If there’s one thing that every nurse will come across in his or her career, it’s a difficult patient. Sometimes, the sweet patients that make the long hours and tired feet worthwhile are outshined by that one ornery, demanding or hostile patient who is miserable, and finds a way to share that misery with anyone who comes within a few feet of him or her.
You and your fellow staff may find yourselves avoiding their calls, and delaying their checkups, but the fact is, even patients with the worst attitudes deserve the best treatment possible.
So before you hide out from your less than favorite patient, consider the following advice to help establish a functional patient-health care provider relationship that isn’t so painful.
Make Sure You’re Communicating Effectively
Sometimes, your frustration with a patient may translate into your communication style. You may be a bit short when speaking with them, become arrogant in response to their disbelief or give vague answers just to hurry up and get outta there, but that can lead to more strife in your interactions. Instead, Dr. Robert H. Blotter of AAOS Practice Management Committee suggests that when speaking to any patient, pretend they’re member of your family who has no background in medicine.
If you gave your mom or cousin the same kind of answers you’re giving your difficult patient, would they understand you or ask for a better explanation? Would they be satisfied with the conversation? Whether you have to remind yourself to slow down or pretend that the patient is your grumpy grandpa whom you love, approach your difficult patient with the determination to treat them well in spite of their unwillingness to do the same. Slow down, listen and try to identify the nuts and bolts of their concerns before you dismiss them. You may even find that they eventually warm up to you.
Make Sure You’re Communicating Effectively
When some people don’t get there way, they may feel slighted or victimize themselves, believing they were targeted and treated differently. Instead of silently calling them crazy in your head (or probably out loud for some of you), simply defer them to policy. If your patient is complaining about how unfair a policy is, explain that it is fair because this everyone in the hospital has to abide by it and if possible, share a printed copy of the rules or point to a sign that explicitly states the policy.
Don’t Take Things Personally; Establish Boundaries
Some people don’t know how to be anything but miserable, whether stems from hurt in their past or current problems in their personal lives, so there’s no point in taking in personally. However, if your patient is constantly yelling, spewing hateful words or physically violating you, you have to lay down the law.
Give a verbal warning, emphasizing that he or she (the patient) is treated with respect, and you demand the same. If need be, discuss the possible consequences of bad patient behavior, including you terminating your treatment of the patient.
Severing Ties with your Patient
Sometimes you’ve done all you can to make your patient-provider relationship work, but you have no success.
“Physicians have an obligation to support continuity of care for their patients. Physicians do have the option of withdrawing from a case, but they cannot do so without giving notice to the patient, the relatives, or responsible friends, which allows the patient sufficient time to secure further care,” The American Medical Association (AMA) stated.
If you can’t bear to be around your patient and the doctor agrees that this patient should find another health care provider, Dr. Deanna R. Willis of Indiana University has an effective three-tier approach gives great guidance on how to end care with the patient.
Check out Dr. Willis’ tips for terminating the treatment relationship here:
http://www.aaos.org/news/aaosnow/nov09/managing3_f1.pdf
Have you had any success improving your relationship with a difficult patient? How did you do it?
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