Calming the Kraken: Dealing with Difficult Patients

Dealing with difficult patients can be one of the most challenging aspects of nursing. It’s been about 5 years but I still get fired up when thinking about a patient who pointed a finger gun at my head and pulled trigger when I told him the doctor had ordered a Covid test. I do fantasize of a type of Yelp review system where providers can review patients. Unfortunately, none of this is going to help me handle that gassed up charger. Whether it’s a demanding family member, a non-compliant patient, or a patient who is simply having a bad day, these interactions can take a toll on your emotional well-being. However, with the right strategies and mindset, you can navigate these situations with confidence and compassion.

Understanding Difficult Patients

• Identify the root cause: Try to understand what might be causing the patient’s behavior. Is it pain, fear, frustration, or something else?
• Empathize with the patient: Put yourself in their shoes and try to see things from their perspective.
• Recognize your own emotions: Be aware of your own feelings and reactions to the situation.

Effective Communication Strategies

• Active listening: Give the patient your full attention and show that you’re listening by maintaining eye contact, nodding, and paraphrasing their statements.
• Assertive communication: Express your concerns and needs clearly and respectfully, without being aggressive or passive-aggressive.
• Use “I” statements: Instead of blaming or accusing the patient, focus on how their behavior affects you. For example, “I feel frustrated when you don’t follow the doctor’s orders.”
• Validate the patient’s feelings: Acknowledge the patient’s emotions, even if you don’t agree with them.
• Set boundaries: Clearly communicate your expectations and limits.
• Don’t assume: so many times I thought I knew what the patient was about to say and jumped in with a response only to be put in check when my assumptions proved wrong. Less talking and more listening.

Building Rapport and Trust

• Show empathy: Demonstrate that you care about the patient’s well-being. Sometimes, you gotta just fake it until you make it – kind of like a “build it and they will come” situation.
• Be patient: Give the patient time to express their concerns and feelings. This can feel almost impossible given all of the demands on our time but research shows that even two minutes more really matters: in a study of healthcare providers, it was found that patients were much more like to sue a provider who spent two extra minutes at the beside and gave faulty information than the provider thant spend two less minutes at the bedise and gave accurate information.
• Be consistent: Maintain a consistent approach to the patient’s care.
• Involve the patient in decision-making: Empower the patient to take ownership of their care.
• Explain Time Expectations: a lot of patient frustration comes from not knowing what to expect especially on wait times. Just letting patients know wait times and the plan of action can immediately take 100 lbs of pressure off of you.

Managing Difficult Situations

• Stay calm: Avoid getting defensive or reacting emotionally. Remember, this isn’t really about you.
• De-escalate the situation: Use calming techniques, such as deep breathing or counting to ten.
• Seek assistance: Don’t walk away mad, just walk away. If the situation becomes too difficult to handle, don’t hesitate to ask for help from a supervisor or colleague.
• Document the interaction: Record the patient’s behavior and your response.

No doubt challenging patients make a hard job even harder but truth is, they aren’t going anywhere so learning how to be comfortable being uncomfortable is critical to your well being.