Working with Displeased Patients

Transcript:
Hello my name is Dr. Tablet, but you can just call me Tab. Have you ever encountered a displeased patient while on practicum? It can be an uncomfortable situation especially when emotions are running high. In this video, I’ll be talking about how to work with displeased patients using the BLAST technique. The “BLAST” technique is a complaint-resolution method that is helpful for addressing patients’ concerns or complaints. Let’s begin.BLAST stands for Believe, Listen, Apologize, Satisfy, and Thank. To explain how to use the BLAST method, let’s work through a scenario together:Natasha was completing her practicum at a community pharmacy when Bruce stormed up to the counter and demanded to speak with her.“You didn’t tell me these antidepressants could cause weight gain!” he said. “If I had known, I never would have taken them. I’ve gained 5 pounds in the past month and it’s all your fault.”Natasha is taken aback by this accusation, but she knows that responding angrily or defensively could escalate the situation and create adversarial feelings and mistrust between herself and the patient. When emotions are running high, it’s helpful to have the BLAST technique in your tool box to help you work through difficult situations.The first step in the BLAST technique is B, believe the patient. This refers to acknowledging and validating the patient’s experience and emotions even if there are parts of their story you don’t agree with. Even though it isn’t Natasha’s fault that Bruce gained weight, arguing this point would be counterproductive and Natasha needs to respond in a way that acknowledges his experience and validates his feelings. For example, she could say something like, “I’m sorry this happened, and I understand you feel you were not properly informed about this medication.” Accepting the patient’s concern as legitimate shows empathy and tells the patient that you hear them, you understand their concern, and you want to work with them.The L in BLAST stands for Listen. Active listening is necessary to help you discern the patient’s unmet expectations and resolve the issue. In this case, the patient is upset because he trusted the pharmacy to explain all the side effects of his medication and he feels that they failed to explain the risk of weight gain. Natasha allows the patient to fully express himself and demonstrates active listening by facing the patient with an open posture, making eye contact, and being attentive and empathetic.After Bruce is finished speaking, Natasha should restate his concerns in simple, non-medical terms. She might say something like this: “It sounds like you have some concerns about your antidepressant causing weight gain and you feel that important information may have been missed when the pharmacist counselled you on your medication last time. Is that correct?Going back to the BLAST technique, the A stands for apologize. Apologizing helps you to de-escalate the situation while opening up an avenue to provide more of an explanation without appearing defensive. Natasha might say: “Bruce, I’m sorry that this happened to you and it sounds like we could have done better. I’m open to talk about how we can address your concerns.”

Natasha’s response leads us into the next step, S, which stands for Satisfy. While you may be able to resolve certain concerns for the patient, there may be times when you are not able to give the patient what they want. It is helpful to address these things first so that patients have a clear idea of what you can and cannot do about their situation. It helps to manage their expectations at the onset of the conversation to prevent further misunderstandings. You might consider asking the patient what they want as it gives them some control over their situation and offers you more information about what they expect from you. If the patient proposes a reasonable solution, the problem may be solved without further conflict. If the patient proposes something that cannot be done, you can explain why their proposed option is not possible and try to provide them with other options.

When Natasha asks what would make Bruce feel better about the situation, Bruce states that he does not want other patients to experience what he went through. He suggests that Natasha explain every possible side effect, no matter how rare, to every patient that picks up a new drug. How do you think Natasha should respond to this? Is his request reasonable?

Natasha responds by saying: “Yes, I appreciate your concern and want to assure you that we also want what’s best for our patients. It may be overwhelming for some patients to be counselled on every potential side effect. Some side effects are rare and may not be applicable to all patients, so counselling is often focused on the most common side effects likely to be experienced. In your case, I could have provided you with additional written information with a comprehensive list of all potential side effects. If you want, I could provide that to you now and I’d also be happy to discuss options for managing the weight gain.”

Notice how Natasha started her answer with “yes”. Starting your sentences with positive words like this can help to show the patient that you’re on their side rather than arguing with them. Natasha explains why she can’t accept Bruce’s solution as it is and redirects him to other options. If possible, it is best to provide the patient with 2 or 3 of options. To ensure that you have resolved the issue to the patient’s satisfaction, ask the patient if they are satisfied or if they have any other concerns to talk about.

That brings us to the final step in the blast technique, Thanking the patient. Remember to thank the patient for taking the time to share their feedback and concerns with you. All feedback is an opportunity to reflect and identify how we can better serve the patients under our care

As a student, you should always inform your practice educator immediately about any complaints or concerns that are shared with you. This gives them a chance to step in and help you address the patient’s complaint and follow up with the patient.

In some situations, students may experience rudeness and criticism directed at them. If you ever feel unsafe or if you are losing control of the situation, it is okay to remove yourself and ask for help from your practice educator or another member of the team.

In summary, the BLAST technique can help you navigate through challenging patient interactions step by step. Through practice and over time, you will become more comfortable with handling these situations. The key is to stay calm and work alongside the patient to address their concerns.

I hope you found this video helpful.

Thanks for watching. I’m Dr. Tablet and I hope you have a fanTABulous practicum

Acknowledgements:

We would like to thank Alyssa Low (Undergraduate Student) for helping to create this video and Garrett Tang (Undergraduate Student) for designing original images (e.g. Dr. Tablet).