As a nurse, you’ll be expected to deal with various kinds of situations and many emergencies. However, while you might be prepared to deal with emergencies, dealing with difficult patients is what will tax your resources. You’re not alone in this. Every health care facility has its share of difficult patients. You dread seeing their names on your nursing schedule. The hospital staff is wary of returning their calls.
Difficult patients are usually clingy, manipulative, dependent, non-compliant, self-destructive, hostile and even litigious. They feel that they deserve complete and dedicated attention from you and your staff. You can try your best and still feel frustrated over their lack of positive response. Their attitude speaks plainly that you’re not doing enough and this leaves you feeling guilty and inadequate. What do you do about such demanding, difficult patients?
Here are a few tips that might help you deal with difficult patients and build good relationships with them.
Communicate Effectively and Honestly
It’s easy to say a patient is difficult and blame the bad nurse-patient relationship entirely on the patient. However, a bit of introspection will help you come to a better understanding. Are you sure that you are really trying to understand the patient’s needs? Health care staff members sometimes talk in jargon that regular people don’t understand. This causes a lot of negative buildup in patients who perceive that doctors are nurses are arrogant. They might not understand that you have many patients and cases to deal with and that you cannot spend too much time clarifying one patient’s doubts.
Every time you work with a challenging, difficult patient, be sure to question yourself whether a friend or family member of yours would be just as challenging when not satisfied interaction. People who have no medical background or experience are usually frustrated when faced with explanations that don’t seem to be clear to them. Understanding the patient’s mindset and slowing down your communication will help you here. Slow down and listen with respect.
The patient may not understand medical jargon or time lines but you must not allow your real perceptions to cloud your judgment. Respect the patient’s intelligence, and explain clearly and effectively. If you feel that you can perhaps dilute your communication into more lay terms, your communication issues will be resolved.
Time and the lack of it are often to blame for the poor communication and the resulting difficult relationships that we face in healthcare situations. Understand that some patients just require more time to absorb the information. If you can make this understanding a part of your daily interaction, and schedule more time for apparently difficult patients, you can go a long way in addressing the problem. However, this method will not work on truly difficult patients who will not be happy with any information you provide.
Use Standardized Approaches
Most health care centers have standardized approaches to help reduce the emotions involved in dealing with difficult patients. Build on these reasoned, consistent processes to set clear boundaries from the beginning. This will help you avoid problems down the road, and also help defuse situations before they escalate.
For example, take a uniform medication refill protocol. If your health care center has a policy that medication refills are only allowed during weekdays, ensure that there are signs in every room to that effect. If a patient bothers you repeatedly with questions regarding refills, point the patient to the printed sign and detail on the walls.
A second example can be a clear stipulation as to where a patient can approach you for information or clarification. Patients have the habit of catching nurses as they rush to deal with an emergency situation, or to prep for surgery. A standard rule that a nurse can only approached between so and so hours and only at the nursing station will ensure that patients don’t take the free for all approach.
The American Medical Association (AMA) opines that a patient’s care post operation or post treatment should be restricted to 30 days only. This ensures that patients cannot bother hospital staff for weeks after their treatment is complete. However, if a hospital does not provide sufficient notice, the patient can sue the hospital for patient abandonment. The definition of patient abandonment varies from state to state; it’s always wise to consult a medical liability provider with regard to the correct protocol before terminating your relationship with a patient.
You can also involve the patient’s insurance company in very difficult cases. The insurance company may be able to appoint a patient advocate who can act as a liaison officer between the health care facility and the patient. It’s possible that the patient-doctor, patient-nurse and the patient-health care facility relationships can be solved via a third party liaison officer sent by the insurance company.