Changing Perceptions; Changing Care

Very few of us would say we share the same perspective on things today as we did 10 years ago. I entered the human services field 20 years ago . . . and now that I’ve dated myself and feel completely old . . . my perspectives are certainly different. Best practices are certainly different.

I find it fascinating, really, how our perceptions and perspectives change over time; how one little interaction can change the way we think about a certain topic. Some people call these occurrences epiphanies, or aha moments. They cause us to take pause, they connect dots that were not connected before, and they change who we are at our core beliefs.

Some of my perceptions or perspectives have changed through personal experiences and the natural maturing that most of us do over time. A personal example of this came early in my career. I thought I had pretty good self-control, and I thought I was pretty good at de-escalation skills—until I met “Brian” (names are changed to protect the innocent).

One day, hot on Brian’s tail to get him to go back into his individual pod’s dayroom, I went to slam the door behind him as if that added emphasis would convince him to stay in there as I wished. Just as I was pushing the door shut, he stuck his head back out and I caught his head between the doorjamb and the door. As we both stood there stunned, I made an attempt to gain control of my own behavior, shouting “Are you okay?”

I had an epiphany in that moment of how difficult it was to get back in control when I was losing control, and it gave me a new appreciation for every young person I worked with who at times would get angry, yell, or slam a door. Forevermore, I have been more patient as I’ve worked to de-escalate someone who has lost emotional and rational control. It’s really difficult, but I have coping skills—and that different perspective.

My perceptions or perspectives have also been changed through my work with other professionals. I have a dear friend who’s a trainer of CPI’s Nonviolent Crisis Intervention^® training program. He works in a locked psychiatric hospital that provides care for all ages. He, along with many others, saw restraint—especially mechanical restraint—as a tool. People acted out, and using restraint was how the staff responded.

My friend shared a story about how his perspective was changed, and that story further cemented a newly budding perception I had at the time about the risks of re-traumatization by restraint use. My friend and his fellow team members were transitioning a young woman into mechanical restraint when she burst into tears and began begging and pleading with staff. She simply made one plea: “I’ve been raped. I’ll let you restrain me, but please, please let me keep my legs together . . . Please—I’ve been raped.”

In that moment, my friend saw this young woman as a victim and vowed from that moment on not to further victimize any patient at his hospital. He took a hard stance against the use of mechanical restraints. He was very unpopular, but he stood up for his beliefs, his perceptions—and his facility has not used mechanical restraint for several years now. What was perceived as an essential tool for daily practice is now perceived as something they would never do. And staff and patients are still safe.

My work at CPI has changed my perception and my perspective on many things. I work hard not to pass judgment on individuals I consult with or speak with when they use phrases like “frequent flier” or call people “the borderlines” or “the schizos.” Any one of us is a heartbeat away from being one of our patients.

Especially in healthcare, it often takes a while to get to really know your patients, if you get to really know them at all. At CPI, we teach a concept called the Integrated Experience. It’s the concept that the behaviors and attitudes of staff impact the behaviors and attitudes of the individuals in your care and vice versa. How we perceive the individuals in our care greatly impacts the level of patient care we provide.

Watch our short video, “Changing Perceptions. Changing Care.” Take a moment and think about how your behaviors, attitudes, and perceptions ultimately shape your patient care. My wish for all professionals is that they continue to grow and strive to better understand the individuals they provide care for. We’ve come so far in providing for better patient care while ensuring safety for everyone, but there is still work to be done.