Distress, anger and conflict

Why this matters on day one

Anger directed at you is usually fear, grief or exhaustion wearing a different face. Arguing with the content escalates it; acknowledging the feeling almost always de-escalates it. And an apology is not an admission of liability — the duty of candour requires one.

The sequence

1. 1Position yourself safely. Private space but not cornered; keep an exit accessible, sit if they will sit, stay at eye level. Know where the alarm is. If you feel unsafe, leave and get help — that is not a failure.
2. 2Let them finish. Do not interrupt, correct or defend. Most people wind down if allowed to say the whole thing once.
3. 3Name the feeling. "I can see you're furious, and I'd want answers too." Acknowledging the emotion is not conceding the argument.
4. 4Apologise for what happened. "I'm sorry this has happened, and I'm sorry you've had to chase us." Sincere, specific, not qualified with a justification. Never blame a colleague or a department.
5. 5Find what is underneath. Ask what they are most worried about. It is very often a fear about the patient, or guilt about a delay of their own.
6. 6Commit to something concrete. A name, a time, a specific next step — and then do it. Signpost PALS without using it to end the conversation. Document the discussion and complete an incident report if a failure occurred.

What goes wrong

• Defending the organisation instead of listening.
• Speculating about what went wrong before the facts are known.
• Blaming another team or an individual.
• Withholding an apology in the belief it admits liability.
• Ending with reassurance but no concrete commitment.