How to Handle Difficult Patients

Posted on: May 11, 2016

written by

Emma Siemasko

As a clinician, you’re comfortable with the healthcare system. Because you go to work every day in a hospital, clinic, or other care center, you’re used to the environment. It’s easy to forget that some patients are afraid of hospitals and that many people spend significant time wallowing in illness or pain before seeking treatment.

Anxiety related to getting medical care is prevalent enough that it has a name — white coat syndrome — and according to WebMD, it affects roughly 20 percent of the population.

This puts you in a tough position. When patients are filled with panic and anxiety, they may lash out and/or become noncompliant, making it difficult for you to do your job. A study from BMJ Quality & Safety found that doctors made 42 percent more mistakes when diagnosing complex medical issues in difficult patients than in agreeable ones.

Whether you’re a nurse practitioner, physician assistant, or physician, you’re going to deal with difficult patients, and it’s important to give them quality care. How can you effectively manage your feelings to ensure professionalism, continue to diagnose correctly, and not get burned out from the abuse?

Consider Potential Reasons for the Behavior

Although it’s not acceptable to abuse a caregiver, patients are usually difficult for a reason.

Some are under the influence of drugs, have issues with substance abuse, or are undergoing psychiatric trauma. Others are aggravated by long wait times, and many medical assistants and nurses bear the brunt of patient frustration when people feel their needs are not being met.

Other difficult patients have white coat syndrome and struggle with being in a caregiving setting. These patients’ anxiety, fear, and insecurities may come out in negative ways.

As a caregiver, it’s a good idea to look for trends at your institution. Are patients consistently frustrated by long wait times? Does your facility often treat psychiatric patients or those that suffer from substance abuse? Knowing what to expect can help you develop strategies for coping.

Let the Patient Explain Their Feelings

Sometimes, difficult patients just need a sounding board. They lash out because they feel as though their needs are not being met, so ignoring their bad behavior might make the situation worse.

Ask the patient why they’re upset, and do your best to give them logical answers to make them feel at ease. Sometimes these patients are scared of a medical procedure going wrong, or are concerned that something will be painful. Do your best to calm their fears and anxieties.

Set Boundaries and Insist on Respect

Some patients treat caregivers as though they have no feelings at all, and this behavior is unacceptable. If you are wishy-washy with the patient, they will think their behavior is acceptable. It is essential that you, the medical professional, are clear about the boundaries.

You should practice saying concrete phrases such as “I won’t tolerate this behavior” and “You need to treat me with respect.” If a patient insults you, do your best to not take these outbursts personally.

Become Familiar With Workplace Policy

It’s one thing if a patient rubs you the wrong way, but it’s another if they’re inappropriate, disrespectful, or mean.

Whether you’re a locum tenens provider or have a permanent place of work, you should get to know your current hospital’s policy on caregiver abuse. Each institution has policies to protect you from bad behavior, and you should review them with a supervisor to ensure your organization is on your side. Most hospitals have alarms and security personnel to help you if a situation gets out of hand.

Check in With Your Colleagues

Your colleagues have experienced difficult patients, just like you have. Sharing your stories with other clinicians can help you come up with coping strategies and remind you that difficult patients are an inevitable part of working as a healthcare provider.

If you are having trouble with a particular patient, make sure to loop in your colleagues, and to do so without using disparaging language. Calmly explain the situation and ask for help.

Coping With Difficult Patients

Dealing with troublesome patients will never be easy, but these strategies can help you feel safe, professional, and competent when working with someone who is difficult. It can be frustrating, but do your best to be kind and understanding. Often, a patient just needs someone to talk to.

How have you handled difficult patients in the past? Find us on Twitter and share your story.

About Emma Siemasko

Emma Siemasko is a writer and marketing consultant who specializes in career advice, startups, and healthcare. She has contributed to a variety of healthcare publications, and enjoys the attention she gets when she visits a doctor or nurse.

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