OET Rx (Student Pre-Class)
Lesson 22: Dealing with an Angry or Upset Patient
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Course Progress
Part 1: Lesson Objectives
By the end of this lesson, you will be able to:
- Use de-escalation techniques to manage a patient's anger or frustration.
- Acknowledge and validate a patient's feelings without becoming defensive.
- Move a conversation from a state of conflict towards a constructive resolution.
- Document a patient complaint and the steps taken to resolve it.
Part 2: Vocabulary & Examples
General Vocabulary
just /dʒʌst/:
فقط، دقیقا
I understand you're upset; can you tell me just what happened so I can try to help?
justify /ˈdʒʌstɪfaɪ/:
توجیه کردن
While there was an emergency that caused the delay, nothing can justify the lack of communication you experienced.
keep /kiːp/:
ادامه دادن، نگه داشتن
It's important that you keep your voice calm, even if the patient is shouting, as this will help to de-escalate the situation.
key /kiː/:
کلیدی، اصلی
The key to resolving this conflict is to first listen to the patient's full story without interruption.
know /noʊ/:
دانستن
I know this is a frustrating situation, and I am very sorry for the experience you have had today.
knowledge /ˈnɒlɪdʒ/:
دانش، آگاهی
My medical knowledge suggests a different course of treatment, but I want to understand why you are so insistent on this alternative.
label (v.) /ˈleɪbl/:
برچسب زدن
We should avoid the temptation to label a patient as "difficult"; instead, we should try to understand the reason for their frustration.
lack /læk/:
فقدان، کمبود
The patient's anger stemmed from a lack of information and feeling ignored by the staff.
large /lɑːrdʒ/:
بزرگ
A large part of handling complaints is simply letting the patient feel that they have been heard.
largely /ˈlɑːrdʒli/:
تا حد زیادی
The misunderstanding was largely due to a communication error, for which I sincerely apologize.
last (v.) /lɑːst/:
طول کشیدن
The wait has lasted for over an hour, and I completely understand why you are upset.
late /leɪt/:
دیر
I am very sorry that I am running so late for your appointment; there was an unexpected medical emergency.
lately /ˈleɪtli/:
اخیرا
The patient reported feeling lately that her concerns have not been taken seriously.
later /ˈleɪtər/:
بعدا
We can discuss the clinical aspects of your case later; right now, I want to address your concerns about the service you received.
lay (the blame) /leɪ/:
مقصر دانستن
It is not helpful to lay blame at this stage; our key focus should be on finding a solution.
layer /ˈleɪər/:
لایه
Anger is often the top layer of emotion, and underneath it, you may find fear or sadness.
lead to /liːd tuː/:
منجر شدن به
Poor communication can often lead to frustration and formal complaints.
leading /ˈliːdiŋ/:
اصلی، پیشرو
The leading cause of patient complaints is not clinical error, but rather poor communication and long wait times.
learn /lɜːrn/:
یاد گرفتن
We will learn from this incident to ensure it does not happen to another patient.
least /liːst/:
حداقل
The least I can do is offer a sincere apology and listen to your full story.
leave /liːv/:
ترک کردن
I want to resolve this with you before you leave the clinic today.
Medical Vocabulary
Aggression /əˈɡreʃn/:
پرخاشگری
If a patient's anger turns into verbal aggression or threats, you must prioritize your own safety and call for security.
Anger /ˈæŋɡər/:
عصبانیت
It's important to acknowledge the patient's anger with a statement like, "I can see that you are very angry."
Assertiveness /əˈsɜːrtɪvnəs/:
قاطعیت، ابراز وجود
Assertiveness involves calmly stating the facts and setting boundaries, for example, "I am here to help you, but I cannot do so if you are shouting at me."
Complaint (formal) /kəmˈpleɪnt/:
شکایت رسمی
The patient was so dissatisfied with the delay that they decided to file a formal complaint with the hospital manager.
De-escalation /ˌdiːˌeskəˈleɪʃn/:
تنش‌زدایی
The first step in de-escalation is to use a calm tone of voice and open body language.
Frustration /frʌˈstreɪʃn/:
استیصال، ناکامی
I can hear the frustration in your voice, and I want to understand what has led to this situation.
Grievance /ˈɡriːvəns/:
شکایت، گله
Our patient advocacy service is here to help you with any grievance you may have about your care.
Non-verbal cues /nɒn ˈvɜːrbl kjuːz/:
اشاره‌های غیرکلامی
The patient's clenched fists and crossed arms were non-verbal cues that indicated a high level of anger.
Reflective Listening /rɪˈflektɪv ˈlɪsnɪŋ/:
گوش دادن انعکاسی
Reflective listening is powerful: "So, what I'm hearing is that you felt dismissed, and that made you feel very frustrated. Is that right?"
Resolution (conflict) /ˌrezəˈluːʃn/:
حل و فصل
Our mutual goal is the resolution of this issue to your satisfaction.
Part 3: Pre-Class Practice Tests
Reading Task (Longer & More Professional):
Excerpt from a Hospital's Patient Grievance Policy
The hospital is committed to the timely and respectful resolution of all patient grievances. While we strive for excellence, we acknowledge that there will be instances where a patient's experience does not meet their expectations. Our formal complaints procedure is a key component of our quality assurance framework, providing an opportunity to learn from our mistakes and improve our services. The procedure is initiated when a patient files a written complaint with the Patient Advocacy Department.
Upon receipt, the complaint is formally acknowledged in writing within two business days. The case is then assigned to a complaints manager, who will conduct a thorough investigation. This largely involves gathering statements from all staff involved and reviewing the relevant medical records. The objective is not to lay blame, but to establish a clear and factual timeline of events that led to the grievance. The lack of clear documentation is often a major barrier to a swift resolution.
The investigation should be completed within 28 days. Following the investigation, a formal written response is sent to the patient. This letter must include an apology if a failing has been identified, a clear explanation of what happened, and the steps that have been taken to prevent a recurrence. The key to a satisfactory resolution is often not financial compensation, but a sincere apology and the sense that their complaint has been taken seriously and has led to positive change.
Question: According to the policy, what is the primary objective of the investigation into a formal complaint?
Listening Task (Part A Simulation):
Scenario: You will hear a hospital's patient liaison officer taking details over the phone from an upset patient.
Task: Complete the notes on the complaints form. Write one or two words for each gap.
Patient Complaint Form
Patient Name: (1)
Department: (2)
Date of Incident: Yesterday
Main Grievance:
- A long (3) for his scheduled scan.
- Felt his concerns about the delay were (4) by the staff.
Desired Outcome:
- A formal explanation.
- A (5) appointment.
Part 4: Answer Key for Pre-Class Work
Reading Answer: c) To create an accurate and factual account of the events that occurred.
Listening Answers: (1) David Chen, (2) Radiology, (3) wait / delay, (4) dismissed / ignored, (5) rescheduled
Part 5: In-Class Preparation
This section is designed specifically for doctors. Be prepared to discuss the vocabulary and practice the following tasks in class.
Speaking Task: OET Role-Play Card (Medicine)
Setting: The waiting room of your busy GP clinic.
Patient: A patient has been waiting for 45 minutes for their 10:00 AM appointment and is now complaining loudly and angrily to your receptionist. It is 10:45 AM. You have just finished with a patient who had a medical emergency. You hear the commotion as you leave your room.
Task:
- Approach the angry patient in the waiting room.
- Acknowledge their anger and the long wait.
- Offer a sincere apology for the delay.
- Briefly and calmly explain the reason (e.g., "I'm very sorry for your wait; I was with another patient who had an unexpected emergency that required my immediate attention.").
- Invite them into the privacy of your consulting room to de-escalate the public situation.
Writing Task:
You are the doctor from the speaking scenario. After you have seen the patient and resolved the issue, you need to write a brief incident report for the practice manager. Document the event, the reason for the delay, the steps you took to de-escalate the situation (e.g., "apologized, explained, moved to a private room"), and the final outcome.