Recording incidents, concerns and agreed actions

Records after difficult contacts should be factual and helpful. Avoid labels such as "awkward" or "difficult" unless the note explains what happened.

A clear record lets the next colleague understand the patient's request, the patient's words, any risks, any behaviour that affected safety, the limits set, and the action taken. Records should support continuity of care and avoid shaming the patient or venting staff frustration.

Separate four things

• Emotion: upset, crying, angry, distressed or frightened.
• Behaviour: shouting, swearing, threatening, repeatedly interrupting, refusing to leave, or ending the call.
• Risk: urgent symptoms, self-harm wording, safeguarding concern, staff safety issue or unclear safety.
• Action: advice given, route used, escalation, supervisor involvement, incident report or follow-up owner.

Use factual wording

Examples of factual wording include: "Patient shouted, 'I will come down there and make someone listen'", "Caller said they could not cope with waiting", or "Staff member ended call after warning because discriminatory abuse continued".

Avoid labels that do not help future care, such as "horrible", "attention seeking", "rude as usual" or "kicked off". These terms damage trust and can obscure the practical issue.

Record the agreed next step

After a heated contact, the next step can become unclear. Note who owns the task, what the patient was told, whether urgent escalation occurred, and whether an incident report was completed under local policy.

Incident Reporting

A good record separates emotion, behaviour, risk and the practical action taken.