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Handling Difficult Conversations – when things don’t go to plan

We know that the NHS is under pressure – pressure on waiting times, hospital beds, referrals and funding to name a few. The resulting pressure felt by the workforce is acute. On top of pressures within the system, stress is amplified by the need for staff to manage difficult conversations with patients and their families in high pressure situations when emotions are running high. Given the staff are already under acute stress in their day-to-day roles, it’s easy to feel harassed, bullied or overwhelmed by these difficult conversations.

The cost of unresolved conflict
At Miad Healthcare we’re very aware of the effects of conflict at work on staff and patient outcomes, and soft skills training is increasingly the type of training we’re asked for at all levels of healthcare. A study by Health 4 Work, the NHS’s network of occupational health teams, found that unresolved conflict at work leads to a number of problems:

  • Stress and anxiety
  • Absenteeism
  • Decreased productivity
  • Increased employee turnover
  • Grievance and litigation
  • Accidents and injuries

This diary-based study carried out with NHS workers analyses the emotional effect on employees of witnessing unpleasant interactions with co-workers. The study included doctors, nurses, specialists and administrative staff in a UK hospital over a period of 15 days. The research found that:

“Employees reported feeling significantly more emotionally drained after witnessing unpleasant interactions” and “felt more drained on witnessing the interactions first-hand”. The research concluded that these interactions had the potential “not only to have a negative effect on the individual but to pervade the organisation”.

Although the study acknowledged that a certain amount of conflict will happen when people with differing opinions and expectations work together in what can be at times a stressful environment, it also concluded that there is a risk that “if conflict remains unresolved or poorly managed it can have a negative effect.”

The importance of clear, compassionate communication
Clear, compassionate communication between colleagues, patients and family members is an ideal that anyone involved in healthcare would sign up to. The BMA puts it front and centre of its training priorities:

“Clear, compassionate communication is important to patients with life-limiting disease and their families. This is reflected in policy commitments to improve this area of care. However, poor experiences of communication remain a principal area of complaint within the British National Health Service (NHS) and are associated with patient and caregiver distress and poor staff outcomes. Therefore, providing effective, evidence-based communication skills training remains a priority.”

However, as we’ve explored on our blog, there are many factors influencing behaviour at work, and the immense workplace stress is the major influence. We’ve written in our previous posts about combatting doctors’ stress, creating a culture of care to improve patient safety, and providing support to those returning to practice. In all of these scenarios, the ability to communicate in a clear and compassionate way, even in difficult situations, will improve outcomes for all.

Expressing ourselves through effective communication
Given the diversity of the population we work with in the health service including Locally Employed Doctors, SAS doctors, and Trainees, all whom come into contact with patients and families, it’s important to invest in developing communication skills. Whether it be managing millennials, understanding bias or dealing with harassment, we can build our skills to be better prepared for difficult conversations.

Miad Healthcare has launched two new programmes specifically on difficult conversations and managing conflict that link directly to the GMC Generic Professional Capabilities Framework. ‘Challenging Consultations’ is aimed at trainees and ‘Difficult Conversations with Colleagues’ is appropriate for all doctors.

  • Challenging Consultations helps participants deal with challenging patients and relatives. This includes identifying common problems and challenging people and the reasons for their behaviour. Participants have the opportunity to understand and practise the behavioural styles of assertiveness, passivity and aggression, learning how to use language, listening skills and body language effectively.
  • Difficult Conversations with Colleagues focuses on managing conversations professionally with colleagues. Participants review the types of difficult conversations they have experienced with colleagues and learn how to effectively give feedback. This is an opportunity to practise applying communication techniques when faced with challenging situations, specifically emotional responses such as anger or disappointment, and to recognise and respond to bullying or harassment.

To find out more about these new courses and other courses on effective communication, please contact us.

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What Our Clients Say...

  • Ruth Frost, Provider Development Lead/Advisor, Health London Partnerships, NHS England. - Miad were a pleasure to work with, engaging, perceptive and flexible to the changing needs as the programme rolled out. They engaged well with the wide range of General Practice
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