This course gives you practical, published approaches for conversations that involve anger, disagreement, complaints or expectations that cannot be met, including the NURSE approach to responding to emotion. It teaches you how to stay calm, listen, acknowledge feelings, explain clearly and agree a way forward, with worked dialogue examples and a case study.
What you will learn
- Explain why conversations with patients and families become difficult, and recognise your own reactions under pressure.
- Use the published NURSE approach (Naming, Understanding, Respecting, Supporting, Exploring) to respond to emotion, within a simple sequence of listening, explaining and agreeing next steps.
- Respond to anger and complaints without becoming defensive, and apologise appropriately.
- Manage disagreement and requests for treatment that is not clinically appropriate, while respecting autonomy and shared decision making.
- Set boundaries, document conversations accurately and know when to escalate or end a conversation safely.
Course content
- Why conversations become difficult (2 min)
- Responding to emotion: the NURSE approach (4 min)
- Responding to anger and complaints (5 min)
- Disagreement and unrealistic expectations (4 min)
- Boundaries, safety and escalation (2 min)
- Documentation and reflection (3 min)
- Knowledge check (10 questions, 10 min)
- Guided reflection (15 min)
Standards and guidance covered
- GMC: Good Medical Practice (2024), including the duties on communication, partnership and dealing with complaints
- GMC: Decision making and consent (2020)
- NMC: The Code (2015, updated 2018), including 'Prioritise people', 'Communicate clearly' and 'Be open and candid'
- HCPC: Standards of conduct, performance and ethics (2024)
- GPhC: Standards for pharmacy professionals (2017), standard 3: communicate effectively
- NHS complaints procedure under the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009
- Back AL and colleagues (2005): the NURSE approach to responding to emotion, Approaching difficult communication tasks in oncology
Certificate
Courses are free to study. When you pass the knowledge check (80%) and complete your reflection, you can buy a verified certificate showing your CPD time, with a unique ID and QR code that anyone can check on our verification page.
Study free at your own pace on any device.
Related guides
How to Respond to and Reflect on a Patient Complaint
How to respond to a patient complaint calmly and professionally, and how to write a reflection on it that shows insight, with a worked healthcare example.
The SPIKES Protocol for Breaking Bad News, With Example Conversations
The SPIKES protocol for breaking bad news explained step by step, with example conversations, useful phrases, common mistakes and what to do afterwards.
How to Handle Difficult Conversations With Patients and Families
How to handle difficult conversations with patients and families: calming anger, the NURSE approach, apologising, complaints, disagreement and safe boundaries.
Practitioner Insight is an independent education provider. It is not affiliated with or endorsed by the GMC, MPTS, NMC, HCPC, GPhC or any NHS organisation, and this information is not legal advice. If you have been referred to a regulator, speak to your defence organisation, trade union or legal representative.