9 Expert Tips for Dealing Difficult Patients

As a nurse, you will encounter many different types of people throughout your

career. Some will have pleasant personalities, others not so much. Likewise, many of

the individuals you will work with will be experiencing various emotions due to

their situation, which can affect how they engage with other people. For instance,

someone who is normally very even-keeled may become frustrated, angry or even

aggressive when he or she is in pain or worried about an impending medical

condition. Whatever the case may be, there will inevitably be times when you will

have to treat someone who is unpleasant to deal with. And while it’s par for the

course, that doesn’t mean there aren’t certain things you can do to make the best

out of a challenging situation. To follow are nine expert tips a try.

Stay calm.

This may seem easier said than done, but it’s imperative that you remain as calm,

cool and collected as possible. As mentioned, the patient may be dealing with a lot

of emotions, such as fear, anxiety or anger, which can impact how they interact with

those around them. Or he or she may simply be a difficult person in general. In

either case, remaining calm will allow you to maintain control over the

situation and deliver the appropriate treatment needed.

Remember, it’s not you, it’s them.

Sometimes a patient will be difficult simply due to their personal beliefs,

regardless of whether they are right or wrong. For instance, some people still feel

that nurses should be female. It’s important that male nurses not take outdated

opinions like this personally. Likewise, someone who is frustrated and

lashing out may say things they don’t mean or know nothing about. For example, a

patient who is upset may call you uncaring or unprofessional, even though you’re

doing your absolute best. Keep reminding yourself that it’s not you, it’s them.

Be confident.

You know what you’re doing, even if the patient you are attempting to treat seems to

be questioningyour every move. Yes, you should listen to what the patient has to

say, but at the end of the day, be confident in your training and experience. Keep

in mind, also, that people who exude confidence earn respect. If you feel your self-

assurance starting to wane, take a step back and remind yourself to “Fake it ‘til

you make it.”

Start a dialogue.

Oftentimes a difficult patient doesn’t even know why he or she is lashing out in the

first place. Other times, it’s simply because they feel as though they aren’t being

heard. Taking a moment to start a dialogue and engage in conversation can give the

patient a voice and help them work through their feelings. Always refer to the

patient by his or her first name, speak softly and calmly and maintain eye

contact. Avoid using negative language or an inflammatory tone. Whenever feasible,

ask the patient what they need. And when all else fails, sometimes you just need to

listen while they vent.

Avoid arguing.

There will sometimes be patients who are simply looking to pick a fight, and as

their nurse, you will likely become a target at some point in time. Again, remain

calm and practice active listening. No matter how difficult it is, never allow a

patient to draw you into an argument. Always remain respectful, regardless of the

situation and don’t engage or escalate. For instance, if a patient is demanding to

know why he isn’t getting enough attention or why his meds were late, instead of

going back and forth, simply apologize and reassure him that you’ll take care of the

situation.

Demonstrate empathy.

One of the fastest and most effective ways to diffuse a tense situation with an

angry or difficult patient is to show them some empathy. Put yourself in their shoes

for a moment and remember that it’s not always easy to be on the opposite side of

the stethoscope – especially for someone who is feeling frightened or experiencing

pain. Take a few moments to let the patient know that you understand how upsetting

the situation must be for them. If possible, share a personal story of a similar

situation you or someone close to you experienced. At the very least, show them that

you genuinely care about them.

Set some boundaries.

When it comes to a patient who is being difficult by making unreasonable or never-

ending demands, you may need to set some limits for your own sanity. For instance, a

patient in the hospital may be insisting that you spend more time tending to her

needs, despite the fact that you have half a dozen other patients on your list. Set

boundaries, such as letting her know that you will be in to check on her at

specific time intervals (i.e. every 30 minutes) and follow through. It may not be

the answer she’s looking for, but it’s the closest thing to a compromise you can

offer. Setting expectations is the key.

Stay positive.

Ever notice how someone’s smile, laugh or general good mood can really rub off on

you? The opposite can also be true, so try to set the tone with all of your patients

by staying positive. When you enter a room with a cheerful demeanor, you might be

met with a reciprocal smile. Even if it doesn’t happen right away, maintaining a

consistently good natured attitude will produce dividends over time, not just

amongst your patients, but also your colleagues and everyone you encounter.

Shake it off.

If, after trying all of the above, you are simply unable to break through or make

any headway with a patient, don’t let it drag you down. After an unpleasant

interaction, it’s normal to feel frustrated or upset. Take a moment to work through

those feelings (away from the patient, of course) and then let them go. Remind

yourself that this comes with the territory of being a nurse and while there will

occasional moments like this, the good and rewarding parts of your career will

always outweigh the bad.