How to Deal with Difficult Patients as a Nurse

Your dream has always been to become a nurse and help others for a living. You’ve gone through a difficult journey in nursing school and you’re now ready to graduate. All of your hard work is about to pay off as you’ll finally earn your degree. But beneath all of the excitement, there is one fear that is still in the back of your mind: What if you encounter difficult patients?

Nursing is just like any profession that involves dealing with the public. So this can mean working with people that are difficult in a manner of ways. You can run into all reactions including defensiveness, anger, fear, demandingness, hysteria, and a whole list of other things and that’s just the patients, not the families that you need to work with and workaround.

Add in medications or diseases that can cause confusion, drowsiness, or agitation, and it’s a whole new ball game of trying to give the best care, professionalism, and empathy. But there are useful strategies in handling unrelenting, frustrated, unpleasant, or uncooperative patients.

Tips for Dealing with Difficult Patients

Handling difficult patients comes with the territory of your new nursing career. You want to be prepared as you enter the workforce. Take advantage of this expert advice to help you diffuse these situations or perhaps avoid them altogether.

1. Don’t take it personally

“Just knowing that the nastiness is not about you is a good start.”

It’s easy to think a difficult patient is upset with you personally, but that’s almost never the case.

Remember that the patient is dealing with unfortunate circumstances and likely isn’t in the best mood. Continue to do your job and don’t let their negativity get in your head. “Just knowing that the nastiness is not about you is a good start,” says Haydel.

2. Look for the underlying cause

Many patients are dealing with medical conditions, pain, or side effects from medications that can alter their mood and make them more irritable. Sometimes you can alleviate a patient’s bad mood by determining the underlying cause of the problem.

3. Learn to prioritize

An agitated patient may try to goad you into tending to their needs above your other patients. It’s important to view your patients’ needs objectively.

All nurses need a healthy sense of what’s important and what won’t diminish the quality of care if it never gets done. Never neglect a patient in need because you feel pressured into helping a difficult patient who doesn’t require immediate care.

4. Show that you care

Sometimes difficult patients make a fuss about minor requests because they feel like no one is listening to them. Set aside your frustration with the patient and do what you can to meet their needs, as long as it doesn’t take away from other patients’ level of care.

Angelis recalls swallowing his pride and getting a second cup of coffee for a particularly irritable patient: “I stayed gracious and her whole demeanor changed. She just wanted to know that someone cared and she wasn’t going to be ignored.”

5. Know your strengths & weaknesses

Angelis says simply being aware of your strengths and weaknesses in tough situations can help you prepare for difficult patient interactions.

For example, you may be able to rely on your good sense of humor to keep you feeling positive or to improve a patient’s mood. If you’re easily discouraged by negative comments, you can plan to take a few moments to yourself to regroup before moving on in your workday.

6. Pay attention

Nurses may be able to prevent difficult situations before they happen just by being observant, according to Angelis. Learn to recognize pathological processes that may soon cause a patient pain or distress and be on the lookout for escalating social situations. You may be able to diffuse a tense situation before it starts.

7. Stay calm

It’s easy to become annoyed, irritated, and angry when you’re faced with a difficult patient. Taking your frustration out on the patient will only make matters worse. Staying calm will help you ease tension and keep the situation from escalating.

Don’t hide your feelings behind fake smiles, Angelis advises.  That will only make you more stressed. Instead, try taking some deep breaths and pausing outside a patient’s room to collect your emotions and calm down.

8. Connect with the patient

No one wants to be just another patient. Taking the time to get to know and connect with difficult patients is a great way to show you care about them as a person and not just another item on your to-do list.

9. Don’t accept abuse

It’s never in a nurse’s job description to be the victim of verbal abuse from an agitated patient. You must be careful not to establish habits where you are accepting abusive behavior or continually confronting patients. You must be careful not to establish habits where you are accepting abusive behavior.

The line between a patient who is abrasive and abusive will depend on your work environment. A nurse working in a prison will likely have different tolerance for abusive behavior than a nurse in an intensive care unit.

10.  Focus on patient care

All patients deserve the best care you’re able to provide—even the difficult ones. Make it your main focus to deliver excellent, positive care to all of your patients. Even if a patient remains agitated, you’ll leave your shift knowing that you did your job to the best of your ability.

11. Acknowledge the Situation

Start by saying, “I understand why you are upset” or “I feel our communication has been broken down”. Most importantly, remain calm and take stock of your own emotions. Avoid negative language which may lead to escalation of the situation.

12. Set Boundaries

Keep yourself, your patients, and your colleagues safe by staying in control while defusing the situation. It’s okay to end a consultation if a patient is becoming increasingly angry and you don’t think the situation is going to improve – particularly if you feel there is an imminent risk of physical aggression.

13. Explore Your Thoughts/Feelings/Opinions

Self-awareness is extremely important when learning how to deal with difficult patients. Allowing ourselves to be aware of our own experiences, feelings, and triggers because we can dictate how we respond to others in heated situations. For example, suppose you are someone who grew up in a household where you frequently experienced violence — in that case, you might respond in an unexpected, unhelpful, and unprofessional way when exposed to angry behavior from others, such as shouting back. On the flip side, perhaps you grew up in a household where there was little to no conflict and you are unsure of how to properly respond when someone behaves angrily towards you. Maybe you have been judged harshly for your feelings and/or resulting actions, and consequently, judge others the same in turn.

Oftentimes we aren’t aware of our own tendencies until we step back and intentionally evaluate them. Considering your own experiences, thoughts, judgments, and things that trigger you can help you to become aware of why you react to situations the way that you do. You’ll then be more prepared to respond in a deliberate way when you next find yourself in a scenario with a disgruntled patient. 

As a nurse, you’ll have the rewarding opportunity to work with patients from all walks of life. Sometimes this results in unexpected situations, so it’s important to be prepared to handle yourself confidently.

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