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It's 'okay' to apologise to patients with valid complaints, says RCN

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Apologising to a patient making a complaint is not an acceptance of guilt and can help defuse the situation, according to latest guidance on feedback handling from the Royal College of Nursing.  

The new guidance has been published by the RCN to help frontline nurses and support workers “understand how to deal with feedback, both good and bad, as well as concerns, complaints and compliments”.

The college said it was intended to help frontline nursing staff know what was expected of them when they received feedback from patients, and also what support they should expect from their employers.  

“It is important that all staff are given the right information and training to handle them appropriately”

Peter Carter

The guidance, designed for easy access and use as part of staff inductions, highlighted that the way a nurse or healthcare assistant responded to someone will “set the tone” for the rest of the conversation.

It encouraged staff to be “open, honest, and friendly”, as this was “much more likely to result in a positive experience for everyone, irrespective of whether you are actually able to resolve anything”.

The guide also stated that it was “perfectly okay to apologise” to someone if they had a valid complaint, adding that “offering an apology does not constitute an acceptance of responsibility”.

“In many cases an apology will help you to manage the immediate problem of someone wanting to share their bad experience with someone who cares, so that hopefully you can ensure that it doesn’t reoccur,” it said.

In addition, it noted that if the problem could not be resolved quickly or required escalation, the complainant must be given all the information they need to make a formal complaint, including the clinician’s name and contact details. However, it also advised the clinician to “make a record for yourself of what happened and what you said or did, so that you can refer back to it”.

Some “simple steps” are also suggested for dealing with complainants who may be “distressed, angry, or exhibiting the effects of alcohol or drugs”, such as trying to keep your voice calm and level, and finding a quiet place with seating to discuss the problem.

The document stated: “This guide is not meant to be exhaustive and we appreciate that each workplace will be different. However, we hope you’ll find it provides simple and straightforward advice that will help you in your day-to-day work.”

The 16-page pamphlet – titled Good practice for handling feedback – has been developed following discussion with RCN members about their own experiences.

The college said the pamphlet was part of its “commitment” to help improve the way the NHS handled feedback and complaints, which it made in response to the Clwyd-Hart review into the NHS complaints system.

Ann Clwyd

Ann Clwyd

The review, co-chaired by Ann Clwyd, MP for the Cynon Valley, and Professor Tricia Hart, chief executive of South Tees Hospitals NHS Foundation Trust, was commissioned after the Francis report highlighted that complaints were a warning sign of wider problems in a hospital.

The review’s report, published in October 2013, made a raft of recommendations and called for a “revolution” in the way the NHS handled complaints.

The RCN said consultation with its members had revealed that many felt there was a lack of information in their workplace from their employers on what the process is for dealing with complaints, and what is expected of them.

Peter Carter, chief executive and general secretary of the RCN, said: “Our members say that there is often a lack of information about how they are supposed to deal with complaints.

Custom_Name_Peter_Carter_MG_5356

Peter Carter

“These complaints will often be sensitive, and made during a vulnerable time for patients and their families, so it is important that all staff are given the right information and training to handle them appropriately,” he said.

He added: “Employers must also demonstrate to their staff and patients that when feedback is received, it is acted on and used to improve patient care in future, not simply filed away.”

 

What do you think of this guidance?

Let us know using the comments section below or join the discussion on Twitter by following #NTtwitchat from 1pm Wednesday 19 November.

  • 12 Comments

Readers' comments (12)

  • michael stone

    That it is 'okay to admit mistakes' isn't something nurses need to hear from the RCN - nurses need to hear that, from the NMC.

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  • 'Defuse' not 'diffuse'. Big difference. We really don't want situations to be diffused, do we?

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  • Steve Ford

    Good spot, thanks. I've corrected it.

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  • While I'm a student nurse and may therefore be speaking from lack of experience, I'm surprised that this isn't just a normal way of responding to complaints - I apologised today (as a natural reaction) to a school on behalf of an inpatient ward that they weren't more involved in discharge planning and felt this was completely appropriate - to the apparent disapproval of some staff members. Do we really need to be told it's 'okay' to apologise when a complaint is valid? Surely this is common sense?

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  • While I'm a student nurse and may therefore be speaking from lack of experience, I'm surprised that this isn't just a normal way of responding to complaints - I apologised today (as a natural reaction) to a school on behalf of an inpatient ward that they weren't more involved in discharge planning and felt this was completely appropriate - to the apparent disapproval of some staff members. Do we really need to be told it's 'okay' to apologise when a complaint is valid? Surely this is common sense?

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  • I agree with the sentiments but this still requires the nurse to make a judgement call on whether the complaint is valid or not. It would be easier to apologise to every complainant whether their complaint is valid or not. This will diffuse most complaints immediately. A little humble pie is better than a formal enquiry..

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  • I have many years of experience and over that time have heard the most stupid complaints you can imagine, and some very valid ones. I always tell the complainer that I am very sorry that (whatever it is) has upset them so much, because obviously it has or they would not be complaining. I then explain why nothing different could have been done, or why we failed if we did. In many instances my explanation is accepted and the matter is closed. I would rather someone complain at the time of the incident rather than later as that makes it more difficult to investigate what has occurred. However that is so much better than the patient who goes to the local press with a story which is often printed prominently without any investigation by the said rag, and where I am unable to reply in any way due to patient confidentiality.

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  • michael stone

    Anonymous | 14-Nov-2014 12:48 pm

    'I would rather someone complain at the time of the incident rather than later as that makes it more difficult to investigate what has occurred.'

    I 100% agree. But it is also important, that responses - at least initial ones - are also immediately forthcoming: if you (layman) complain, and do not get the staff's side of it at the time, you tend to be suspicious that things might be 'covered up'. Once you've moved into territory where the staff think a complainant is 'malicious', and where at the same time the complainant believes the staff are 'trying to cover things up', all hope has been lost !

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  • there so also rbe dress if the compliaint is unfounded or the media prints lies

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  • I do not really get this article or some the well meaning comments. Who decides that the comment is valid? And if so, the perpetrator(s) of the action/omission that led to the complaint or by proxy.
    Does it mean that as a Nurse arriving on night shift and before handover that I/we would be accountable in the act of personal apology that a patients water jug was empty or the bedding was soiled?
    The above is only an example.
    It is easy enough to solve an immediate problem: fill the jug, change the bed etc.
    What exactly is the RCN condoning that its members and nurses apologise for?
    The article is incongruent. To expect anyone to apologise in a professional capacity whilst engaged in their duties for events/actions/omissions outwith their purview is problematic at best.
    If an apology is required, it should be from the responsible person(s). Nurses are accountable enough without bearing the brunt of other organisational or personal failings.

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