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Part 4: Managing ‘difficult’ calls
Learning Objectives At the end of this session you be able to describe appropriate ways to:  ,[object Object]
deal with a caller in crisis
respond to non-priority callers
manage an aggressive caller,[object Object]
I can hear you’re anxious/angry/upset and we need to talk about what your needs are, so I can give you appropriate help. Can you do this now or would you like to call me back later when it’s easier for you to talk?
Caller in crisis
Caller in Crisis
Caller in Crisis:Clinician assessment of the risk of self harm
What should you do when non priority groups want an appointment?
Non priority groups wanting an appointment 	If the caller is adamant that they want to attend the service and they are not triaged as an STI priority … Be firm -- not defensive or overly apologetic -- and polite.  Be aware of the tone of your voice, it is probably easier to convey empathy in your voice, if you think about what the caller wants and the feelings they are experiencing. Remember the role of triage includes finding the right service for the caller.
Non priority groups wanting an appointment Inform the caller you are happy to assist in finding an appropriate service for them. It may be difficult for some people to communicate over the phone and it may be appropriate to offer to refer them to a nurse or manager.
I’m not sure I can assist you any further, would you like to talk to a nurse or manager? We are a specialised service and what you are requesting can be done by a GP.  I’m happy to help you find an appropriate service you can attend.
Client wants free services 	Sometimes non-priority clients want to come into a sexual health clinic because it is free and some other services that provide testing may come at a cost which the caller is reluctant or unable to pay. 	Essentially, there is not enough funding or resources for sexual health services to provide testing to the whole NSW population.
It sounds like the cost of testing may be an issue for you. If you wish, I can suggest a service that may be able to provide you with some other options. It’s called the NSW Sexual Health Info-line and you will be able to speak to a Sexual Health Nurse….
Verbal aggression and threats NSW Health has a zero tolerance for any aggression in the workplace and it is not your role to be a recipient of such offensive behaviour. If a caller becomes verbally aggressive, inform them of your limits.
Verbal aggression and threats Describe the specific behaviour that you want the caller to stop. 	If the caller continues to raise their voice and make threats, inform the caller you will end the call and then do so. Follow theNSW Health Policy Directive – Zero Tolerance Response to Violence in the NSW Health Workplace. Follow local procedures related to responding to aggression in the work place.
I can’t assist you if you keep shouting and swearing. If you don’t stop I’ll have to end this call.
Reflective Exercise Think about the last time you dealt with a difficult call  What listening skills did you demonstrate?  What did the caller want?  How did that make you think and feel?  Did you remain calm?
 Was your manner positive and professional?  Were you able to say no without feeling anger, guilt or fear?  Did you avoid  responding forcefully and arguing back? What did you say to convey empathy and understanding? Were you happy with the information you provided to the caller? Did you remain patient and in control of your emotions? Did you feel angry and if so, were you able to relax enough to respond calmly to the caller? If you had the same type of call what would you do differently next time?

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Triage Course For Sexual Health Clinic Intake Staff Part 4

  • 1. Part 4: Managing ‘difficult’ calls
  • 2.
  • 3. deal with a caller in crisis
  • 5.
  • 6. I can hear you’re anxious/angry/upset and we need to talk about what your needs are, so I can give you appropriate help. Can you do this now or would you like to call me back later when it’s easier for you to talk?
  • 9. Caller in Crisis:Clinician assessment of the risk of self harm
  • 10. What should you do when non priority groups want an appointment?
  • 11. Non priority groups wanting an appointment If the caller is adamant that they want to attend the service and they are not triaged as an STI priority … Be firm -- not defensive or overly apologetic -- and polite. Be aware of the tone of your voice, it is probably easier to convey empathy in your voice, if you think about what the caller wants and the feelings they are experiencing. Remember the role of triage includes finding the right service for the caller.
  • 12. Non priority groups wanting an appointment Inform the caller you are happy to assist in finding an appropriate service for them. It may be difficult for some people to communicate over the phone and it may be appropriate to offer to refer them to a nurse or manager.
  • 13. I’m not sure I can assist you any further, would you like to talk to a nurse or manager? We are a specialised service and what you are requesting can be done by a GP. I’m happy to help you find an appropriate service you can attend.
  • 14. Client wants free services Sometimes non-priority clients want to come into a sexual health clinic because it is free and some other services that provide testing may come at a cost which the caller is reluctant or unable to pay. Essentially, there is not enough funding or resources for sexual health services to provide testing to the whole NSW population.
  • 15. It sounds like the cost of testing may be an issue for you. If you wish, I can suggest a service that may be able to provide you with some other options. It’s called the NSW Sexual Health Info-line and you will be able to speak to a Sexual Health Nurse….
  • 16. Verbal aggression and threats NSW Health has a zero tolerance for any aggression in the workplace and it is not your role to be a recipient of such offensive behaviour. If a caller becomes verbally aggressive, inform them of your limits.
  • 17. Verbal aggression and threats Describe the specific behaviour that you want the caller to stop. If the caller continues to raise their voice and make threats, inform the caller you will end the call and then do so. Follow theNSW Health Policy Directive – Zero Tolerance Response to Violence in the NSW Health Workplace. Follow local procedures related to responding to aggression in the work place.
  • 18. I can’t assist you if you keep shouting and swearing. If you don’t stop I’ll have to end this call.
  • 19. Reflective Exercise Think about the last time you dealt with a difficult call What listening skills did you demonstrate? What did the caller want? How did that make you think and feel? Did you remain calm?
  • 20. Was your manner positive and professional? Were you able to say no without feeling anger, guilt or fear? Did you avoid responding forcefully and arguing back? What did you say to convey empathy and understanding? Were you happy with the information you provided to the caller? Did you remain patient and in control of your emotions? Did you feel angry and if so, were you able to relax enough to respond calmly to the caller? If you had the same type of call what would you do differently next time?
  • 21. Please click here to test your knowledge

Editor's Notes

  1. NSW Health (2005) NSW Health Policy Directive – Zero Tolerance Response to Violence in the NSW Health Workplace Document Number PD2005_315, Publication date 27-Jan-2005.Health Services should have in place local procedures and protocols to supportthe range of available options. Procedures need to be communicated to staff,and staff should be provided with training to enable them to exercise the optionsappropriately and effectively, particularly those involving clinical restraint.Immediate and short-term options available to staff (in no particular order)include the following:● issuing a verbal warning (violent patient or visitor)● using verbal de-escalation and distraction techniques (violent patient or visitor)● seeking support from other staff (violent patient or visitor)● requesting that the aggressor leave (violent visitor)● requesting review by a clinician (violent patient)● retreating (violent patient or visitor)● utilising NSW Health clinical restraint policies as appropriate (violent patient)● utilising NSW Health sedation policies as appropriate (violent patient)● negotiating conditional treatment, or determining inability