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As a paramedic working frontline for an ambulance service, we are first contact for many patients for an acute compliant and with the increased NHS pressures caused by the global pandemic where service users can wait longer for a response this can lead to heightened levels of frustration. This can lead to conflict not only for the service user themselves, but also other people involved be that on scene or not.
During this reflection I hope to improve my understanding of conflict resolution and learning new and improved way of dealing with conflict situation for my future practice.
For this reflection I have decided to use Gibbs reflective cycle (The University of Edinburgh) as I feel this will provide the best structure for my reflection as it not only considers the positivesnegatives of the event but also my own feeling on an event but my future plans for it use and continued learning that I need to strive for at a registered HCPC (HCPC)
The incident which I'll be using for this reflective piece is a job I attended while working on a double crewed ambulance with a paramedic. We attended a patient in the early hours of the morning who had suffered a fall. When we were greeted by the patient partner who informed us that they had both come back from an evening out drinking and the patient had suffered an unwitnessed fall down the stairs. We proceeded to assess the patient and retrieve a brief history of what had happened.
The patient had full recollection of the event and their initial observations were unremarkable. From a head-to-toe physical assessment, it was found that the patient had palpation tenderness located on their cervical spine which with the history of fall couldn't possibly mean a fracture. We explained to the patient that due to this we would need to transport to hospital for further assessment and as a precaution we would need to immobilise them for transport to ensure no further damage could be caused.
The patient was happy with what we had discussed but their partner began voicing concern that we were wrongfully restraining his partner. Even though we explained that the use of head block, cervical collar, orthopaedic board, and straps was for the patient's safety and also with their express permission, the partners aggressive behaviour about the situation continued to escalate.
For our own safety and for the safety of the patient's injuries we informed control of the escalating situation and police we dispatched to our location where their dealt with the partner allowing us to continue with patient care and transport the patient to hospital.
My feelings about the incident started with that of confusion. We had remained open and engaged with both the patient and the partner about our proposed treatment. We reiterated numerous times that we weren't forcing the patient in any way and all treatment was being done with the patient full consent.
A great feeling of relief came when the police arrived promptly due to the possible risk to crew safety. Their presence meant the incident could be quickly resolved and had it escalated further they had the means to deal with it allowing us to continue our patient care.
Looking back, I felt a certain amount of disappointment in myself for not being able to deescalate the situation myself. Whether a different technique would have worked with the partner I'll never know as the incident is unlikely to occur again with the exact same perimeters
From a clinical point of view the incident was a success. Even with the partners disruptive involvement the patient received the correct care for their complaint and no further injury was sustained during transport to an appropriate centre for further assessment and treatment in a timely order due to utilisation of police at the earliest opportunity.
The main area for improvement in this incident was that of the techniques I employed to deescalate the situation with the partner. I feel that a using a different type of conflict resolution technique could have mean that I could have handled the situation without needing to rely on the police who I am aware are as busy as our service.
While reflecting on this incident I concluded that the primary reason for this conflict situation was the patient partner reaction to the treatment plan they were unhappy with due to not being able to fully understand the reasons for its implementation.
There are many models available to break down the flow of communication, through research I've found the found the Sharron-weaver model to do this in the best way for my learning style.
The Sharron-weaver model consists of 5 elements of communication, information source, transmitter, channel, receiver, and destination. The author discusses how issues within one or many of the step can lead to communication issue which ultimately leads too conflict. As an example, the author speaks of how effectively the received meaning of the communication affects the behaviour of the receiver. The model discusses how it is best to carefully choose the wording of the information being communicated so that the correct meaning can be taken by the receiver to avoid any communication issues.
Reflecting on the incident where a lack of understanding and communication led to a conflict situation, I feel through analysis I have identified areas of improvement in my ability to resolve conflict for future incidents.
This reflection has enables me to research communication techniques and aggressor red flags which will best help me to deal with situations but also to protect myself and crewmate if a situation is likely to escalate beyond my control.
I will utilise the techniques I have learnt through my reflection in my future practice is in conflict situations. I intend to maintain and develop this by keeping up to date with the trust policies and training on conflict resolution.
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