Dealing with difficult patients is every nurse’s daily cup of coffee. After all, nurses tend to interact with patients when they’re at their best and worst versions of themselves. One report even goes as far as pointing out that at least 15 percent of patient encounters are what we would consider “difficult.” Yet, as nurses, caring for challenging patients is part of the job. A difficult patient can be:
- The dependent clinger that makes unreasonable demands
- The entitled demander who’s often a bully and has a long list of needs
- The manipulative will do anything to make things go their way
- The self-destructive who engages in dangerous behaviors
No matter what type of difficult patient you’re dealing with, following these helpful tools will help you stay calm and take care of yourself as well.
Give Yourself a Break
When the situation has escalated, and you start to feel tense, it can be impossible to deal with a problematic patient without taking a break. Most people will advise you not to take it seriously, but deep down, you know that’s easier said than done. After all, nurses are known for their ability to remain calm in stressful situations or to work with troublesome patients.
Communications skills are key here. Make sure you remain calm and continue to speak in a soft voice to your patient. However, allow yourself a break and set time to reset. To let it go, you need to step away from the situation. Go for a brief walk, talk to a colleague about it, fit in a quick meditation session, or maybe enjoy a sweet treat to bring the stress down. Giving yourself a break will help you come back recharged, refreshed, and ready to give it another try.
Consider the Root Cause
Patients can get irritated by infinite things while at the hospital. If you’re struggling with an angry or irritated patient, think about the root cause. Is it fear? Are they stressed? Could it be a side effect of medications? All of these are potential root causes that can improve the nurse-patient relationship. Try to think about the possible causes of their outburst. Once you understand this, it will be easier to assess the situation and know the next steps into achieving harmony. Talk to the doctors and other nurses, consider speaking to their family, whatever it takes to help you understand the patient better will help you find the best way to manage them.
Check Your Body Language
Nurses like to believe their patients can’t tell when they don’t like them. In reality, your body language speaks volumes. So does the tone of your voice. After the first rocky encounter with a patient, you might look tense, and your voice might sound more irritated, patients can quickly pick up on these pointers. At this point, both of you have your defenses up and are ready to fire at each other.
Before walking into the room or even speaking to your patient, do a body and mental check-in. Take a deep breath and remember that having an attitude towards your patient won’t do much good in the long run.
Lean on Empathy
When people say not to take it personally, they mean it. Remember that your role is about the patient and their journey. Lean on empathy and try to look at the situation from the patient’s perspective. Being at a hospital, for whatever reason, is a scary situation for anyone. Not being their best self is quite common. Lean on empathy and try to communicate your efforts for understanding how they’re feeling with your patient.
Even when you can’t 100% be in their shoes, expressing that you’re thinking about things from their perspective will make patients feel understood and cared for. It might also help them lose their guards since they’ll realize that you’re there to care for them.
Use the Behavior Agreement
Here’s the most crucial tool of all — the behavior agreement. Listen, while nurses are empathetic and caring, that’s no excuse for tolerating abuse. Set up clear boundaries with abusive patients that don’t understand these boundaries. Never let a patient yell, curse, diminish, or discredit you in any way. Ensuring they’re fully aware of these boundaries the moment they exhibit abusive behavior is paramount to stop them on their tracks.
Ask your supervisors about your abusive behavior protocols; many hospitals will allow you to be discharged from treating those patients. If that’s available to you, let the patient know that you won’t be treating them any longer due to their abusive behavior and that their abusiveness won’t be tolerated in the clinic. It’s surprising how many patients will change their demeanor after hearing such agreement and terms.
Know When to Ask for Additional Help
Sometimes, some patients will need additional help, and so will you. Recognize when you need to speak to another nurse for support. If you believe your patient might benefit from talking to a counselor or mental health specialist, don’t be afraid of raising the question. In the end, it’s all about the patient and their wellbeing.
Throughout your career as a nurse, you’ll always encounter difficult patients. Keep these helpful tools to stay centered and calm so that you can offer your patients the best care possible.
