How should a CNA respond to a situation where a patient or family member is expressing dissatisfaction with the care being provided, and what are the appropriate channels for resolution?

When a patient or family member expresses dissatisfaction with the care being provided, a Certified Nursing Assistant (CNA) must respond with professionalism, empathy, and a commitment to finding a resolution. This situation requires a calm demeanor, active listening, and clear communication to address the concerns effectively and maintain a positive environment. The focus should always be on understanding and resolving the issue, while also following the appropriate channels within the healthcare facility.

First, the CNA should immediately acknowledge the concern and allow the patient or family member to express their dissatisfaction fully without interruption, unless the expression becomes verbally abusive or threatening. Maintain eye contact and show that you are actively listening by nodding, making appropriate facial expressions, and using verbal cues such as "I understand," or "I see what you mean." Avoid being defensive or dismissive, even if you feel that the complaint is unjustified. Acknowledge their feelings by stating things like "I see that you are upset," or "It sounds like you are feeling frustrated". Do not invalidate their feelings by stating that "it's not that bad". For example, if a patient states, "I've been waiting for an hour for my pain medication, and it's really unacceptable,” avoid saying “You’re wrong, it hasn’t been an hour.” Instead, say "I understand you are upset that you have been waiting, and I'll check on that right away."

Second, actively listen to understand the specific nature of their concern. Ask clarifying questions to gather specific details. Try to understand the reason they are upset, which may not be obvious at first. Ask questions such as “Can you please tell me more about what happened?”, or “Can you be more specific about what you are not satisfied with?”, or "What is it about the care that is upsetting you?" It’s important to differentiate between factual concerns and emotional reactions. Do not make assumptions about the complaint without clarifying it with the patient or the family. For example, if a family member complains that “the care is terrible,” you should seek further clarification by asking them what specific issues are making them feel that way.

Third, apologize for the inconvenience or distress, even if you are not personally at fault. A sincere apology can help de-escalate the situation and open the door for a productive conversation. It is important to show empathy by expressing concern and regret over the situation. Use statements like "I'm sorry that you are experiencing this difficulty" or "I apologize that you have not received the care that you were expecting". Do not make excuses or blame others, and focus on what can be done to address the situation. For example, even if the delay in medication was not your fault, you could say, "I'm sorry that you had to wait so long for your pain medication."

Next, take steps to address the issue immediately if possible. If you can take steps to resolve the situation, do so right away. For example, if the issue is a delay in medication, inform the nurse, and ensure the medication is given as soon as possible, and keep the patient or family informed about the status. If the issue is with the cleanliness of the room, address that situation immediately. If you are unable to immediately resolve the situation, assure the patient or family member that the issue will be addressed and that it will be reported to the relevant authority. Even if the issue is not within the scope of your practice, make an effort to try to help.

Report the issue to your immediate supervisor or the nurse in charge of the patient’s care promptly. Clearly explain the nature of the complaint, the steps you took to address the concern, and any relevant details. It's crucial to ensure that the appropriate staff are aware of the situation so they can take further action. Provide an accurate, detailed account of the situation, and the actions you have taken. Do not try to minimize the situation, or hide details. For example, report the complaint immediately to the nurse and provide a full explanation, rather than trying to resolve it on your own.

Follow the facility’s policies and procedures for documenting complaints. Document all of your findings, including the date, time, the details of the complaint, the actions you took, and any steps that have been taken to follow up on the complaint. It's important to be objective and avoid personal opinions in your documentation. This record is essential for tracking and follow-up, and for compliance with the standards of care. For example, document all aspects of the complaint, including what the patient or family member said, what actions you took and what was the outcome, and any other pertinent information. Be sure that you are using facility approved forms and documenting in the EHR system as required by your institution.

Collaborate with the healthcare team, including nurses, physicians, social workers, and patient advocates, to develop a comprehensive plan to resolve the patient or family member's concerns. By working collaboratively, you are more likely to be able to address all aspects of the complaint, and to ensure that the resolution is satisfactory. This approach helps create a collaborative and caring environment for the patient. For example, follow up with the nurse or supervisor and determine the best course of action.

If the patient is not satisfied with your initial responses, or if their complaint is regarding a broader organizational issue, advise them of other available channels for resolution. This includes informing them of their right to speak to the patient advocate or the administrator of the facility, and assisting them if they want to contact these entities. You can also inform them of the option to file a formal complaint. It is important to ensure they are aware of all available options to address their complaints. For example, ensure the patient knows how to access the facility's patient advocate.

In summary, when responding to patient or family complaints, CNAs should actively listen, empathize, seek clarification, address immediate concerns if possible, report the complaint to the supervisor, document all details, and collaborate with the healthcare team. By following these steps, and by showing sensitivity and respect, CNAs can effectively address the situation and work toward a positive outcome.