One of the most crucial tasks nurses do is helping patients get the medical assistance they need by interviewing them about their pertinent medical histories, medications, and allergies, and asking them how they’re feeling. But what happens when a patient refuses to answer questions and is being difficult? What is the right approach when it comes to dealing with difficult patients? How can a nurse provide adequate care amid challenging patient interactions?
In this article, we discuss what nurses can do when dealing with difficult patients and the possible reasons why patients become challenging to handle.
Behind the resistance: Why do patients become resistive?
According to a 2021 study, 15% of patients are experienced and tagged as “difficult” by their medical providers. Difficult patients typically display one or more of the following challenging behaviors:
· Being overly controlling and demanding
· Refusing to listen and cooperate
· Being verbally abusive or threatening to themselves and others
· Being physically violent on objects or people
Based on the same 2021 study, often, these difficult behaviors are exhibited by individuals who are likely living with personality disorders, depression, anxiety, and other mental disorders. However, it’s also possible for difficult behaviors to stem from the following conditions:
· Being in pain or feeling unwell
· Fear and distress
· Having had a previous bad hospital experience
· Having unrealistic expectations
It’s important to note that nurses and healthcare professionals don’t just experience challenging patients, but also challenging family members and friends.
Helpful tips for nurses dealing with difficult patients and their loved ones
Remember to communicate well
Imagine if, all of a sudden, you find yourself in excruciating pain, being rushed to a hospital, and having tests ordered on your behalf that aren’t being explained to you. On top of being in pain, you might also feel confused, which could push you to exhibit challenging behaviors. This is just a glimpse of what a difficult patient might be going through, which could be alleviated by proper communication.
The importance of communicating well couldn’t be more evident in healthcare. Always keep your patients in the loop. Explain each important step or procedure to your patients as they happen and do your best to answer their questions patiently. Active listening can also help you understand what your patients are feeling and even help you uncover why they are being difficult.
As part of being a good and effective communicator, you should also be empathetic to their plight — acknowledge their feelings of frustration, fear, and distress and establish trust. This will help you communicate and implement the proposed plan of care without resistance.
Be professional and be in control of the situation
During your nursing journey, you’ll experience being yelled at and being on the receiving end of verbal attacks. As a healthcare professional, you should remain professional. A good way to keep your calm is to remember that a patient’s acting out is not a personal attack on you — these patients feel overwhelmed by a bevy of emotions and are lashing out because they’re unwell and afraid.
Be understanding of how they’re feeling while establishing healthy professional boundaries. Tell them that while you understand that they’re feeling frustrated, you will not be spoken to disrespectfully. Certain requests, especially those that don’t align with their treatment plan, will not be accommodated.
Stay in control and do your best to make them understand that you’re there to help them get better and go home as soon as possible. To do that, you’d need to be able to do your job without resistance. For example, if they want to get pain meds, you’d need to be able to conduct a full pain assessment, check their vitals, and check for allergies.
Always remember to stay calm, understanding, reasonable, and patient. If the patient is being overly difficult, you can step out of the room to de-escalate the situation or seek support and assistance from other nurses.
