7 Tips for Dealing with Difficult Patients
How to cope with angry, manipulative, or aggressive patients
People in the hospital are rarely at their best emotionally. Health problems are often painful, expensive, and frightening. And apart from the obvious, sometimes s a patient has sources of anxiety that aren’t immediately apparent, like fear of losing a job, or anxiety about childcare. Because of this, patients are often at their very worst, inflicting their pain and frustration on everyone around them. Part of nursing is learning how to deal with this kind of patient aggression. Every seasoned nurse has an arsenal of stories about the difficult patients they’ve seen. Keeping some basic principles in mind will often get you through the most trying encounters.
Empathize with difficult patients
You are likely a nurse because you genuinely care about people. You shouldn’t allow patients to take advantage of your kind nature, but showing genuine empathy goes a long way to soothing stressed and angry patients. Listen, make eye-contact, and reference your shared desire for this difficult situation to be over as soon as possible. Try not to react defensively to angry criticisms but rather to affirm the patient’s needs and expressed preferences. People often are immediately calmer when they realize you truly care about their well-being.
A penny of prevention is worth a pound of cure
An experienced nurse learns to predict situations that might create a difficult situation on the floor. For instance, she can call a doctor when she suspects that a patient’s pain management protocol needs an adjustment, or she might learn which visiting family members are most likely to create an upset. Not every conflict can be avoided. However, if you can step in before a problem escalates you are much more likely to resolve it in a peaceful way.
Stay calm when patients are abusive
It’s difficult to stay calm when someone is belittling you, your expertise, and your commitment to your job. It’s something nurses must learn to do though, and there are some techniques that can help. Keep your body language relaxed – don’t cross your arms and continue to make friendly eye-contact. Breathe as deeply as possible. Listen respectfully even if you need to defend your treatment protocol. Finally, remove yourself from the situation quickly if it becomes clear that the patient is too upset to have a conversation.
Prioritize your emotional health
To deal with a high-stress job like nursing you have to be emotionally healthy. Dealing with angry people can be triggering and doing it day after day can be downright exhausting. Find your healthy coping strategies and make time for them. Whether you go for a run, talk to a therapist, write, or spend time with friends, make sure you’re staying grounded. If you sense that you’re burning out, maybe take a few weeks off to recharge. Nursing burnout is a real problem, and the only way that you can prevent it is by faithfully tending to your emotional needs.
Set boundaries with difficult patients
Difficult patients need to know that their angry behavior isn’t acceptable. Explain clearly to the patient how their behavior affects you, the health care team, and their quality of care. Some hospitals are having particularly abusive patients sign behavior agreements. These written agreements outline inappropriate patient behaviors and also clearly state consequences patients might incur. Even without this kind of institutional response, you can make it clear that you aren’t willing to tolerate certain kinds of manipulative or aggressive behavior from your patients. Set clear boundaries and people will often respect them.
Do your job to the best of your ability
Unfortunately, all nurses deal with difficult patients. Sometimes the only thing you can do is keep your head down and do your job until that difficult patient is discharged. Your top-priority is to provide the best care that you can under the circumstances. After all, you are a health care practitioner, not a concierge. Sadly, difficult patients may sabotage lines of communication and make it harder for you to give them the kind of care that they need. Still, you are a professional and with experience you can learn to care for even the most demanding.
Use your resources effectively
Always remember that you’re not alone! If you suspect a patient needs more support than you can give, reach out to the behavioral health team. Psychologists, psychiatrists, case management, and social workers may be able to assist with treatment recommendations and other services. If a patient is really challenging it may be wise to have a third-party present for all care and communication. They can serve as a witness in case the patient makes a formal complaint or involves the hospital in litigation.
Use your resources outside the hospital as well. Surround yourself with people who love and care for you and who understand how hard you’re working. The Uniform Outlet is proud to have been supporting tenacious nurses and health care personnel for almost twenty years. It’s our mission to support you in yours.