Conflict resolution – The patient is always right, mostly.

conflict resolution - conflict management

Understanding and addressing your patients’ needs is the ultimate goal of the conscientious care worker. In any work environment, too often, when employees are confronted by angry customers, they inadvertently escalate the situation rather than address the root cause. Conflict resolution and customer service are key skillsets used effectively by experienced carers.

De-escalation techniques for employees.

The health care environment is an extremely stressful yet rewarding area to work in. Care workers have a responsibility to their patients, the patient’s relatives and their colleagues.

They have a duty of care to ensure the safety and well-being of those around them. They need to treat patients with the dignity and respect they deserve while keeping patient information confidential throughout.

These challenges are difficult at the best of times but can become a ticking time bomb when challenged by the patient or their relatives. Emotion will often play a part in client unhappiness, usually because they have an underlying illness or condition that they need help with. The key to resolving patient concerns, particularly where anger or frustration is evident lies with the demeanour of the care worker and certain de-escalation techniques that can be employed.

Most situations, regardless of work, can be defused when the challenged party remains calm and removes emotion from the conflict. By listening carefully to the complaint, acknowledging the patients concerns and more importantly providing a plan, all parties can walk away with the time and space they need to process independent of feeling.  This isn’t easy, but with some training and a lot of patience, the ability to resolve conflict can create an atmosphere of greater respect and trust in a vocation that thrives on both.

Nurses, care assistants, midwives and domestic care workers are all the first line of defence when dealing with an irate patient or relative. Identifying these potential problems, before they happen can help negate the conflict quickly and effectively. Patients are often frightened and confused and by allaying these fears, with understanding and respect will help develop a bond between all parties that can overcome further hurt or upset.

A common practice in the area of Conflict Resolution is to use what is known as the C.L.A.P. method.  By remembering key aspects of customer service and coupling with conflict resolution through the CLAP abbreviation, you can help de-escalate difficult situations in a passive and calm manner.

Calm – Take a step back, breathe and remain neutral.

It is easy to suggest this but remaining calm in a confrontational situation is highly advantageous to the person being challenged. It takes considerable practice and patience to remain cool when someone is shouting or becoming more distressed.

Patients may not understand why something is happening to them while relatives of patients may feel helpless around their loved ones. They may have a legitimate complaint, they may be completely wrong in their approach, but the key to regaining control in any confrontation is to remain calm and level-headed.

Keep your body language neutral. Do not make exaggerated movements or take on a defensive posture. Retain eye contact with the complainant to show you are listening. Empathy is a powerful tool when dealing with irate patients, so keep your emotions in check regardless of what is said.

When you speak, keep your voice level neutral. Don’t shout, don’t whisper, keep it at the same level you would if speaking to a valued colleague. At the beginning of any conflict, the worst thing you can do is shout back. If you do, you’ll either escalating the problem or worse come across as someone that doesn’t care.

Remain polite throughout the process. Responding to personal attacks (no matter how difficult to take) will only cause emotions to spin out of control.  It is very difficult for an argument to continue if only one party is involved, so be the bigger person and take a step back. If they continue to be aggressive or loud in their complaint explain you are willing to listen and that you will help them if they help you understand what the problem is; at a level that is polite.

Tactics can include asking them to sit down to discuss the problem (it takes more effort to lose your temper when seated) or draw their attention to the fact that the conflict is impacting others in the locality. Where issues pertain to their specific illness or condition, highlight that they are entitled to privacy and suggest discussing it in an empty room.

Breathe at a consistent pace. Try to breathe through your mouth rather than your nose. Breathing through your nose keeps your heart rate steady. It may seem strange at first but if you think about it, this is one of the most effective methods of regaining control in a panic attack. If you show you are in control, you will find it much easier to calm the other parties down.

Remember, no matter what is said, the process of conflict resolution begins through staying calm.

Listen – Words may be powerful, but silence used effectively in conflict resolution can hand you control.

The frustrated patient and their relatives want to be heard. So, listen. Concede the ground and let them have their say. Sometimes when they hear out loud what they are saying in the throes of anger, while showing that you are listening can make them realise how irrational they sound.

It is easy to let someone speak – yet it takes great patience to listen to what they mean. Allow them time to make their complaint. Do not submit to the urge to talk over them or at this point correct them. It’s their turn; yours will come. Speaking over someone or interrupting a patient that is already angry will make things worse.  Give them time to air their concerns and allow them to see that you are actively listening.

Respond, when appropriate, by repeating their concerns back to them. Learn how to paraphrase issues while dialling down the emotion effectively. Ignore personal attacks, or sweeping comments about yourself, others or the organisation and focus on exactly what the problem is.  By repeating back to them the key concerns they have, you are connecting with them and ensuring they can see that you are attempting to understanding their issues.

Saying “It’s not my fault” adds to the tension in areas of conflict resolution.
Don’t do it.

You don’t need to admit to any aspect of the complaint. You can use phrases like “I can see why this has caused upset” or “I’m beginning to understand your concerns” without taking blame.  Be empathetic towards their predicament. This will show that you are the caring person they need at the current time.

Work on the team aspects of the dilemma.  When responding use words like “together” and “we” or “us” instead of “you” or “I”. A phrase such as “Let us see what we can do together about this” is extremely powerful in these situations. It shows you value them as an equal, that the problem will be resolved through teamwork and that ultimately you are acknowledging the legitimacy of their complaint.

Acknowledgement. Understand and value their opinion. It may be wrong, but in conflict resolution it’s a big part of the immediate crisis.

The seasoned listener will be able to filter out the real reason for the complaint. If you’ve followed these steps of conflict management so far, you are now in the right place to acknowledge that there is a problem.

Again, don’t take it as an admission of guilt.  Pride plays a big part in arguments on both sides, but as the professional, it’s time to put that in check. The patient may be blaming you personally for everything but acknowledging that there is a problem is not the same as acknowledging you are at fault.

The issue may be very small, something that can be fixed simply. Alternatively, it could be a complex series of legitimate problems relating to bad experiences the patient has had in the past. Regardless, you need to acknowledge that they have a complaint and that you will work with them to fix it.

You can further defuse the situation at this point by letting the complainer know that nothing they say has been taken personally or will be held against them. Depending on their underlying nature, this tactic can often lead them to apologise for something they may have said in the heat of the moment. If that’s the case, great, you have the upper hand and possibly their respect.

Even with the most aggressive type of person, by acknowledging that there is a problem that needs fixing and that you will look to help solve it together, you are taking crucial steps in the process of resolving any conflict.  Leave your own emotions out of the discussion, and you will be able to bypass pride and keep your reputation intact.

Plan. Resolving the issue is central to conflict resolution. Plan to fix the issue and the crisis is over.

Whatever the issue, or reason the patient is upset, you need to come up with a solution to resolve whatever is troubling them. Major or minor, the issue is important enough to the client to complain about, so you must do your utmost to be seen to negate it.

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Now that you’ve hopefully taken the sting out of their behaviour by remaining calm, listening and acknowledging that there is an issue, it is time to convert these gains into a win for all parties. Where possible try to include those involved in this process, as it may offer some closure to the problem. Remember to use the “we” and “us” approach in dialogue.

Ask them what they think may help in the situation.  The answer may not be viable, but you’ve again acknowledged that you have their best interests at heart.

If the issue is simple to fix, at least from your side of things, offer the solution and ask if it’s something they think is suitable at the current time.
Even if they don’t like the answer – you’ve done your bit by trying to appease them.

If it’s more complex, explain how you may need to seek advice or support from other colleagues to work towards their desired outcome. If they’ve been passed from pillar to post at this point, quite often the cause of the problem, explain that you will keep them updated throughout the process and actively work to ensure that this is the case.

Frustration and the fear of not knowing how to deal with a condition by the patient is often a by product of severe illness. As a care worker, you are the person responsible for helping patients and their family through these trying times. You may be tired, stressed, and overworked but creating space to resolve issues relating to medical concerns – no matter how trivial – will make you a better carer.

Break the problem into smaller manageable processes. Take a step back and look at how you’d like to be dealt with if the tables were turned. Again, empathy is a powerful tool in conflict resolution.

Complicated issues can be handled easier if they are separated into steps. Involving the patient (and their relatives where appropriate) in the overall strategy can help greatly.

Break larger problems down with positive, proactive suggestions.

Suggestions like – “How about we try this first, while I speak to a colleague about this part of the problem?” or “We might not be able to resolve this part of the issue quickly but how about we consult with a doctor on this bit that is worrying you?”

Their involvement where-ever possible shows that you’ve listened that you understand their concerns and are actively looking to resolve it.

Good customer service is something that takes a lot of patience and in some cases extensive training. In the care sector, your customers are your patients and the people around them. Conflict resolution and customer service work hand in hand when dealing with the real-world issues facing patient care.

Mistakes are made by responding like for like to any form of aggression. Learning how to apply the CLAP method in difficult situations and attending our courses on customer service and conflict resolution will reinforce skills that are already prevalent in all care workers.  It will increase your opportunities at work and ultimately, you’ll be a better person.

Resolving conflict in the care sector

Complaints handling in care

Care home management

For Management level training relating to conflict resolution, customer service and complaints handling please take a look at this external course;

QCF Level 7 Management

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