Keeping calm: how to manage confronting situations

Updated

Wednesday, 22 Jul 2026

Frontline staff in any organisation, including medical practices, often face anger from the people they serve. 

If your practice changes a process which impacts on patients, for example, changing appointment scheduling, patients may become angry or aggressive towards the staff managing that change. 

All staff should be ready to deal with angry patients. They need support, training, and clear strategies to protect their own wellbeing. They need to know the practice cares about their safety and wellbeing. 

Know how to respond

Aggressive patient behaviour should be part of your practice’s risk management plan.

It could include a script for staff when a situation occurs and clear steps for when to involve the practice manager. Role-playing scenarios will help staff respond well, even under pressure.   

Prepare people for change

Patients often become aggressive when change takes them by surprise. Prepare everyone ahead of time, including patients, practitioners and the support team. Agree on a lead time for any changes that affect patients and put a communication plan in place.

Set boundaries

The whole team should follow the same approach. Consistency helps patients understand boundaries and reduces the chance of difficult encounters, and stops patients favouring one team member who bends the rules. A complaints policy gives patients a way to raise concerns and feel heard. 

Keep safety front of mind and recognise that some staff are more vulnerable than others. Regular debriefs on handling angry patients are essential. Practices are more likely to deal with threats and complaints than physical violence, but all must be taken seriously. 

If a situation turns violent, staff should try to stay calm, avoid making things worse, and move to a safe place if needed. Make sure you have a tested safety policy that all staff know (for example, run a safety drill in the same way your practice would run a fire drill) and review it regularly.  

An expected behaviour policy is also useful because it signals staff wellbeing matters and sets out acceptable behaviours for all people in the workplace. 

Try listening 

It’s natural to want to defend yourself when someone is aggressive.  But listening, rather than reacting defensively, is usually more effective.  Giving the patient a chance to speak may be enough to defuse the situation, as long as it does not put the staff member’s wellbeing at risk.  

Acknowledging someone's experience and showing empathy can go a long way. Even if you are not responsible for what happened, saying you are sorry they had that experience is not an admission of legal responsibility. It is simply a step that may reduce the tension. 

Avoid being manipulated

Be careful not to compromise patient care by giving in to unreasonable demands. For example, a patient may threaten to make a complaint or take legal action if you refuse to prescribe certain medication. They may believe they are entitled to this, and you are unlikely to be able to persuade them otherwise. 

Clear practice guidelines can help you respond consistently. Try to help within reasonable limits but be ready to say no and ask a colleague for support if needed. If you do make an exception, explain it is a one-off and make a note in their medical record. 

Know your limits

Stress can make us more likely to react in a way that escalates a situation. Taking a few slow breaths and noticing your reactions can help. Watch your body language and tone of voice – try to keep calm, speak in a neutral voice and keep an open posture.

You may not be the best person to handle a situation, someone else could be more effective. They may have more experience, have a better rapport with the patient, or simply be having a better day.  

Ending a patient relationship 

Doctors are generally not required to keep treating a patient if they have genuine concerns about their safety or the safety of staff. However, you must consider that patient’s care needs and your obligation not to refuse emergency care.

Ensure the steps taken are reasonable in the circumstances. You may wish to contact your medical indemnity insurer before ending a treating relationship, or before addressing how a staff member has handled a situation. 

Document any confronting incidents in the patient record. Keep the notes factual and objective because the patient may read them. A separate detailed incident report may also be needed in the practice records, separate from the clinical notes.

Useful resources: