Takeaway
When encounters feel stressful, double down on clear communication. After difficult patient interactions, debrief with colleagues to identify which communication strategies did and did not work.
Lifelong Learning in Clinical Excellence | January 16, 2026 | 2 min read
By Stacy Colimore, MS, RN, CPXP, Johns Hopkins Medicine
Delivering clinically excellent care with compassion is the gold standard in healthcare. Before we enter the field of medicine, we dream of moments when we’ll provide care in a way that validates patient feelings, empowers them with information, and creates a trusting bond.
The opportunity to connect in a meaningful way can feel elusive when patients express anger, or act in a demeaning, violent, or threatening manner. These behaviors are increasingly common and normalized in our society, as well as in healthcare settings. As providers, it can be daunting, draining, and even intimidating to engage with a patient or care partner who’s yelling, cursing, and threatening. Often, we’re at the bedside alone attempting to manage these stressful scenarios and hope that we’re doing it “right.”
Our Johns Hopkins Health System Patient Experience team decided to de-silo these experiences and create a high-stress communication simulation program that allows clinicians to practice providing compassionate care under trying circumstances. Hopkins’ patient experience staff worked with clinical teams to create relevant stressful to capture issues that are relatable and challenging to navigate. On the day of the event, we set up mock patient rooms with actors who bring these stressful scenarios to life. Each provider gets an opportunity to try managing the scenario while a small group of peers observe and note the verbal and non-verbal tactics that were particularly impactful, as well as opportunities for improvement.
The primary goal is to allow clinicians to identify best practices and effective communication tools that they can add to their toolbox and draw upon during future stressful events. A secondary goal emerged from an outcome we observed early in the program—learners enjoy socializing with colleagues that they don’t get to work side-by-side with every day. Their shared challenges, willingness to be vulnerable in simulations, and respect for the demonstrated skills of their peers bring colleagues together in a new way.
Here are five tips to improve communication strategies during stressful encounters:
1. Include discussions about patient communications during team meetings.
2. Identify verbal and non-verbal communication best practices that your team will adopt to enhance compassionate and effective communication.
3. Identify challenging topics and scenarios that the team frequently manages.
4. Debrief with colleagues after engaging in challenging scenarios to identify what worked and what didn’t.
5. Discuss strategies that worked and strategies that didn’t work in managing challenging communication scenarios during team meetings.
It takes courage, vulnerability, and compassion to choose to care, now more than ever. With the support of our colleagues, we can do it together.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.