Most nurses are used to dealing with difficult patients and it is usually the patients who make the sore feet, paperwork, and hours without a bathroom break worth it. However, not all patients are rosy, happy people, and sometimes they can truly test a nurse’s compassion, patience, and communication skills.

As nurses, we all occasionally run into patients that are more “trying.” For any of a variety of reasons, they’re unusually difficult to work with. They may complain constantly, be non-compliant, or even aggressive. Sometimes it’s due to a psychiatric or medical condition, like dementia or mental illness. In other cases, they’re just not the most pleasant people. Or they are really just feeling out of sorts with the world due to their illness.

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What can you do when you get assigned that notorious patient that no one else wants to take? As healthcare professionals, we can’t simply ignore or ‘unselect’ a patient, the way that some professionals can with their business clients. What we can do is to find strategies for managing the patient as best we can, and in worst-case scenarios where the patient may be aggressive, put our own safety first.

Tips for Dealing with Rude, Demanding, or Otherwise Difficult Patients

The most common type of “difficult patients” are those who are just plain rude and obnoxious. They are largely unappreciative and demanding, and downright rude. In some cases, there’s a medical issue at play. Irritability can occur as a side effect of some kinds of medication, or because of Alzheimer’s disease or some other neuro-degenerative condition. But in other cases, no such organic or psychiatric cause can be identified. It is just the bad nature of the person that comes to the fore.

Here are a few tips for diffusing conflict with unusually difficult patients in a healthcare setting.

  • Never take anything personally. It is not about you. Don’t interpret the situation as, “I have personally done something wrong,” or “This person is upset with me, specifically, and doesn’t like me.” Most of the time, this isn’t the case. It probably has little or nothing to do with you. It’s important not to let yourself take it personally, or become too emotionally upset due to the way the patient is treating you. Reacting personally to the conflict of others will only exacerbate the situation.
  • Bear in mind possible underlying causes. Irritability can sometimes have an organic cause. Many types of medications can cause anxiety and tension as a side effect. Mood disturbances and behavioral changes can also occur in elderly patients with Alzheimer’s disease or other cognitive impairment. In some cases, a change in medication can help improve the patient’s mood and outlook.
  • Remain calm always. Even though you can feel that your frustration levels are on the increase and you want to lose it, it is vitally important that you remain calm and even-keeled when chaos reigns around you. You have to avoid becoming emotionally upset, which can cloud your judgment. It’s important to realize that in most cases, the patient is lashing out at you simply because you happen to be in the way, not because you did anything to deserve it.
  • Do not enter into an argument with a patient. Arguments simply perpetuate themselves in a positive feedback cycle when it comes to this type of patient. Try to avoid being pulled into an argument or becoming too defensive, which can worsen the situation. Rather call for back in order to diffuse a potentially explosive situation.
  • Set boundaries. In many cases, difficult patients will try their luck by requesting the impossible. And then some. In these situations, it is completely acceptable to set some clear boundaries with the patient. While you are at their beck and call in a sense, you do not have to be their puppet.
  • Keep perspective. Irritable, agitated, and difficult patients sometimes demand that you put their needs first while there are other patients who need your attention more. It’s important to retain a clear, balanced sense of what is and isn’t important in-patient care. If a difficult patient is pressuring you to do something, but it isn’t urgent, it’s quite acceptable to tell them you will take care of it as soon as it is possible for you to do so.
  • Never tolerate abuse. It’s difficult to really draw the line between being rude and being outright verbally abusive. However, it’s not a good idea to establish habits where you’re simply accepting verbally abusive behavior from a patient. If you’ve asked a patient to desist, but they’ve continued to berate you, you may want to consider informing one of your supervisors to figure out an appropriate course of action.

Dealing with difficult patients is sometimes one of the most challenging parts of your jobs. It’s frustrating when all the empathy, respect, and compassion you show doesn’t seem to be enough to inspire the patient to treat you better or give you the respect you deserve. It is then that all of the above become relevant.

How do you deal with a difficult patient? Share in the comments section below.

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