By 
As nurses, we all occasionally run into patients that could be described as “difficult.” For any of a variety of reasons, they’re unusually difficult to work with. They may complain constantly, hesitate to comply, or even be aggressive. Sometimes it’s due to a psychiatric or medical condition, like dementia or mental illness. In other cases, they’re just not the most pleasant people.
What can you do when you get assigned that notorious patient that no one else wants to take? As healthcare professionals, we can’t simply “fire” a patient, the way that some professionals can with their clients. The best we can do is to find strategies for managing the patient as best we can, and in worst-case scenarios where the patient may be aggressive, putting our own safety first.
Tips for Dealing with Rude, Demanding, or Otherwise Difficult Patients
The most common type of “difficult patients” are those who, frankly, are just plain rude. They’re unappreciative, demanding, and even downright mean. In some cases, there’s a medical issue at play. Irritability can occur as a side effect of some kinds of medication, or as a result of Alzheimer’s disease and other neurodegenerative conditions. But in other cases, no such organic or psychiatric cause can be identified.
Here are a few tips for diffusing conflict with unusually difficult patients in a healthcare setting.
- Don’t take it personally. Don’t interpret the situation as, “I have personally done something wrong,” or “This person is upset with me, specifically.” Most of the time, this simply isn’t the case. It probably has little or nothing to do with you. It’s important not to let yourself take it personally, or become too emotionally upset due to the way the patient is treating you.
- Look for underlying causes. As we’ve mentioned, irritability can sometimes have an organic cause. Many types of medications can cause irritability as a side effect — as you can see from the link, the list is quite extensive. Mood disturbances and behavioral changes can also occur in elderly patients with Alzheimer’s disease or other cognitive impairment. In some cases, a change in medication can help improve the patient’s mood and outlook.
- Stay calm. Remaining calm is incredibly important in these situations. You have to avoid become too emotionally upset, which can cloud your judgement. It’s important to realize that in most cases, the patient is lashing out at you simply because you happen to be in the way, not because you did anything to deserve it.
- Avoid letting the patient pull you into an argument. Arguments simply perpetuate themselves in a positive feedback cycle when it comes to this type of patient. Try to avoid being pulled into an argument or becoming too defensive, which can exacerbate the situation.
- Set boundaries. In many cases, difficult patients can drive you up the wall by giving you an endless stream of ridiculous demands. In these situations, it is completely acceptable to set some clear boundaries with the patient.
- Prioritize. Irritable, agitated, and difficult patients sometimes harp at you to put their needs first before other patients. It’s important to retain a clear, balanced sense of what is and isn’t important in patient care. If a difficult patient is pressuring you to do something, but it isn’t urgent, it’s okay to tell them you will take care of it in fifteen or twenty minutes after you tend to another patient.
- Don’t accept abuse. It’s difficult to really draw a line between being rude, and being outright verbally abusive. However, it’s not a good idea to establish habits where you’re simply accepting verbally abusive behavior from a patient. If you’ve asked a patient to desist, but they’ve continued to berate you, you may want to consider informing one of your supervisors to figure out an appropriate course of action.
Dealing with Difficult Patients
Dealing with difficult patients is sometimes one of the hardest parts of our jobs. It’s really frustrating when all the empathy, respect, and compassion in the world doesn’t seem to do anything to inspire the patient to treat you better or give you the respect you deserve. But you can do everything you can to try to set boundaries and cope with rudeness and other unpleasant behavior from patients.
