Staff & Management Responsibilities – Managing Stress Nick Nurden Business Partner – The Ridge Medical Practice

The story so far We Have: Understood what is an unreasonable complaint Considered strategies to avoid unreasonable complaints Considered how best to manage unreasonable complaints Learnt some techniques to deal with difficult behaviour Looked at some communication skills

We can’t eliminate stress! Despite all these steps to minimise and manage unreasonable behaviour it will happen, and it will be stressful! We need to understand the impact unreasonable complaints have on staff We need some tools to manage that stress Focus on the role of organisational culture in such situations

Types of unreasonable complaint We have already identified some general types of unreasonable complaints Persistent Complainers Complaints with unreasonable content To complain purely to cause annoyance rather than genuinely to seek redress Abusive, threatening or violent complainants These will affect different employees in different ways and bring different types of Stress

Two types of staff to keep in mind Complaints handling teams who deal with the complainants The complaints team Staff (clinical or administrative) who are the subjects of unreasonable complaints The “ordinary” staff

Key management responsibilities We have an obligation to provide our employees with a safe place of work We have a responsibility to safeguard our employees health and wellbeing Develop policies and procedures for staff to follow that will achieve this, without compromising the integrity of the complaints process

Achieving our responsibilities Minimise the risk of stress Maintain a commitment in our approach to dealing with unreasonable conduct Provide staff with adequate supervision and support in dealing with unreasonable conduct Give staff sufficient time and resources to deal with unreasonable conduct Provide staff with adequate training and guidance

Staff responsibilities Remain calm at all times Show respect for all complainants, whether acting unreasonably or not Act impartially in all matters Demonstrate professionalism in dealing with complainants

Complainant stress Most complainants genuinely believe they are being reasonable If we behave calmly and professionally it will reduce the chance of aggression and conflict Consistent and firm application of process should support complainants and staff alike Important to make sure the organisation does not hide behind process though

Tools for reducing stress Focus in the conduct and not the person Unreasonable complaint or unreasonable conduct NOT an unreasonable person! Separate out the behaviour from the issue Is it a reasonable complaint with unreasonable conduct Deal with the complaint and manage the conduct

Established processes reduce stress Have model Ground rules Follow established procedures Keep Good Records Have a checklist Spot the warning signs

Preventing unreasonable conduct Manage Expectations from the beginning Ownership and control Communicate clearly and promptly Consistent and firm Insist that the complainant shows respect. Set boundaries in terms of not tolerating rudeness, anger or aggression

How you support the staff Staff welfare process embedded in the culture of the organisation Need management awareness of what is happening on a daily basis Simple established responsive mechanism in place for immediate needs Ongoing periodic review of processes

Management commitment Will allow staff to respond confidently and appropriately Staff can then act confidently and robustly knowing that they will be supported Supporting staff does not mean “taking over” or “giving in” to complainants Managers should remain “invisible” to complainants

Supporting Staff & the Team Support and protect your complaints staff Meet with staff regularly to agree a plan Stick to the plan wherever possible Limit access of complainant if required Give them the autonomy and authority to act Be realistic – it will be hard work at times!

Provide enough time Always our biggest enemy! But very important in this potentially very stressful environment Be well trained with ongoing training Time to prepare Time to follow process Time to debrief

Signs of critical incident stress Exposure to incident stress can have a serious effect on staff physical, emotional, professional and social wellbeing; signs include: Lack of engagement Physical illness symptoms Interpersonal issues/social withdrawal Substance misuse

Managing this stress Providing regular debriefing Encourage a supportive team environment Ensure staff know that they will be supported Be clear that getting stressed (and admitting to it) is not a sign of weakness Be observant and don’t ignore the signs

Impact of unreasonable complaints on the organisation Potentially destructive Time sapping Morale sapping Staff feel they are not appreciated Potentially divisive within and between teams Adversely affect future behaviour Leads to increase in absenteeism

Mitigating the impact of such issues Debriefing very important Clear and formal process for this Well facilitated by trained staff Establish a peer support system Debriefing components: Prompt – 24/72 hours after incident Be aware reaction may be delayed Private and discussions confidential Provide ongoing support

Stress for staff complained about Most staff are very conscientious and get distressed about complaints against them (whether reasonable or unreasonable) Staff may over react initially to a complaint against them May lead to competent or excellent staff questioning their own capability Could adversely affect their working life whilst the situation is resolved

Support for these staff Ensure that communication with them is effective Timely Detailed Supportive Using the chain of command where appropriate Guide them through the process of responding Flag up to others any signs of stress

The importance of Organisational Culture The integrity of the complaints process is important and staff must be accountable for their actions achieved either by: A blame culture that seeks to find scapegoats and excuses or sees complaints as a chore A learning culture that seeks to support staff in helping the organisation to learn and improve

Managing Stress - Summary Mitigate and Prepare to minimise stress Can support the team and staff without undermining the integrity of the process Thorough training essential Excellent processes crucial Be consistent and confident Establish a supportive culture