Verbal De-escalation. Rules for Negotiating with an Uncooperative Patient

Doctor/ healthcare professional

Have  a 10-minute conversation with a difficult patient in hospital. Use the techniques of active listening to get all the information you need.

Next retell what they said and then ask follow-up questions using appropriate organising phrases.

The patient is in the postoperative room after gastric cancer surgery. He is aggressive and loud, insults the nurses, has a negative attitude towards the doctor and all staff.

Two other patients are hospitalized in the postoperative room who are calm and unable to sleep due to the behaviour of this patient.

The patient is an impulsive, difficult person. Such a person becomes emotional easily, wants to get information quickly, is not interested in details, does not seem to be listening, and ignores the interlocutor.

Be assertive, use the negotiating techniques and tactics and various negotiation styles.

 

To do this exercise the student should:

1) read on active listening,

2) analyse the material read and refer to the issue presented in the workshop,

3) prepare a conversation script,

4) read on assertiveness techniques,

5) rehearse the role play with the use of negotiation styles,

6) memorize questions and phrases,

7) role-play the scenario in class ,

8) as a group - evaluate the correctness of the exercise.

9) list all your strengths that will allow you to believe in your abilities, as well as all your weaknesses, to be aware of  them and not let your opponent take advantage of them,

10) think about how you can fix them,

11) during the conversation with the patient, establish all conditions, taking into account the demands of both parties.

 

Background notes

When talking to a difficult patient about his health issues and related fears, the doctor should use negotiation tactics and techniques and pay attention to:

·      the role of the patient's family in the treatment process;

·      the issues of adaptation of the patient and his family to the disease as a difficult situation and to events related to it, including dying and the family mourning process;

·      the role of stress in the etiopathogenesis and course of diseases and the mechanisms of coping with stress;

·      principles of motivating the patient to pro-health behaviour and informing about unfavourable prognosis;

·      building an atmosphere of trust throughout the treatment process;

·      conducting a conversation with an adult patient and family using the technique of active listening and expressing empathy, as well as a talking with the patient about his life situation;

·      informing the patient about the purpose, course and possible risk of the proposed diagnostic or therapeutic measures and obtaining his / her informed consent to undertake these activities;

·      patient involvement in the therapeutic process;

·      providing the patient and his family with information about an unfavourable prognosis;

·      providing advice on compliance with therapeutic recommendations and a healthy lifestyle;

·      identifying risk factors for the occurrence of violence, recognising violence and responding appropriately;

·      basic use of psychological motivating and supportive interventions.