To develop communication and conflict resolution skills, enhance teamwork between senior and junior nursing staff, practice decision-making under pressure, and address the needs of an agitated patient in a professional and empathetic manner.
Ask the students as a group to quickly discuss or role-play how to seek support or guidance from a senior colleague. This can be followed by brainstorming calming statements and positive body language techniques.
Scenario Overview
Characters
Patient: A middle-aged individual with an injured leg, in visible pain, becoming increasingly agitated due to a long waiting time. The patient expresses frustration and escalating in tone.
Senior Nurse: Calm, authoritative and experienced in conflict resolution.
Junior Nurse: Eager but less experienced, potentially feeling overwhelmed.
Setting
A busy Accident & Emergency (A&E) department with multiple demands on staff.
Roles Key Behaviours
Agitated Patient:
Behaviours:
Slam hand on the counter, yell or raise voice, express frustration about waiting and pain, demand immediate attention.
Tone:
Loud, assertive, and increasingly agitated.
Attitude:
Angry, impatient, and focused on getting relief, but may calm down if acknowledged and reassured.
Junior Nurse (Overwhelmed at Registration Desk):
Behaviours:
Display visible signs of stress (e.g., hurried speech, avoiding eye contact). Attempt to placate the patient with brief responses, and show hesitation in handling escalating tension.
Tone:
Nervous, apologetic, or uncertain.
Attitude:
Overwhelmed but willing to learn from observing senior nurse's approach.
Senior Nurse (De-escalating the Situation):
Behaviours: Step in calmly, use open body language, acknowledge the patient’s concerns, validate their frustration, and clearly explain the next steps or expected timeline.
Tone: Confident, calm, and empathetic.
Attitude: Focused on de-escalating tension, building trust, and providing clarity while maintaining professionalism. feels acknowledged and calms down, or a resolution is agreed upon.undefined
Hospital room
Simulation Flow
Set-up
Arrange a mock A&E environment with props such as a stretcher, chairs, medical notes, and a clock. Add distractions like noise or other simulated patients.
Introduction
Brief the participants on their roles privately, emphasizing the emotional and situational dynamics of the scenario. Outline the timeline of events and the objectives for each role.
Execution
The simulation begins with the agitated patient storming to the nurses’ station, slamming his hand on the counter and complaining about the wait and his pain.
The junior nurse attempts to de-escalate the situation, but her efforts are not effective.
The senior nurse enters the scene and takes over or assists in addressing the patient’s concerns. Effective communication and teamwork helps to de-escalate the patient’s agitation.
The simulation concludes when the patient
Learning Outcomes
By the end of the simulation, the participants should be able to:
- Recognise warning signs of escalation.
- Demonstrate effective communication strategies for de-escalating an agitated patient
- Utilise teamwork in high-pressure situations
- Apply empathy and professionalism while addressing patient needs
- Recognise the importance of senior mentorship in developing junior staff’s confidence and skills
Possible Distractors or Disruptors
Background noise from other simulated patients or medical equipment.
Simulated interruptions, such as another nurse requesting help or a telephone call.
The patient escalating the challenge.
Debriefing Plan
- Self-reflection – the participants express their immediate emotional reactions to the simulation
- Analysis - explore together what happened during the simulation and why.
- Highlight the strengths demonstrated by the students and identify areas for improvement.
- Summarise main learning points from the session.