This document provides guidance for nursing professionals on how to respond respectfully to difficult questions. It recommends using the four Cs of control, clarify, content, and closure when answering. For each question, listen attentively to assess the intent, confirm the question, and identify the level of interest before providing an honest, clear, and concise answer. Verify that the response addressed the question and end positively while maintaining control of the discussion.

1. Stay Above the Fray: Give Respectful Answers to Difficult Questions
Dawn Pepsnik, MEd, MS, RN-BC; dpepsnik@nmh.org Jeff Zurlinden, MS, RN-BC; nsginfo@earthlink.net
Abstract –Nursing Professional Development (NPD) specialists encounter
challenging questions in their day-to-day practices. By listening attentively, they
can quickly assess the real question, as well as answer diplomatically and
accurately while remaining poised and professional. Difficult questions often fall
into four different categories:
 requests for specific information
 requests for uncertain information
 requests for off-topic information
 expressions of opinions or displeasure
NPD specialists would like to improve their skills when answering difficult
questions from patients, colleagues, and others during classroom, or e-mail
communications. Learn how to maintain control of your answer, as well as the
question, the person asking the question, others hearing the question, your
time, and your composure. Regardless of the kind of question, you can improve
your response by using the four Cs:
1. Control
2. Clarify
3. Content
4. Closure
Establish Ground Rules
Questions now, later or throughout?
Open the Floor for Questions
2014 ANPD Annual Convention July 16-19, 2014, Orlando, FL
Listen Attentively
&
Assess the Intent of the Question
 Specific information?
 Uncertain information?
 Off-topic question?
 Expression of opinion or displeasure?
Confirm the Question
 Remain calm and non-judgmental (words, tone
& body language).
 Manage expectations.
 Clarify the objectives of the encounter.
 Am I the best person to answer the question?
If not, then who would be the best person?
Identify Level of Interest
 Seek consensus of others’ interests.
 Answer now or later.
 One on one or as a group.
Answer the Question Respectfully
 Be honest.
 Be clear.
 Be concise.
 Avoid over answering.
 Reframe negatives to positives.
 Use appropriate health literacy language.
 Admit when you don’t know the answer.
Verify the Answer
 Seek feedback, did this answer their question?
 Negotiate how and when to provide additional
resources.
 Escalate as needed.
 Redirect to audience’s experiences, as appropriate.
 End positively and with a sense of completion.
 Move on to the next question.
•
Emphasize Benefits
 Reframe when necessary.
 Address all benefits for the questioner.
References:
— Gallo, C. (2009). The Presentation Secrets of Steve Jobs: How to Be Insanely Great in Front of Any
Audience. Columbus, OH, McGraw-Hill.
— Steele, W. (2009) Presentation Skills 201: How to Take it to the Next Level as a Confident, Engaging
Presenter. Parker, CO, Outskirts Press.
— Toogood, G. (2010). The New Articulate Executive: Look, Act and Sound Like a Leader (2nd. Ed.).
Columbus, OH, McGraw-Hill.
— Weissman, J. (2013). In the Line of Fire: How to Handle Tough Questions...When It Counts (2nd ed.).
Upper Saddle River, NJ, Pearson Education.
— Weissman, J. (2009). The Power Presenter: Technique, Style, and Strategy from America's Top
Speaking Coach. Hobeken, NJ, Wiley.
— Weissman, J. (2013). Winning Strategies for Power Presentations. Upper Saddle River, NJ, Pearson
Education.
— Dickens, C. & Piano, M. R. (2013). Health Literacy and Nursing: An Update. American Journal of
Nursing, 113 (6): 52-58.
— Dickens, C. Lambert, B. Cromwell, T. & Piano, M. R. (2013). Nurse Overestimation of Patients’ Health
Literacy. Journal of Health Communication, 18: 62-69.
Summary
CONTROL (Response cycle repeats)
CLARIFY
CONTENT
Regain the Floor
CLOSURE
CONTROL (Response cycle begins)