Critically discuss how de-escalation strategies could positively affect the outcome of challenging interpersonal situations in the clinical environment. You will be expected to demonstrate that you understand the key skills of effective de-escalation

Assignment Task

1. De-escalation

Critically discuss how de-escalation strategies could positively affect the outcome of challenging interpersonal situations in the clinical environment.

You will be expected to demonstrate that you understand the key skills of effective de-escalation techniques and some of the factors which lead to situations in the clinical environment which require de-escalation. As well as:

• Barriers or challenges to effective de-escalation. You can also discuss factors which can cause challenging interpersonal situations.
• Key communication strategies used in de-escalation.
• The utility of positive behavioural support plans.
• How authoritative or facilitative approaches can influence the outcome of the interaction (Herons’ Six Category Intervention Analysis). You can Choose to identify one or two of these and briefly discuss these in relation to communication in de-escalation or you can discuss how understanding various communication interventions can enhance interpersonal communication.

2. Difficult conversations and breaking bad news

Describe, using the appropriate theory, how you would share difficult news with a person in a clinical setting.

Demonstrate an understanding of protocols surrounding the breaking of bad news:

• Including a relevant framework of communication for example SPIKES protocol.
• Demonstrate your knowledge of communication strategies that can be applied when breaking bad news.
• Integrate a reflective evaluation of the impact of difficult conversations on you as a practitioner. This should include a discussion on your experience or involvement as a practitioner.

Some things you could consider including in the reflective evaluation could include,

Why breaking bad news was difficult/could be difficult for you as a practitioner? 

How you managed to tackle the difficulty and/or difficulties as a practitioner considering the effective communication strategies and framework applied. 

How did you manage your own feelings and responses, what personal strategies could you utilise to manage your own emotional labour?

Any challenges experienced when and/or/during and/or after breaking bad news and how, why you might manage this differently in future.

3. Interpreting and sharing information about treatment options.

Demonstrate an understanding of key principles and approaches utilised in interpreting and sharing information about treatment options, within the clinical environment.

• Demonstrate an understanding of key principles in interpreting and sharing information about treatment options including key communication strategies – such as informed decision-making aids and tools – see NICE guidelines on sharing treatment options. Examples of key principles could include Empowerment; think about your duty to empower and demonstrate your knowledge and understanding; identifying when service users might feel empowered in making decisions.
• An understanding of the ethical principles of shared autonomy/autonomy and link the ethical discussion to the NMC code.
• The communication needs of your service user in relation to interpreting and sharing information; Person centred principles; Theories of partnership working. Evaluate how applying these principles would help develop a collaborative partnership with the service users.
• Integrate a reflective evaluation on improvements you might make in your future approach to interpreting and sharing information about treatment options.

4. Implementing one or more therapeutic interventions (e.g., CBT, solution focused therapy etc.)

With reference to one specific talking therapy, critically analyse the benefits and limitations of its uses in an identified area of your nursing practice.

Demonstrate an understanding of the theory surrounding one therapeutic approach (for example CBT, solution-based therapy / motivational interviewing, Including referencing key theorists in relation to your chosen approach.

• Demonstrate an understanding of what health conditions this therapeutic intervention could be applied to and why?
• How you may apply this within your own area of clinical practice (within your own field of nursing, i.e., adult nursing or mental health nursing).
• Demonstrate a critical appreciation of the strengths and limitations of your chosen talking therapy