The NHS e-learning for Health has a learning module on conflict resolution. Several models are described, but the PALMS model (Box 1) is a non-aggressive stance designed to help communicate to the patient that you do not want to engage at their level of communication; rather that you want to help them. Position relates to your environment, being aware of your surroundings so that you and the patient do not block the exit. Attitude relates to how you are perceived by the patient. Are you using open body language? Smile and talk calmly, emphasising that you want to help the patient find a solution to what has upset them. It is not helpful to blame a third party, as this may cause a repeat of the behaviour with another colleague or cause the behaviour to escalate. Be aware of using positive language and avoid using 'loaded' or neutral words. Focus on looking and listening. Maintain normal eye contact, but not sustained eye contact, and use your active listening skills (for example, nodding, minimal use of gestures and repeating phrases) to show the patient that you understand.
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