As a nurse, you’re going to be dealing with your share of difficult patients through the years. These patients can range from a bit rude to downright dangerous.
But how should you respond to these patients? I’ll tell you how I’ve dealt with those difficult patients by sharing a couple of stories below.
The Patient Who Hated Everything and Complained Constantly
Within a couple of months of working as a new nurse, I clocked into one of my shift one day and got report from another nurse. During report, this nurse informed me that a particular patient had been extremely difficult for the entire staff. The patient was unhappy with all the nurses, doctors, etc. The patient felt like they were getting horrible care, complaining constantly, etc.
After giving me report, the nurse essentially said, “Good luck dealing with this person!”
As a new nurse, I tried to prepare myself that this was probably going to be tough, especially since I had to go knocking on this patient’s door at 7:00 in the morning.
I walked in to the patient’s room and tried to introduce myself in a cheerful way. And sure enough, the patient was not very nice. The patient immediately went into a rant, saying that they were getting horrible care, they wanted to go home, etc.
You could just feel the tension in the room, and even the patient’s spouse was trying to calm the patient down.
Let me stop right here and say that when someone is unhappy in life, there’s generally a reason for it. As I tried to think about how I could handle the situation, I thought back to a communications class I took in nursing school. In that class, I learned that it can be helpful to ask an “open-ended question.”
So I asked the patient something like, “Can you tell me what is making you feel this way?” And like magic, the patient began to open up. The patient felt as though we were hiding things, that he/she didn’t have control over their care, and that they had no clue what was going on.
I thought to myself, “Hey, I can fix that!”
I sat down with the patient and began to explain their labs, diagnostic reports, the physician’s plan of care, what testing was coming up, medication information, and all of that.
And after I did that, this patient transformed before my eyes. Suddenly, the patient was nice instead of grumpy. The patient told me, “you are the only person who has taken the time to do this for me!”
For the rest of the shift, the patient was an absolute dream to work with. In fact, this patient made their spouse go out and buy me a surprise gift. It was an adorable fall decoration that I still put out in my house nearly 14 years later. It holds special meaning to me because it reminds me of this patient and what happened.
The ironic thing about it is that this patient was supposed to be so “difficult and mean,” yet they turned out to be one of the nicest patients I’ve ever had! In fact, it was the first patient to ever buy me a surprise gift, which I didn’t expect at all.
What I learned from that experience was extremely important: By listening to my patient’s concerns and frustrations, and then trying to address those concerns, it totally changed the entire situation.
As nurses, it’s easy to get wrapped up in the endless tasks we have to do. It’s easy to forget that people are often sidelined by medical issues. They can experience a flood of emotions. Patients can experience distressing levels of fear, anxiety, and so forth. They can be confused and scared.
By taking the time to communicate the details of care with our patients and providing patient education, we can sometimes make a bigger impact than by performing our “routine” nursing skills.
Does This Strategy Work for Every Patient?
Now, will all rude patients respond in the same way as my “difficult-turned-nice” patient? Of course not. Sometimes, people have things going on that you can’t easily solve.
For example, sometimes people are under the influence of mind-altering substances, may have a neuro disease, or even a severe mental disorder that robs them of their ability to reason or respond appropriately.
In those situations, doing something like asking an “open-ended question” might not work. In fact, it could even put your life in danger.
When Patients Turn Aggressive or Dangerous
When a patient becomes violent or aggressive in any way, you have to now worry about the patient’s safety as well as your own.
On another occasion, a nurse warned me during report that a patient had a history of being violent and even had a sitter assigned to the room. When I took over care, the patient was fine and even polite.
However, as my shift went on, the patient suddenly began to have outbursts of profanity. Before I could even contact the doctor, I looked up and saw the patient standing in the doorway with a determined look on their face. The patient had stripped off all medical equipment and was standing in their underwear only.
This patient was a tall, strong, burly type of person. Without any warning, the patient ran out of their room, sprinting down the hallway as fast as they could.
The hallway was connected to another wing in the hospital, and it literally looked like it went on for a mile. As the patient ran down the hall, you could hear the patient’s feet pounding the floor: boom, boom, boom. It reminded me of that movie Jurassic Park, when everyone could hear T-Rex walking.
I was terrified while all of this was happening. I was worried about the patient’s safety, other people’s safety, and even my own safety. I called security as fast as I could.
Thankfully, an equally large and intimidating male nurse was working on the connected wing, and he heard the patient running down the hall. The male nurse was able to stop the patient and bring the patient back to me. By God’s grace, the patient had calmed down by that point.
I contacted the doctor, and the doctor treated the patient immediately, and for the rest of my shift, everything went great.
What I learned from that situation was that asking an open-ended questions wouldn’t have worked, and if I would have confronted the patient, I may have been in danger.
Therefore, every patient’s situation is different, and you have to know what approach you should use. As a new nurse, you’ll gain experience on how to deal with different patients over time.
However, when things take a turn for the worse, and a patient becomes aggressive or dangerous, you definitely want to follow your facility’s protocols for such situations.
In most cases, you’ll want to contact security immediately. Get other nurses to help you, too, and call the doctor if necessary.
In addition, you’ll want to be extremely detailed in your documentation, and include exactly what happened, who you contacted, any injuries that occurred, and all of the details surrounding the event.
It will likely be necessary to involve the charge nurses and/or nurse manager when things turn ugly.
Here’s the Big Takeaway When Dealing with Difficult Patients
Patients can be rude or even downright aggressive. As a nurse, you’ve got to find ways to provide exceptional care to all of them.
Many “rude” patients you encounter may have some issue going on that you can easily solve. By working on your communication skills, you might be able to make a huge difference in your patient’s care and outcome.
On the flip side, you also need to recognize that some patients can turn aggressive and dangerous, and you’ll want to be familiar with your facility’s protocols and resources when dealing with those situations, too.