Communication
CPSA · Communication · De-escalation
The angry patient / relative
Stay calm, acknowledge the anger explicitly, and find the underlying concern. Don’t get defensive — listen, empathise, and offer a constructive way forward.
The framework
Set up safely
- Ensure a safe environment (exit accessible, consider a colleague); sit at the same level
- Introduce yourself calmly and give them your full attention
Acknowledge & explore
- Name the emotion — “I can see you’re really angry, and I want to understand why.”
- Let them vent without interrupting; listen actively
- Explore the underlying concern — often fear, poor communication, or a genuine error
Empathise & respond
- Validate their feelings; apologise for any distress/failing (an apology is not an admission of liability)
- Be honest; don’t make promises you can’t keep or become defensive
Resolve & safety-net
- Agree a concrete next step; explain what you’ll do
- Offer PALS/complaints routes; document; escalate if a genuine safety/candour issue
Phrases that work
- “I can see you’re really upset — help me understand what’s happened.”
- “I’m sorry this has been such a difficult experience.”
- “You’re right to raise this. Here’s what I’m going to do…”
- “I want to get this right for you.”
Pitfalls that lose marks
- Getting defensive or matching their tone.
- Dismissing or minimising the concern.
- Failing to acknowledge the emotion before problem-solving.
- Not offering a concrete next step or escalation route.