Communication Module for dealing with an Angry patient or relative

The basic structure for communication skills remains the same. Recall the mnemonic P I CX3.

Take into considerations of following points during consultation.

AAcknowledge1. Acknowledge the problem
2. Acknowledge the concerns
3. Acknowledge and validate the emotions of the patient/relative
AApologize and EmpathizeApologize for the issue
RRequestEngage the patient in determining the solution by requesting information
RResolvePresent the options and pay close attention to the patient’s response — both verbal and non-verbal cues. Confirm the resolution you picked up on, so all parties know the agreed upon solution.
RRespectRespect them throughout the encounter.
Let them talk & don’t interrupt them
Remain polite & avoid confrontations
Occasionally when communicating with patients we may feel there is a possible threat of violence. If this is the case you should remove yourself from the situation and prioritise your own safety.

Close the consultation ensuring if you have managed to address his/her concerns & if he/she wants to ask anything else.

Example – Dealing with an angry patient whose surgery is postponed (Taken from Dr. Tourky notes):

Good morning Mr………, my name is Dr……….., I am the orthopedic trainee covering for my consultant.

I understand that you have come today for your knee operation. Mr.………, I am very sorry to say that but unfortunately my consultant has been called away for an emergency case and we will be unable to carry out your case today

Again, I do apologize. I can see that your knee has been really troubling you. It would have been good to be able to have it done today. I understand your frustration as I see from your notes that you were postponed once before. However surgical emergencies have to be prioritized and this is why my consultant was called away. I am really sorry for that.

Sorry, as I told you he is busy now with that emergency case and he will be unable to pickup my call.

Mr…., It is your right to choose your doctor but I am afraid that also will be time consuming as the new consultant will study your case from the start.

I am sorry but i am not authorized to do such operations without supervision.

I am sorry but I cannot give you the next available date just now. We will call you once we put in a date. But I promise I will mention your circumstances and emphasize the importance of having you listed the next possible soonest session.

I am sorry sir, but if such an emergency should rise again, it will need to be prioritized.

I can write a letter to your employer explaining the medical reason of why you will not be able to carry out your job as a post man for now and that you will need more sick-leave as your procedure has been postponed. If you want I can call him for you.

Well, there will be some wearing and tearing. However, you should remain active with non-weight bearing exercises such as swimming to keep the muscles around your knee strong. I can also refer you to a physiotherapist who will recommend some good exercises to strengthen your knee.

I can prescribe a different type of pain killer. You should stop diclofenac as it increases the risks of stomach ulcers. Again, accept my sincerest apologies.

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