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Most frontline staff ‘feel gutted’ when patients complain

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The majority of healthcare professionals view complaints from patients as damaging to themselves and their wider relationships with those they provide care for, according to a UK study.

Research by King’s College London found that receiving complaints left health service staff with what they described as feelings of “devastation”, “awful shame”, “shock” and “incomprehension”.

“Healthcare professionals viewed events of patients’ complaining as damaging to themselves”

Study authors

Academics interviewed 41 healthcare professionals at different seniority levels from four trusts across England, comprising two community providers and two acute providers.

Within each trust, they interviewed staff from two services. Overall, they included trusts and services that had a mix of positive and negative ratings for patient experiences and staff wellbeing.

“With few exceptions, healthcare professionals viewed events of patients’ complaining as damaging to themselves and to their wider relationships with their patients,” they said in the journal Health.

“Interviewees described feelings of ‘gutting’, ‘devastation’, ‘awful shame’, ‘disbelief’, ‘shock’ or ‘incomprehension’ that a complaint should be raised about themselves or colleague and, as often, about the service where they worked,” said the study authors.

They noted that such views did not seem to be affected by whether the complaint was reported to managers or not, or by any specific issues that the complaint was about.

“We wanted to understand why a complaint was so difficult for clinical workers to hear”

Mary Adams

In fact, the researchers found it was “rare for complaints about care raised by patients to involve more than immediate teams or to be progressed beyond the clinical division”.

However, their findings suggested that staff in struggling teams or those with poor ratings were more deeply affected when patients complained.

“We found that staff who worked in service settings where overall work experiences and patient care experiences were poorer were more likely to describe complaints made by patients as having a negative effect on their work and on their wider attitudes towards patients,” they said.

Some senior clinicians said they had learnt to stand back and not feel the effects of a complaint. But, significantly, frontline healthcare staff often found complaints “highly emotive, irrespective of their profession and seniority, said the study authors.

Dr Mary Adams, co-author of the study and a registered midwife, said: “This report does not in any way criticise staff, but we wanted to understand why a complaint was so difficult for clinical workers to hear – even if the complaint is not directly about them.”

Health professionals spoke to researchers about patients being unaware of the care they received and being more concerned with tasks that some nurses thought less important.

One nurse said: “We stop them [cardiac] arresting. It’s not being dramatic, we really do and half the patients are oblivious to what you’ve done and they’re more bothered about, ‘they haven’t even offered me a bloody cup of tea for five hours’.”

“They’re more bothered about, ‘they haven’t even offered me a bloody cup of tea for five hours’”

Nurse interviewee

The study also found that staff tended to “rationalise” individual complaints as being indicative of wider issues about “patient mistrust in their authority or expertise”.

Staff also criticised patients for failing to appreciate the reasoning behind particular care decisions, saying they “only saw what was in front of them”.

A staff nurse who working in emergency admissions told the researchers that discharge patients were oblivious to the amount of planning involved in discharge.

Meanwhile, some staff dismissed complaints from the families of older patients, claiming they were only partial witnesses of what actually happened on wards.

But staff on a haematology ward involved in the study were more optimistic when complaints were made by their patients.

“They understand their illness better than we do, they’re observant, checking that everything’s been done, they have the experience,” a senior nurse said.

Staff on that ward tended to see complaints as being more constructive, something Dr Adams suggested should be copied in other areas.

“Complaining has got its place. It is important for learning and quality improvement. It should not be a damaging activity,” she told Nursing Times.

However, Dr Adams highlighted that complaints were too often seen by staff as ingratitude.

“Content of complaints were often issues that staff recognised were a problem, the worst thing was, was that someone complained,” she said.

“Instead of this, we should change our approach to improve services,” she told Nursing Times.

Earlier this week, a separate report indicated that patients themselves lacked confidence in the NHS complaints system.

As reported by Nursing Times, a survey revealed that two-thirds of people who complained about older relative’s treatment did not think it would make a difference.

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