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Early intervention can help prevent disruptive behavior.

It’s not like a doctor or nurse starts the day out planning to be disruptive. There are a series of deep-seated, sub-acute, and acute events that may trigger a disruptive response (see Table 1). Unfortunately, most of the interventions start in the post-event stage after a disruptive event has already occurred. Interventions at this stage of the process often take on a confrontational, punitive approach, that have varying degrees of success. For some individuals simply discussing the event and raising the level of awareness about how the event was perceived at the receiving end impacting the individual’s perception and reaction is enough to raise their level of awareness and sensitivities to the point that another disruptive event would be unlikely to occur. In others there are more deep-seated issues that may benefit from participation in educational programs or training workshops. Some individuals may require more intensive counseling. For the small number who refuse to comply, disciplinary action such as temporary suspension or termination may be required. But a greater opportunity for success would be to intervene earlier on in the process. Identifying individuals who are “at risk” for a disruptive event and proactively providing coaching or emotional support is a more positive and successful approach than the post-event intervention process.