Understanding the Experiences of Nurses Managing Querulous Complainants: What Does Health Care Know?
Bibliographic record
Abstract
Society demands and rightfully deserves excellence in health care but unfortunately, this expectation is not always met. Having worked in the Department of Patient Relations for 13 years, I am privileged to have conversed with thousands of patients and families to resolve concerns related to unsatisfactory health care experiences. Unfortunately, I have also engaged with countless patients and families who remained unsatisfied with their care and are thus labeled difficult or querulous. I became increasingly perplexed by the presentation of such complainants and recognized that there was more to be understood about the experience of attempting to reach resolution. For this research study, I have utilized a qualitative design of hermeneutic inquiry as guided by the philosophical hermeneutics of Hans-Georg Gadamer (1900-2002) to address my research question: How might we understand experiences of nurses managing querulous complainants? I recruited five Registered Nurses (RN) employed by Alberta Health Services (AHS) as Patient Concerns Consultants (PCC). The data for my research were generated through planned, skilfully conducted, semi-structured interviews with participants. This approach allowed me to listen and be open to the participants’ understandings of their experience with querulous complainants. My research relied on the concepts of the hermeneutic circle and fusion of horizons in order to understand the experiences and bring forth interpretations. Through the research process, new and altered understandings emerged through the interpretations of Apology, War, Monsters, Soldiers, Robots, Gods, and the Black Hole. The research suggests that there is an absence of relationship between querulous complainants and PCCs. Querulous complainants cause distress, suffering, and require a unique concerns management process. The ways in which politics and Groupthink in health care play an integral part in querulous complaint management is also tendered. This study is the first known qualitative research inquiry intended to explore querulous complainants which creates a platform for new research related to managing health care complaints.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.035 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.015 | 0.023 |
| Scholarly communication | 0.012 | 0.010 |
| Open science | 0.003 | 0.011 |
| Research integrity | 0.005 | 0.008 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".