing also allows you to set limits on inappropriate behaviors. For example: “Okay, great. Thank you. I’ll take care of that right now. And to recap, you agreed not to yell or curse anymore. Please just ask the triage nurses for updates or to report any changes in how you are feeling.” Finally, summaries should always be followed up with a good closure. “Well, that started out tense, but I’m glad you spoke up. I’m going to check on when we might have a room available, and I’ll be right back to update you.” 

MARCUS: I can see how this systematic approach would be incredibly helpful in high-stress situations where it's easy to get overwhelmed or forget the basics.

NATALIE: That's exactly right. And Vistelar emphasizes being careful not to make what they call "listening mistakes" – things like advising, complimenting inappropriately, excessive querying, dismissing, or identifying too much with their situation. The focus has to remain on the other person, not shift to you.

Applying the Skills: Real-World Scenarios

MARCUS: Let's talk about the non-verbal side of this. We know that communication is much more than just words. What does it look like when using non-verbal communication as good speak?

NATALIE: Non-verbal communication is absolutely crucial, and often it's where we either build trust or create defensiveness without even realizing it. This ties into their principle of being "Alert & Decisive" – being aware of your surroundings and ready to take appropriate action.

MARCUS: Can you break down what that looks like in terms of body language and spatial awareness?

NATALIE: Sure. Let's start with positioning. When you approach someone who might be upset, approach from the side rather than directly head-on. A direct approach can feel confrontational or threatening. Maintain about a 5 foot distance – close enough to show engagement, far enough to respect personal space and avoid feeling invasive.

MARCUS: That makes sense from a security perspective, too. You're maintaining what we call "safe positioning."

NATALIE: Exactly. And always ensure the person has an escape route. Never position yourself between them and the exit. This isn't just about physical safety – it's about psychological comfort. When people feel trapped, they're more likely to escalate. You should also give yourself an out, making sure the individual isn’t between you and an escape route. 

MARCUS: What about posture and body positioning?

NATALIE: Keep your posture open and non-threatening. Uncrossed arms, relaxed stance, hands open and visible. Avoid sudden movements – everything should be slow and predictable. Your facial expression should be calm and appropriate, not overly smiling, which can seem fake, but not stern either. Patients want to see confidence and empathy from their providers, not pity, judgment, or detachment. 

MARCUS: And eye contact?

NATALIE: Maintain appropriate eye contact without staring. You want to show you're engaged and present, but constant eye contact can feel aggressive or intimidating. It's okay to look away occasionally – it can actually make people more comfortable.

MARCUS: Let's talk about voice volume and tone. How do these function as non-esclation skills?

NATALIE: Your voice is incredibly powerful in setting the tone for the entire interaction. Speak slowly and clearly – when people are upset or stressed, they have a harder time processing information quickly. Keep your volume soft but audible. If someone is yelling, the natural tendency is to raise your voice to match theirs, but that just escalates the situation.

MARCUS: So you're essentially modeling a  calm demeanor to invite them into a calmer space.

NATALIE: That's beautifully put. The first step in both non-escalation and de-escalation is modeling.  Providers must model the energy they want to create for all their interactions. And avoid any language that sounds threatening or aggressive. No medical jargon that might confuse them further. Keep explanations clear and simple.

Using Good Speak in Difficult Moments

MARCUS: Now, let's talk about some specific scenarios. What does this look like when you're dealing with an anxious family member in a waiting room?

NATALIE: Great example. Let's say a family member approaches you, clearly agitated, saying something like "We've been waiting for hours and no one will tell us anything about my mother's condition!" Your initial response sets everything in motion.

MARCUS: So walk me through how you'd apply these techniques.

NATALIE: First, I'd approach at an angle to avoid confronting them head-on,  maintain a safe distance, and use a calm, clear voice. I can begin clarifying while delivering my Universal Greeting, “Hello, I’m Natalie, and I’m a nurse here in the emergency department.  I am here to help. Help me understand what specific information you're looking for about your mother's care." This way, I’m showing respect and gathering information at the same time.” 

MARCUS: And you're not getting defensive about the wait time or making excuses.

NATALIE: Exactly. Then I might paraphrase: "So you've been waiting several hours and you're concerned because you haven't received an update about your mother's condition." I'm showing I heard them accurately. Then I'd reflect with a safety statement: "I can see how worried you are – that's completely understandable, and I want to help get you the information you need."

MARCUS: That's already a completely different dynamic than what often happens in these situations.

NATALIE: Right. Then I'd affirm: "Anyone would be concerned in this situation, and you have every right to want updates about your mother's care." I'm validating their feelings without accepting inappropriate behavior. Finally, I'd advocate: "I'm going to find out exactly what's happening and make sure you get the information you need. Let me go check on that right now."

MARCUS: And if they're still agitated at that point?

NATALIE: That's where you might use some mirroring – if they're speaking with some urgency, I might increase my pace slightly while keeping my volume calm. And then I'd summarize: "Okay, so I'm going to find the nurse caring for your mother, get an update on her condition, and come right back to you with that information. You can wait right here and I'll be back in just a few minutes."

MARCUS: I can see how this approach would be so much more effective than either dismissing their concerns or getting into an argument about hospital procedures.

NATALIE: Exactly. And notice that throughout this interaction, I'm staying in Vistelar's blue zone. I'm not getting pulled into conflict. I'm using my communication skills to prevent escalation while still addressing their legitimate concerns.

MARCUS: Let's try another scenario. What about dealing with a colleague who's frustrated or overwhelmed during a difficult shift?

NATALIE: This is so common, and it's where these skills can really strengthen working relationships. Let's say a colleague snaps at you, "I can't handle another admission! This is insane and nobody cares that we're drowning out here!"

MARCUS: In that moment, it would be easy to either take it personally or respond defensively.

NATALIE: Absolutely. But instead, I might clarify: "It sounds like you're feeling overwhelmed with the current patient load. What's the most pressing concern right now?" I'm not taking the bait about "nobody caring," I'm focusing on what might actually help.

MARCUS: And you're treating their outburst as information rather than as an attack.

NATALIE: Exactly. Then I might reflect: "You're managing a lot right now, and it feels unsustainable. Let me see how I can support you." I'm acknowledging their stress while positioning myself as an ally, not an adversary.

MARCUS: What if they continue venting or become more agitated?

NATALIE: I'd continue to affirm: "You're absolutely right that this is a challenging situation, and it makes sense that you're feeling stressed." Then I'd advocate: "We're a team, and I want to figure out how we can make this more manageable for everyone." Finally, I might summarize: "So you're concerned about the patient load, you're feeling unsupported, and you want to make sure we can provide good care. Let's talk about what options we have."

MARCUS: I notice that in both scenarios, you're not trying to solve every problem immediately, but you're creating space for problem-solving to happen.

NATALIE: That's a key insight, Marcus. Sometimes the best intervention is simply demonstrating that you understand the problem and you're willing to work on solutions. People often escalate when they feel unheard or dismissed. When you show genuine engagement with their concerns, that alone can defuse a lot of tension.

MARCUS: Now, let's talk about patient interactions. These can be particularly challenging because patients are often scared, in pain, or facing difficult diagnoses. How do these techniques apply in direct patient care?

NATALIE: Patient interactions require extra sensitivity because you're dealing with people who are often at their most vulnerable. Let's say you walk into a room and a patient immediately says, "The nurse from the last shift was terrible! She didn't listen to me, and I didn't get my pain medication on time. I want to file a complaint!"

MARCUS: That's a situation where it would be tempting to either defend your colleague or dismiss their concerns.

NATALIE: Right, but neither of those approaches helps anyone. Instead, I'd start with clarification: "Tell me more about what happened with your pain management." I'm gathering specific information rather than getting into general complaints about staff.

MARCUS: And you're focusing on their current need rather than re-litigating the past.

NATALIE: Exactly. Then I might paraphrase: "So you're saying you didn't receive your pain medication when you expected it, and you felt like your concerns weren't being heard." I'm reflecting back on what they said without making any judgments about whether they're right or wrong.

MARCUS: What would reflection look like in this situation?

NATALIE: I might say: "You're clearly uncomfortable right now, and that's the most important thing we need to address. I'm here to make sure you get the care you need." I'm acknowledging their current state while reassuring them about my commitment to their care.

MARCUS: And affirmation?

NATALIE: "It makes complete sense that you'd be frustrated if you felt your pain wasn't being managed properly. Pain management is a priority, and you deserve to have your concerns taken seriously."

MARCUS: I can see how that would completely change the patient's attitude toward you, even if they had a negative experience with someone else.

NATALIE: That's the power of validation. When people feel heard and understood, they're much more likely to work with you collaboratively. Then I'd advocate: "I'm going to review your pain management plan and make sure we're doing everything we can to keep you comfortable. We'll also look at what happened earlier so we can prevent it from happening again."

MARCUS: And summarize?

NATALIE: "Okay, so my priorities right now are to assess your current pain level, review your medication schedule, and make sure you understand how to communicate with us if you're not getting relief. Does that sound right to you?"

MARCUS: I notice you ended with a question that gives them some control over the conversation.

NATALIE: That's crucial, especially with patients. They often feel like everything is being done to them rather than with them. Giving them a voice in the process, even in small ways, can significantly reduce anxiety and defensiveness.

MARCUS: Let's talk about some of the challenges that come up when trying to use these techniques. What are the most common obstacles healthcare professionals face?

NATALIE: Time is the biggest one. Everyone feels like they don't have time for extended conversations, especially when they're dealing with multiple priorities. But here's what I've learned: taking two minutes on the front end to prevent escalation often saves you twenty minutes on the back end dealing with complaints, incident reports, or trying to repair damaged relationships.

MARCUS: That's such an important point. This isn't just about being nice – it's about being efficient.

NATALIE: Exactly. Another challenge is emotional management. When someone is angry or aggressive toward you, it's natural to want to defend yourself or respond in kind. That's your amygdala – your fight-or-flight response – kicking in. But Vistelar teaches us to respond rather than react.

MARCUS: Can you explain that distinction?

NATALIE: When you react, you're responding emotionally and automatically. When you respond, you're making a conscious choice about how to engage. Vistelar's approach helps you develop what they call a "decision mindset" – the ability to assess a situation quickly and choose the most appropriate response.

MARCUS: That sounds like it requires practice.

NATALIE: It absolutely does. Like any skill, these techniques become more natural and effective with practice. That's why Vistelar emphasizes training and ongoing development. You can't just learn these concepts intellectually – you need to practice them until they become second nature.

Adapting Communication Across Cultures

MARCUS: What about cultural considerations? Healthcare environments are incredibly diverse. How do these techniques adapt across different cultural contexts?

NATALIE: That's a really important question, Marcus. The principles remain the same – respect, validation, safety – but the expression might vary. Eye contact norms are different across cultures. Some cultures are more direct, others more indirect. Physical space preferences vary. The key is being observant and responsive to individual cues while maintaining the core principles of non-escalation.

MARCUS: So it's about being culturally responsive while staying true to the fundamental approaches.

NATALIE: Exactly. And remember, Vistelar's Beyond Active Listening approach emphasizes gathering information. Part of that information includes understanding how someone prefers to communicate and what makes them feel respected and heard.

MARCUS: Let's talk about language barriers. How do these techniques work when you're communicating across languages?

NATALIE: Language barriers add complexity, but the non-verbal elements become even more important. Your tone, body language, facial expressions – these communicate volumes even when words aren't understood. And when you do use words, keep them simple and clear. Use translators when available, but remember that your demeanor and approach are being translated too.

MARCUS: What about situations involving colleagues who might be resistant to these approaches? Not everyone is immediately on board with conflict management techniques.

NATALIE: That's a reality we have to acknowledge. Some people see these approaches as "soft" or time-consuming. The best way to address that is through modeling and results. When people see that these techniques actually work – that they reduce complaints, improve relationships, and make work more pleasant – they become more receptive.

MARCUS: And I imagine that leadership support is crucial.

NATALIE: Absolutely. When leadership models these behaviors and creates expectations around professional communication, it changes the entire culture. It's not just about individual skills – it's about creating an environment of care where respectful and non-escalating communication is the norm.

MARCUS: Let's discuss some advanced applications. What about situations where someone is under the influence of substances or experiencing mental health crises?

NATALIE: These situations require extra care and often additional resources, but the fundamental principles still apply. Actually, they become even more important. People who are impaired or experiencing mental health crises are often more sensitive to threat and less able to process complex information.

MARCUS: So the clarity and calm approach becomes even more critical.

NATALIE: Exactly. Keep your language very simple. Move slowly and predictably. Reduce the environmental stimulation and use one voice–only one person communicating with the individual in crisis. Give them extra time to process what you're saying. And always have backup – these situations might require additional team members or specialized interventions.

MARCUS: What about dealing with grief? Healthcare professionals often encounter people who are dealing with loss or bad news.

NATALIE: Grief is its own category, and it requires tremendous sensitivity. People experiencing grief might cycle through anger, denial, bargaining, and sadness rapidly. The key is not to take any of it personally and to provide consistent, calm support throughout all of those stages.

MARCUS: Can you give an example of how these techniques might look with a grieving family member?

NATALIE: Let's say a family member who just received bad news about their loved one says, "This is all your fault! If the doctors had caught this earlier, this wouldn't be happening!" 

NATALIE: Perhaps I’d begin with reflecting.  "You're devastated by this news and you need answers. That's completely understandable." I'm acknowledging both their emotion and their need to make sense of the situation.

MARCUS: What would affirmation look like here?

NATALIE: "Everyone struggles with news like this. You’re angry, and it's natural to want to understand what’s happening when someone you love is suffering." I'm validating their feelings without accepting responsibility for things that may not be anyone's fault.

MARCUS: And then advocacy and summary?

NATALIE: I'd advocate: "I want to make sure you have all the information you need and that your loved one gets the best possible care moving forward." Then summarize: "So you want to connect with the physician so you can get the answers you need and deserve."

MARCUS: I can see how that approach honors their grief while still keeping the conversation constructive.

NATALIE: Exactly. You're not being defensive, minimizing their pain, or dismissing their concerns. But you're also not allowing the conversation to become destructive or accepting blame.

Self-Care and Emotional Resilience in Practice 

MARCUS: Let's talk about self-care. Using these techniques day after day, especially in high-stress environments, can be emotionally demanding. How do healthcare professionals maintain their own well-being while consistently applying these approaches?

NATALIE: That's such an important question, and it ties into Vistelar's concept of self-compassion. You can't pour from an empty cup. Taking care of yourself isn't selfish – it's essential for being able to take care of others.

MARCUS: What does self-compassion look like in practice?

NATALIE: Let’s face it, nursing is physically and emotionally demanding work, and the stakes are high for everyone. So, it starts with recognizing that dealing with sickness, injury, conflict, and difficult emotions all day is genuinely challenging work. It's normal to feel drained or frustrated sometimes. Self-compassion means treating yourself with the same kindness you'd show a colleague who was struggling. That’s key. Would you tell a peer to suck it up and move on if they were struggling? Of course not. But it’s what we often say to ourselves. 

MARCUS: And what are some practical strategies for maintaining emotional resilience?

NATALIE: Regular debriefing, either formally or informally, with trusted colleagues. Taking real breaks when possible – even if it's just stepping outside for a few deep breaths. Developing rituals that help you transition between work and home. And recognizing when you might need additional support, whether that's employee assistance programs, counseling, or just talking with a friend.

MARCUS: What about in the moment? If you find yourself getting triggered during an interaction, what can you do?

NATALIE: Vistelar teaches the importance of staying in what they call the decision mindset rather than slipping into reaction mode. Take a breath. Remind yourself that their behavior isn't about you personally. Focus on your goal – keeping everyone safe and finding solutions. If you need a moment to collect yourself, it's okay to say, "I want to make sure I can give you my full attention. Let me just take a moment to review your chart, and then I'll be right back with you."

MARCUS: That gives you a brief reset while still showing care for the other person. And know your limits–recognize when it's time to talk with supervisors and peers about your needs in the moment. This is another case where we judge ourselves harshly. We wouldn't turn away a colleague who said they needed time and attention to process their stress, but we usually judge ourselves as weak or incompetent when we need the same grace. Openly talking about these dynamics with co-workers can change that equation for everyone, thereby strengthening the environment of care for the better.

NATALIE: Exactly. Asking for help isn't a sign of weakness. It’s actually a sign of experience and maturity. In high-stakes professions like healthcare, it's also a sign of professionalism, such as when a pilot self-reports they are too tired to fly safely. If an interaction is escalating beyond your comfort level, bringing in a colleague or supervisor is the best choice for everyone involved, including your patients. 

From Individuals to Teams: Building a Culture of Safety

MARCUS: Let's talk about team dynamics. How can these individual skills translate into better team communication and culture?

NATALIE: When team members consistently use these approaches with each other, it creates a ripple effect throughout the entire unit. Conflicts get resolved more quickly, communication becomes clearer, and people feel more supported. It's not just about patient interactions – it's about creating a work environment where everyone can feel safe, actually be safer, and do their best work.

MARCUS: Can you give an example of how this might look in a team setting?

NATALIE: Sure. Let's say during a team meeting, someone says, "I'm tired of covering for people who call in sick all the time. Some of us are doing all the work while others get away with everything." Instead of letting this turn into gossip or blame, a team leader might use these techniques.

MARCUS: How would that look?

NATALIE: They might clarify: "It sounds like you're concerned about workload distribution and fairness. Can you help me understand what specific situations you're referring to?" They're gathering information rather than allowing general complaints.

MARCUS: And then?

NATALIE: Paraphrase: "So you're feeling like the workload isn't being shared equally, and you're concerned about burnout." Reflect: "That kind of imbalance can be really frustrating, and it's important that we address it so everyone feels supported." Affirm: "You have a right to expect fairness in how work is distributed."

MARCUS: And then move toward solutions?

NATALIE: Exactly. Advocate: "I want to make sure we have a sustainable system that works for everyone." Summarize: "So we need to look at our coverage policies, make sure expectations are clear, and figure out how to handle staffing challenges more fairly. Let's put together a plan for addressing these issues."

MARCUS: I can see how that approach would prevent the meeting from turning into a complaint session while still addressing legitimate concerns.

NATALIE: Right. And it models the kind of communication we want to see throughout the team. When leaders consistently use these approaches, team members start adopting them too.

MARCUS: What about measuring success? How do you know if these techniques are working in your organization?

NATALIE: There are several metrics you can track. Patient satisfaction scores, particularly related to communication. Staff satisfaction and retention rates. Incident reports related to verbal conflicts or aggressive behavior. Workers' compensation claims related to workplace violence. But honestly, the most immediate measure is often just the feel of the unit – are people more relaxed? Are conflicts resolving more quickly? Do people seem to enjoy coming to work?

MARCUS: Those qualitative measures are often just as important as the quantitative ones. And don't forget patient satisfaction scores, because the link between staff and patient satisfaction is indisputable. 

NATALIE: Absolutely. And remember, the goal isn't to eliminate all conflict – that's unrealistic in any workplace, especially healthcare. The goal is to reduce unnecessary conflict and manage unavoidable conflict more effectively so it doesn't escalate unnecessarily, damage relationships, or compromise patient care.

MARCUS: Let's talk about implementation. If a healthcare professional or team wants to start incorporating these techniques, where should they begin?

NATALIE: Start with self-awareness. Begin paying attention to your own communication patterns. Do you tend to interrupt? Do you get defensive when criticized? Do you rush through explanations? Just becoming aware of your current habits is the first step toward changing them.

MARCUS: And then?

NATALIE: Practice the Beyond Active Listening techniques in low-stakes situations first. Use them with colleagues, with family members, in everyday interactions. Get comfortable with the approach before you need to use it in a crisis.

MARCUS: What about team-wide implementation?

NATALIE: That's where formal training becomes valuable. Vistelar's conflict management programs provide systematic training in these techniques, along with opportunities to practice in realistic scenarios. But even without formal training, teams can start by committing to basic principles – really listening to each other, validating concerns before jumping to solutions, staying curious rather than judgmental.

MARCUS: Are there any common mistakes people make when they're first learning these techniques?

NATALIE: The biggest one is being too mechanical or artificial. These techniques work because they demonstrate genuine care and respect. If you're just going through the motions, people will sense that. The goal is to internalize these approaches so they become natural expressions of your professional values.

MARCUS: What about the mistake of believing these techniques guarantee positive outcomes in all cases?

NATALIE: That's a great point. Sometimes people think that if they use the right words or techniques, they can guarantee a particular outcome. But that's not how it works. These approaches increase the likelihood of positive outcomes–and experience has shown that they will–but you can't always control other people's responses. The goal is to do your part as trained to keep interactions safe, respectful, and constructive. In this way, you will increase the probability of better outcomes and place yourself in a better position to explain and defend your decisions and actions when questioned. 

Applying Good Speak in Different Healthcare Settings

MARCUS: Let's talk about some specific challenges that come up in different healthcare settings. Emergency departments, for example, have their own unique pressures.

NATALIE: Emergency departments are incredibly challenging environments for these techniques because everything is urgent, emotions are high, and time is limited. But that's also where they're most needed. In the ED, you might have to compress the entire Beyond Active Listening process into just a few minutes.

MARCUS: Can you give an example of how that might look?

NATALIE: Let's say a patient comes in clearly agitated, saying, "I've been in pain for hours and the triage nurse barely looked at me!" You might quickly clarify: "Okay, I’m glad you told me. Tell me about your pain." Paraphrase: "So you're having significant pain and you're frustrated about the wait." Reflect: "That combination of pain and waiting must be really difficult. I'm here to help." Affirm: "Pain is always concerning, and you were right to come in."

MARCUS: And then quickly move to action?

NATALIE: Right. Advocate: "Let me assess your pain and see what we can do to help you feel better." Summarize: "So I'm going to examine you, we'll get some more information about your pain, and then we'll determine the best way to address it. Does that sound okay?"

MARCUS: The entire process might take two minutes, but it completely changes the dynamic.

NATALIE: Exactly. And in the ED, that can be the difference between a patient who cooperates with treatment and one who becomes increasingly difficult throughout their visit.

MARCUS: What about long-term care settings, where relationships are ongoing rather than brief?

NATALIE: Long-term care has its own challenges and opportunities. The advantage is that you have time to build relationships and really understand individual residents' communication preferences and triggers. The challenge is that conflicts can fester over time if they're not addressed well.

MARCUS: So the investment in good communication pays off over months and years rather than just during a single visit.

NATALIE: Absolutely. In long-term care, you might encounter a resident who becomes agitated every time they need assistance with personal care. Using these techniques consistently over time can help you understand what's driving that agitation and find ways to make the experience more comfortable for them.

MARCUS: What about outpatient settings?

NATALIE: Outpatient settings often involve frustrated patients who feel like they can't get appointments when they need them, or who are dealing with insurance issues, or who are managing chronic conditions that affect their quality of life. These techniques are incredibly valuable for building trust and maintaining therapeutic relationships over time.

MARCUS: Let's address something that might be on our listeners' minds. In healthcare, there are times when you have to deliver news that people don't want to hear or enforce policies they don't like. How do these techniques apply when you can't give people what they want?

NATALIE: That's where these skills really prove their value. You can't always give people what they want, but you can always treat them with respect and dignity. Let's say a patient wants a prescription for a medication that's not appropriate for their condition. You can't prescribe it, but you can validate their desire to feel better and work with them to find alternatives.

MARCUS: Can you walk through how that might sound?

NATALIE: Sure. They might say, "I need you to prescribe this medication. It's the only thing that helps." Instead of just saying no, you might clarify: "Help me understand what symptoms you're hoping to address with that medication." Paraphrase: "So you're looking for relief from these specific symptoms, and you've had some success with this medication in the past."

MARCUS: Then what?

NATALIE: Reflect: "It's frustrating when you know what has helped you before, and you want to get back to feeling better." Affirm: "You're absolutely right to want relief from these symptoms." Then advocate: "I want to help you feel better too. Let me explain why this particular medication might not be the best choice right now, and let's talk about other options that might be even more effective."

MARCUS: So you're not just shutting them down, you're redirecting toward solutions.

NATALIE: Exactly. And summarize: "So we both want you to feel better. I can't prescribe that specific medication for medical reasons, but let's work together to find something that will help with your symptoms safely."

MARCUS: That approach honors their concerns while still maintaining appropriate medical standards.

NATALIE: Right. People are much more likely to accept limitations when they feel heard and when they understand that the limitation is in service of their well-being, not just an arbitrary policy.

MARCUS: What about situations involving safety concerns? Sometimes in healthcare, people want to do things that aren't safe, or they resist necessary safety measures.

NATALIE: Safety concerns require clear boundaries, but these techniques can help you enforce those boundaries in a way that maintains dignity and cooperation. Let's say a patient wants to get up and walk around when they're a fall risk. You can't let them do that unsupervised, but you can validate their desire for mobility and work together on safe alternatives.

MARCUS: How would that conversation go?

NATALIE: You might start with clarification: "Help me understand what you're hoping to accomplish by getting up without assistance." They might say they're restless, or they need to use the bathroom, or they just want to feel more independent. Then you can paraphrase: "So you're feeling restless and you want to move around a bit." Reflect: "It's hard to be stuck in bed when you're used to being active."

MARCUS: And then work toward safe solutions?

NATALIE: Exactly. Affirm: "Wanting to be mobile and independent is completely normal." Then advocate: "I want to help you be as active as possible while keeping you safe." Summarize: "So let's figure out how we can help you get some movement and address your restlessness without risking a fall."

MARCUS: That's so much more effective than just saying "You can't get up" and leaving it at that.

NATALIE: Right. And it often leads to creative solutions that meet everyone's needs. Maybe you can arrange for supervised walks, or physical therapy visits, or even just helping them move to a common area for a change of scenery.

Communication as a Safety Strategy

MARCUS: As we start to wrap up, let's talk about the bigger picture. How do these individual communication skills contribute to the overall culture of safety in healthcare?

NATALIE: Communication is actually at the heart of most safety issues in healthcare. When people don't feel comfortable speaking up about concerns, when information isn't shared clearly, when conflicts interfere with teamwork – these communication breakdowns can directly impact patient safety.

MARCUS: So improving communication skills isn't just about being nicer – it's about creating environments where people can do their best work.

NATALIE: Exactly. When people feel heard and respected, they're more likely to follow safety protocols, more likely to report near misses, more likely to ask for help when they need it. All of these behaviors directly contribute to safety and better patient outcomes.

MARCUS: And these skills help with staff retention too, which is crucial in today's healthcare environment.

NATALIE: Absolutely. People don't leave jobs because of the work itself – they leave because of how they're treated. When healthcare organizations invest in communication skills and conflict management, they're investing in their people. And in healthcare, your people are your most important asset.

MARCUS: What would you say to someone who's listening and thinking, "This all sounds great, but I barely have time to eat lunch, let alone have extended conversations with every upset person I encounter"?

NATALIE: I'd say I understand that concern completely, and it's exactly why these skills are so valuable. When you prevent escalation on the front end, you save enormous amounts of time on the back end. One two-minute conversation using these techniques can prevent hours of dealing with complaints, incident reports, or damaged relationships.

MARCUS: And these approaches often make interactions more efficient, not less.

NATALIE: Right. When people feel heard quickly, they cooperate better, they provide better information, and they're more likely to follow instructions. All of that actually saves time.

MARCUS: What's your advice for healthcare leaders who want to implement these approaches in their organizations?

NATALIE: Start with modeling. Leaders need to demonstrate these communication skills in their own interactions with staff. You can't expect frontline workers to use respectful, de-escalating communication with patients if leadership isn't using the same approaches with them.

MARCUS: And then?

NATALIE: Provide training and support. Vistelar's conflict management programs are designed specifically for healthcare environments, and they provide both the theoretical framework and practical skills that people need. But even beyond formal training, create opportunities for people to practice these skills and discuss challenging situations.

MARCUS: What about accountability?

NATALIE: Make professional communication an explicit expectation, not just a nice-to-have. Include it in job descriptions, performance evaluations, and promotion criteria. Recognize and celebrate examples of excellent conflict management, not just clinical excellence.

The Ethical Commitment of Good Speak

MARCUS: Before we close, let's talk about hope. Healthcare can be challenging, and conflict is inevitable. But what gives you hope about the potential for these approaches to make a real difference?

NATALIE: What gives me hope is seeing how quickly these techniques can transform individual interactions and, over time, entire unit cultures. I've seen emergency departments go from chaotic, stressful environments to places where people actually enjoy working. I've seen patient satisfaction scores improve dramatically. I've seen staff turnover and injury rates drop significantly.

MARCUS: And on an individual level?

NATALIE: On an individual level, I've seen healthcare professionals rediscover why they went into healthcare in the first place. When you're not constantly dealing with conflict and drama, when interactions with patients and families are more positive, when you feel competent in handling difficult situations – that's when you can focus on the healing work that drew you to healthcare.

MARCUS: That's beautiful. And I think our listeners should remember that every expert in these techniques started as a beginner. These skills can be learned, and they get easier with practice.

NATALIE: Absolutely. And remember Vistelar's core principle: we cannot control the outcome of every interaction, but we can always manage the process. When you focus on managing your part of the process well – using respectful communication, staying calm, looking for solutions – you're doing everything within your power to create positive outcomes. And no one can question that. 

MARCUS: That's such an empowering way to think about it. You can't control other people's behavior, but you can control your response, and your response has tremendous power to influence the direction of any interaction.

NATALIE: Exactly. And in healthcare, where you're dealing with people at their most vulnerable moments, that power comes with real responsibility. Using good speak  isn't just a communication technique – it's an ethical commitment to treating every person with dignity and respect, even in difficult circumstances.

MARCUS: Well said. I think our listeners have gotten a comprehensive look at how to use verbal and non-verbal communication as shields in healthcare environments. We've covered the theoretical framework, practical techniques, specific scenarios, and implementation strategies.

NATALIE: And we've emphasized throughout that these aren't just "soft skills" – they are practical safety and treatment techniques. 

MARCUS: This podcast uses synthetic voices to share Vistelar's training and communication strategies.