From Awareness to Action: An HR Guide to Making Accessibility Accessible
Dealing Effectively With Angry People Jan 2022.pptx
1. Dealing Effectively With
Angry People
Reddington Hospital Group
Your Logo
Andy Cunliffe
Business Dev
Director
January 2022
2. • Recognising the Patient Is Angry
• Adjusting Your Communication Style
• Understanding Why They Are Angry
• Responding to the Anger
• Things to Avoid When Speaking to
Angry Patients
• Difficult Situations
• Don’t Ignore How You Feel
DEALING WITH ANGRY
PATIENTS
4. RECOGNISE THE PATIENT IS ANGRY
It is very important that we first identify that the
person we are talking to is angry.
Identifying emotions is a very useful skill
• Loud speech or shouting
• Swearing / verbal abuse
• Oversensitivity to what’s being said
• Aggressive posturing, won’t sit down
• Threatening to walk away
• Pacing up and down, shaking, fist clenching
• A rise in the pitch and/or the pace of the voice
• Change in eye contact / frowning
RECOGNISE
THE
PATIENT IS
ANGRY
Behaviour will vary when people are angry. You
might see the following behaviours.
6. Once we recognise our patient is angry we
can adjust our communication style
• Voice
• Body Language
• Acknowledge the Patient’s Anger
ADJUSTING YOUR
COMMUNICATION STYLE
ADJUSTING
YOUR
STYLE
c
o
m
m
u
n
i
c
a
t
i
o
n
8. UNDERSTANDING WHY
THEY ARE ANGRY
• Try to understand why they are angry
• Ask open questions to identify the
focus of why they are angry
• Listen to the explanation as to why
they are angry
10. RESPONDING TO THE ANGER
• Empathy
• Apologise
• Thank the Patient
• Encourage Questions / Solutions
• Ending the Conversation
Once you have gathered information about
the patient’s anger, and they have said what
they need to say, start to respond to the
situation they’ve described alongside any
questions they may have.
RESPONDING
TO THE
ANGER
12. THINGS TO AVOID WHEN
SPEAKING TO ANGRY PATIENTS
• Suggesting a Quick Fix
• Getting Angry Yourself
• Being Defensive
RESPONDING
TO THE
ANGER
13. RESPONDING TO THE ANGER
• Empathy
• Apologise
• Thank the Patient
• Encourage Questions / Solutions
• Ending the Conversation
Once you have gathered information about
the patient’s anger, and they have said what
they need to say, start to respond to the
situation they’ve described alongside any
questions they may have.
RESPONDING
TO THE
ANGER
14. WHAT’S LEFT TO DO
• DIFFICULT SITUATIONS
• DON’T IGNORE HOW YOU FEEL
• CONCLUSIONS
RESPONDING
TO THE
ANGER
Learning how to deal with angry patients and/or relatives is a valuable skill we can develop to support us in clinical practice. Given the nature of the healthcare environment, you will almost definitely encounter these situations at some point.
I will talk through some strategies you can use to assist in these interactions, hopefully resulting in a more positive outcome for both you and the patient or relative.
Examples of reasons why patients/relatives become angry:
• They have been left to wait a long time before being seen in clinic or A&E
• An error has been made by the medical/surgical team
• There has been a delay in diagnosis or treatment
• They have just received bad news
• The patient/relative expectations are not being met
These issues can be exacerbated by drug or alcohol use, underlying mental health problems, a history of anger management issues and or violence/aggression.
Adjusting your style of communication when a patient is angry
Once we recognise our patient is angry, we can adjust our style of communication to try and defuse their anger or at least prevent them from becoming angrier.
Voice
Adjust the tone, speed and volume of your voice:
Try to keep a calm tone and remain composed (this can be difficult when you are being shouted at)
Speak slowly and clearly
Do not raise the volume of your voice if the patient is shouting
Body language
Adopt a professional yet relaxed posture:
An example, if seated, might be uncrossing your arms and legs with both feet on the floor.
Sitting back in the chair can help slightly (though taking care not to appear like you don’t care) to avoid appearing confrontational.
Acknowledge the patient’s anger
At this stage, pointing out to the patient that they appear upset/angry can be helpful:
An example might be: ‘You’re looking very upset by all of this’
Sometimes hearing this back can enable the patient or relative to recognise their emotion and start to process it.
The patient might respond in two ways:
They may correct you: ‘No, I’m actually just frustrated’ (you can then adapt to deal with the other emotion).
They may agree ‘absolutely’ or ‘of course I am!’ (you have then confirmed the emotion).
Try to understand why they are angry
Often there are other emotions behind the anger for example frustration, or more commonly fear.
Ask open questions to identify the focus of why they are angry:
‘Tell me more?’
‘Why are you feeling this way?’
‘Is there anything else that happened that is making you angry?’
Listen to the explanation as to why they are angry:
Demonstrate active listening skills such as eye contact, nodding, verbal responses (e.g. ‘mmm’).
Allow the patient to vent at you completely if needed – they may need to get some things off their chest. Give them plenty of space to speak.
Avoid interrupting the patient * (see the note on interruption below).
Empathy
At this stage, you need to demonstrate empathy towards the patient. Essentially this is the acknowledgement and appreciation of someone else’s emotions. Empathic phrases you could use are:
‘Given everything you’ve told me, it’s understandable you feel that way’
‘It sounds like you have a lot going on at the moment, and it’s natural that you’re feeling angry’
When you demonstrate empathy, patients feel cared about and listened to. This builds rapport between you & the patient to diffuse their anger and create a safe environment for them/relatives to talk openly.
Apologise if an error has occurred. If the patient is legitimately angry as a result of a medical error– apologise.
‘I’m so sorry this mistake has occurred and caused you/your relative harm’. Acknowledge the seriousness of the mistake made and legitimize the patients’ anger.
It is often useful to explain to the patient or relative that when medical errors do unfortunately occur they are taken very seriously and reports are filed to ensure things like this do not happen again.
If we’re not at fault, be careful about how you apologise. Do not enable the patient to blame when you have not done anything wrong. You should still apologise that the unfortunate event has occurred e.g. ‘Im sorry that you are feeling so angry about what has happened’, whilst being careful not to assume responsibility if you or the healthcare team were not at fault. This may affect the patients’ expectations in the future.
Thank the patient
Sometimes it’s appropriate to thank the patient (‘Thank you for sharing how you feel with me, it’s important I understand how you feel so we can work together to help you’).
Encourage questions/solutions
You might like to ask the patient or relative if there’s anything you can do for them. This shows again that you care enough about the situation that you wish to help rectify it (e.g. ‘What can I do to help you?’). Sometimes when people are angry they have difficulty thinking of solutions and may welcome your attempt at suggesting one.
Closing the interview - Conclude the consultation by thanking the patient/relative for their time.
Suggesting a plan going forward can help make sure a patient/relative does not feel abandoned soon after being very angry. Formulating some action points going forward also helps to acknowledge the patient’s anger.
Some examples might include:
Organising a meeting with the clinical nurse specialist if the patient is dealing with a difficult diagnosis.
Advise that you are going to pass on the information to a senior if an error has occurred.
Organize a follow-up meeting with the patient or relative if they wish to discuss the situation further, and suggest they perhaps note down any questions they think of so you can be sure to address their concerns.
Things to avoid when speaking to angry patients
Suggesting a quick fix
Often patients want/need to explore the emotion they are feeling rather than finding a quick solution. Obviously, this will depend on the scenario but think carefully before coming up with a rapid solution that may not even serve you well.
Getting angry yourself
Try to be mindful and aware of how the interaction with the patient is making you feel. You, in turn, might feel angered by how the patient is speaking/the things they are saying. Try to keep control of your emotions and remain professional. You may feel entitled to being angry but demonstrating this to an already angry patient is likely to upset them even more. Perhaps talking to a colleague about the situation afterwards would be more helpful, should you feel the need to do so.
Being defensive
Becoming defensive might feel like the natural thing to do, particularly if you are feeling like someone is being angry at you for no legitimate reason. Try to avoid the temptation of responding defensively as it can escalate the patient’s anger.
Empathy
At this stage, you need to demonstrate empathy towards the patient. Essentially this is the acknowledgement and appreciation of someone else’s emotions. Empathic phrases you could use are:
‘Given everything you’ve told me, it’s understandable you feel that way’
‘It sounds like you have a lot going on at the moment, and it’s natural that you’re feeling angry’
When you demonstrate empathy, patients feel cared about and listened to. This builds rapport between you & the patient to diffuse their anger and create a safe environment for them/relatives to talk openly.
Apologise if an error has occurred. If the patient is legitimately angry as a result of a medical error– apologise.
‘I’m so sorry this mistake has occurred and caused you/your relative harm’. Acknowledge the seriousness of the mistake made and legitimize the patients’ anger.
It is often useful to explain to the patient or relative that when medical errors do unfortunately occur they are taken very seriously and reports are filed to ensure things like this do not happen again.
If we’re not at fault, be careful about how you apologise. Do not enable the patient to blame when you have not done anything wrong. You should still apologise that the unfortunate event has occurred e.g. ‘Im sorry that you are feeling so angry about what has happened’, whilst being careful not to assume responsibility if you or the healthcare team were not at fault. This may affect the patients’ expectations in the future.
Thank the patient
Sometimes it’s appropriate to thank the patient (‘Thank you for sharing how you feel with me, it’s important I understand how you feel so we can work together to help you’).
Encourage questions/solutions
You might like to ask the patient or relative if there’s anything you can do for them. This shows again that you care enough about the situation that you wish to help rectify it (e.g. ‘What can I do to help you?’). Sometimes when people are angry they have difficulty thinking of solutions and may welcome your attempt at suggesting one.
Closing the interview - Conclude the consultation by thanking the patient/relative for their time.
Suggesting a plan going forward can help make sure a patient/relative does not feel abandoned soon after being very angry. Formulating some action points going forward also helps to acknowledge the patient’s anger.
Some examples might include:
Organising a meeting with the clinical nurse specialist if the patient is dealing with a difficult diagnosis.
Advise that you are going to pass on the information to a senior if an error has occurred.
Organize a follow-up meeting with the patient or relative if they wish to discuss the situation further, and suggest they perhaps note down any questions they think of so you can be sure to address their concerns.
Empathy
At this stage, you need to demonstrate empathy towards the patient. Essentially this is the acknowledgement and appreciation of someone else’s emotions. Empathic phrases you could use are:
‘Given everything you’ve told me, it’s understandable you feel that way’
‘It sounds like you have a lot going on at the moment, and it’s natural that you’re feeling angry’
When you demonstrate empathy, patients feel cared about and listened to. This builds rapport between you & the patient to diffuse their anger and create a safe environment for them/relatives to talk openly.
Apologise if an error has occurred. If the patient is legitimately angry as a result of a medical error– apologise.
‘I’m so sorry this mistake has occurred and caused you/your relative harm’. Acknowledge the seriousness of the mistake made and legitimize the patients’ anger.
It is often useful to explain to the patient or relative that when medical errors do unfortunately occur they are taken very seriously and reports are filed to ensure things like this do not happen again.
If we’re not at fault, be careful about how you apologise. Do not enable the patient to blame when you have not done anything wrong. You should still apologise that the unfortunate event has occurred e.g. ‘Im sorry that you are feeling so angry about what has happened’, whilst being careful not to assume responsibility if you or the healthcare team were not at fault. This may affect the patients’ expectations in the future.
Thank the patient
Sometimes it’s appropriate to thank the patient (‘Thank you for sharing how you feel with me, it’s important I understand how you feel so we can work together to help you’).
Encourage questions/solutions
You might like to ask the patient or relative if there’s anything you can do for them. This shows again that you care enough about the situation that you wish to help rectify it (e.g. ‘What can I do to help you?’). Sometimes when people are angry they have difficulty thinking of solutions and may welcome your attempt at suggesting one.
Closing the interview - Conclude the consultation by thanking the patient/relative for their time.
Suggesting a plan going forward can help make sure a patient/relative does not feel abandoned soon after being very angry. Formulating some action points going forward also helps to acknowledge the patient’s anger.
Some examples might include:
Organising a meeting with the clinical nurse specialist if the patient is dealing with a difficult diagnosis.
Advise that you are going to pass on the information to a senior if an error has occurred.
Organize a follow-up meeting with the patient or relative if they wish to discuss the situation further, and suggest they perhaps note down any questions they think of so you can be sure to address their concerns.
