De-escalation grounded in nursing science: A proposed change to de-escalation curriculum

Behavioral health emergencies are increasingly common in healthcare settings, yet most de-escalation trainings remain vendor-driven, generic, and not tailored to nursing’s clinical reasoning or trauma-informed practice. These externally developed programs often emphasize broad applicability over nursing-specific assessment and therapeutic engagement. The purpose of this paper is to propose a novel, theory-informed de-escalation curriculum that integrates proactive assessment and individualized interventions grounded in nursing science. The curriculum draws from Orlando’s Nursing Process Theory, the Behavioral Crisis Response Model (BCRM), Kolb’s Experiential Learning Theory, and Bloom’s Taxonomy to structure content from foundational knowledge to synthesis. Educational strategies include didactic instruction, simulation-based learning, and interprofessional drills to reinforce critical thinking and skill integration. The curriculum emphasizes identifying internal and external triggers, assessing the patient’s phase in the assault cycle, and selecting targeted, evidence-based interventions. By promoting clinical judgment and individualized care, the curriculum moves beyond standardized, algorithmic responses. The proposed curriculum is suitable for application in academic, nurse residency programs, and clinical unit settings, representing a paradigm shift from reactive to proactive crisis response. Positioning de-escalation as a core nursing competency empowers nurses to interpret agitation as communication, preserve dignity, and reduce reliance on restraints or security measures. Embedding structured, theory-driven simulation enhances clinical judgment, emotional intelligence, and workforce readiness, positioning nurses as leaders in compassionate, evidence-based behavioral health emergency intervention.