Confrontational Clients

Posted: Oct 29, 2012
Views: 7087 - Comments: 16

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As a 24-hour ER facility we have clients who call and come in worried, upset, nervous, pissed, and frantic. The emotions can run the gamut and sometimes bring a client to behave in an aggressive and confrontational manner. The goals when dealing with these clients are to defuse the situation, focus on the pet, and keep everyone safe. Here are few tips we use when training new staff members about dealing with difficult clients:

Self awareness

Manage yourself, and then manage the situation at hand. Each individual needs to keep their emotions in check and know what triggers them. The fact is in this field you are going to get yelled at, cried to and be forced to deal with a rainbow of reactions and emotions from clients. If you can’t handle it with grace and professionalism you are in the wrong line of work. Several years ago I worked with a receptionist who could not handle being yelled at. She would become rude and shut down because she believed, “They shouldn’t yell at me.” It’s true they shouldn’t yell, but once it happens how are you going to deal with the situation? If your first inclination is to yell back, you’re not helping the situation. You’re only making it worse. Self awareness can’t be taught but it can be practiced. When we bring a new member of the team on we always discuss real life circumstances that have occurred in the past. We strive to arm the new hire with tricks and tips for handling confrontational clients.

Stay empathetic

We never know what the client experienced before calling or coming through our doors. Keep the focus on the care of the pet and what you can do for the client. Even if the client is behaving absolutely dreadfully, bringing the animal back into the conversation can help refocus the client. The health of the pet is the reason everyone is here (client and staff) and by bringing the attention back to care of the pet we shift the focus to what matters. A few years ago we had a client who yelled and screamed at time of deposit as their pet was being admitted to the hospital due to the cost. In that moment she was very unpleasant and the team did the best they could to calm her down. When she came back the next day to visit her pet in hospital she apologized to the staff and asked that they pass on the apology to the staff on the night before. She explained that her pet’s stay with us was just one more stressor in her life but that she should not have yelled at anyone as she knew we were being helpful.

Know your resources

Who’s your backup if a situation gets out of control? Is everyone trained on how to alert others in the hospital that there is problem? Occasionally another team member is needed to help with a situation, or even the police might be needed. We have an overheard page system in place to alert everyone working in the hospital that a situation has turned for the worse and help is needed either in the form of additional staff or (rarely) from the police. All staff members are trained on safety protocol and a quiz is mandatory to help the information stick. We keep the police non-emergency number handy in case it is needed, as opposed to 911. We also have the number to a local mental health organization that can help triage a client over the phone and talk them down from their emotional perch. If need be, they can come down to the hospital and assess the individual in person to see if additional assistance is required. We once had a grief-stricken client who threatened harm to herself after the loss of a pet and the mental health organization came down to help her get the care she needed. The client came back to visit the hospital several months later and share photos of her dog who had passed, as well as thank everyone for their kindness.

Talk about it

Make sure every team member working knows there is an issue. No one should every walk into an exam room with a volatile client without having knowledge that the client is upset. The team must communicate in that moment with each other to insure the client gets the best service and that everyone stays safe. It is also important for the team to communicate because the client may have offered little bits of different information to different staff members that could change how to best proceed with the client.

Then talk about it again after the dust has settled

Every situation offers a learning opportunity not only for the team members dealing with a given situation but also for those not involved. Share the situation with the staff and talk with them about what went well, what could have been done better and what protocols need to be updated to improve the outcome in a like situation. The idea in reviewing the situation is to allow everyone to imagine themselves in the scenario and review how they would have handled it, as well as offering an outlet for the team involved to de-compress.



Denise Kinstetter's picture

I believe that communication is essential between the front and the back office staff to fill in necessary gaps, to update if there are changes, and all will promote the ultimate continuity of patient care and satisfation for the clients in that particular veterinary office setting.

Denise Mayer's picture

COMMUNICATION is key. All of this information was so true. People have other things going on in their lives that we don't know about and their pet being very ill threw them over. We should try to be more understanding, but not allowing a client to cross the line either.

Brian Stief's picture

Communication is key to a successful visit and breaking down the barrier between front and back is also important. In most cases there is no such thing as "over communicating"- the more the better, both between teams on the floor and our clients.

Rebecca  Obester's picture

I thought the idea of mental health provider access was very useful and we will incorporate into our practice.

Sarah  Sigillito's picture

Can We have more information about the mental health provider aspect? I'm curious how you work this into your practice as I worry about similar situations at my practice.

Brian Stief's picture

@Sarah, at our front desk we have a mini binder that contains frequently used phone numbers and the number to local metal health agency that offers services is included in the binder (here in Portland, OR we are lucky to have a community program available to assist with these types of cases). We review information on this agency and when to utilize them and what types of cases we have called on them in the past with our new staff both in a formal new hire orientation and also during training at the front desk. Our safety committee also sends out reminders of the agency every six months or so in their meeting notes. We are very fortunate that we rarely need to call on their services, maybe once a year at most but it is helpful to know that they are available when such situations arise. Does that answer your question? Please feel free to message me to discuss more.

Kim Tuttle's picture

I agree that communication is key for the best customer and patient care!

Sara McLaughlin's picture

I have seen a few clients that have come in and been upset (crying, hysterical), others who are angry/rude...some become angry at the cost and act out on it. I have had some clients make a scene and then apologize the next day. It is important to realize that they are under a lot of stress because their pet is ill/injured and we can't hold it against them.

Michelle Schriefer's picture

Communication is critical between the treatment floor staff and front desk staff. Nothing worse then watching a team of people look at one another dumbfounded in front of clients because your clinic has no communication between teams. It can cause an angry client to become irate and belligerent when they see that communication is lost between the two parties.

Cally Merritt's picture

Good article. I always try to have the "you don't know what they've gone through" mentality. Though it is difficult to maintain at times.