Responding to Angry Outbursts from Staff

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

A new manager recently asked me about the best approach to responding to an angry outburst from a staff member. A staff nurse on her unit had become very angry in a staff meeting about an upcoming change in policy. She was disrespectful to the manager accusing her of having no clue what staff were up against in taking care of patients with their current staffing levels. She recognized that the angry outburst probably had little to do with the new policy or even her as a new manager but rather was probably pent up frustration about a rapidly changing and somewhat chaotic work environment. The root cause of why the person is upset or stressed may not even be related to work. This is a common challenge that managers are discussing with me – the pent-up rage of staff about their work environments driven by stress and burnout.

Diffusing emotions can be very challenging especially when you are new and somewhat insecure in your role. While it is clear that the behaviors that the manager described to me cannot be tolerated in the long-run, diffusing the emotion in the moment is critical to establishing acceptable behavioral expectations on the unit. In this situation, the manager and I talked through how to both diffuse at the time it happens and manage it so it does not occur again.

Step 1 – Acknowledge the anger and frustration by showing respect and empathy. Don’t react personally as this is not about you.

Step 2 – Make it clear that you expect respectful communication and will discuss the issue with her outside this meeting. Stop the conversation at this point and move on to the next topic.

Step 3 – Plan a follow-up meeting time but make sure you have control of your anger before engaging in the conversation. Recognize that you are probably dealing with a staff member who has very strong emotions so be prepared to manage it.

Step 4 – Meet with the staff member to discuss the issue. Plan out how you will manage the meeting using a cognitive rehearsal. Listen to their concerns and if they have good suggestions, develop some goals.

Step 5 – Specifically address the emotional outburst using the situation – behavior – impact – expectation model. Don’t avoid doing this.

Situation – During our staff meeting on Thursday, I presented the new policy on admission histories. (Be very specific and accurate so there is no confusion about what the outburst was in response to and the timing).
Behavior – In response to this policy change, you became very angry and accused me of having no clue about what staff were up against with staffing on the unit.
Impact – Your behavior was very disrespect and your reaction made it difficult and uncomfortable to discuss the issue in a professional manner.
Expectation – I value your opinions as a professional on this unit but your approach in this situation was unacceptable and unprofessional. It is my expectation that you will manage your emotions and that we are able to engage in a constructive conversation about your concerns. If this happens in the future, I cannot ignore it and it could result in disciplinary action. I am here to talk privately with you but won’t engage in a forum with other staff. Don’t discuss the conversation with any other staff member on the unit – keep it confidential even if staff members question you about “what are you going to do about this?”

I shared with this young manager the importance of dealing with this situation directly. If problems are ignored or not handled well, then the conflict can quickly spiral out of control.