Conflict, complaints and difficult clinical encounters — formative SAQs

SAQ 1 (10 marks)

A father is shouting on the ward because his 6-year-old daughter's scan result, promised yesterday, has not arrived. He is distressed but has no weapon and is not violent. ^{[5] [3]}

1. Describe your immediate assessment and first steps in the encounter. (3) ^[5]
2. Outline the structured verbal de-escalation approach you would use, naming its key moves. (4) ^[5]
3. Describe how you would close the encounter and what you would arrange afterwards. (3) ^[3]

Model answer

Assess safety first: confirm there is no weapon, threat or intoxication, and keep an exit available. Move to a private space with the right people, and ask openly what has happened and what he most needs today. Review the timeline and facts of the result delay and identify any genuine service failure honestly. ^[5]

Use structured verbal de-escalation drawn from the Project BETA consensus: respect personal space and keep an exit; do not be provocative in posture or tone; establish verbal contact with brief, plain language; identify wants and feelings; listen closely; agree, or agree to disagree, rather than argue; set clear, reasonable limits; and offer choices and optimism. ^[5]

Close by acknowledging the emotion, agreeing a clear plan (the result, a timeframe, a contact), and arranging follow-up. Document factually and contemporaneously, and arrange a team debrief; if a shortcoming occurred, apologise sincerely and feed the learning back. ^[3]