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Oct 10, 2022

Verbal de-escalation is a tool that can be learned by almost anyone. In this episode, we learn from two masters in the art of de-escalating those who are agitated and upset:  Jose Pacheco, RN, known affectionately to his co-workers as ‘The Drunk Whisperer’,  and Dan McCollum, MD,  emergency physician at Augusta University. The core of this conversation hinges around an approach to conflict resolution that evolved from the martial arts principle of using your opponent’s energy to resolve conflict, rather than simply butting heads. The name for this method? Verbal Judo.

A proviso to all of this is that if the room/scene needs to be safe. Your top priority is to keep yourself and your team safe. Do not put yourself at risk. That doesn’t always mean physical escalation (though sometimes it does), it can simply mean removing yourself from the physical space of the escalating situation. 

Mentioned in this episode: Awake and Aware Physician conference sponsored by Wild Health. Jan 13-15 Sedona Arizona. Use the code CONSCIOUSPHYSICIAN for 15% off (that’s 15% off the whole package - lodging, meals, the course)


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For full show notes visit our podcast page


We discuss:

  • Jose Pacheco's tactics to de-escalate and defuse agitated patients in the emergency department [03:13];
  • Dan McCollum’s de-escalation sequence based on needs of the situation [09:30];
  • The unifying principle of verbal judo: Empathy absorbs tension [15:50];
  • Present the professional image [22:50];
  • The Universal Upset Patient Protocol [24:20];
  • “We treat people as ladies and gentlemen not because they are, but because we are.” [35:50];
  • You can’t control how an upset person is going to respond to conflict, you can only control how you respond. [36:40];
  • Seeing a situation from the other person’s eyes. [37:50];
  • Sword of Insertion technique aka How to politely interrupt [38:20];
  • Active listening [40:50];
  • Jose Pacheco’s tips for interacting with difficult patients in the ED. [42:30];
  • Non-verbal cues [53:30].