Dealing with Difficult Patients and Family Members

Draw from your own experiences. If you aren't feeling well, you're probably short with people, cranky, unsocial, and just wanting to be coddled or totally left alone, depending on the moment. Combine this with being poked and prodded and asked a million questions, all while sitting on a cold table in a paper gown.

Fear of the unknown, fear of pain, fear of suffering, and fear of death are all racing through your body and your mind. The medical terminology seems completely Greek to you, and, along with losing your dignity, you feel like you just might freeze to death in that paper gown. Coping skills, if you had any, fly out the window.

Alert

Fear of loss of control is a huge problem for many people, and it is most often the root of the behavior issues you will encounter with demanding and difficult patients and families. They will grasp at anything to try to control some aspect of the situation. Because of this, they might threaten to have your head on a platter if you don't do things their way.

Just Listen

One of the simplest ways to diffuse a situation is to validate feelings. You can do this by listening. Be calm and don't react. Let the patient or the family member vent. Don't try to say things such as, “I know how you feel.” That always infuriates people. You can say something like, “I would certainly be angry if this happened to me,” or “I understand how something like this could make someone very angry.” Or even better, “You certainly have a right to be upset about this. What I can do to help the situation?”

Don't make excuses, and at the same time, don't accept responsibility for something you did not do. Offer to assist in finding out what happened or why it happened, or why it hasn't happened, and tell the patient that you'll get back to her or him. Let your patient know that you will take care of the situation. Then do it, and get back to your patient as soon as possible. Keep them updated and informed. Just show that you care, that you are trying to help, and that the person is important to you.

Learn what the patient or family members perceive to be the problem. Perhaps it's a misunderstanding. Perhaps there are huge gaps in communication, or in the patient education process. Perhaps they just perceive something to be more serious than it is or are more fearful of something than they need to be, and a little explanation can go a long way in resolving an issue.

Essential

If possible, give patients and their families a time frame of when you hope to have some answers for them. Check back with them in an hour or two to let them know of any progress and to reassure them that you are working on a solution.

Anticipate Needs

Many times you can avoid an unpleasant situation altogether if you anticipate the needs of the patient or family member. Keep them informed and updated. Always explain procedures before you start and again as you go along.

If you know that the doctor is running at least 45 minutes behind and has two important phone calls to return before she'll get to the patient, let the patient know. Then update him periodically as to the progress.

If the waiting room in the ER was empty when Mr. Gable arrived after trying to slice off his thumb with a carving knife, he's going to assume he will be seen soon. However, there might be several more critical patients being attended to, and the doctor won't get to him right away. Let him know that the doctor is tied up with someone who's in cardiac arrest and it'll be awhile before he gets seen. Meanwhile, explain that he is stable and won't bleed to death, and that you are going to keep an eye on him and make him comfortable.

Wherever you may work in the health care industry, if you keep your patients informed about how things work in your area, how the schedule is flowing or backed up, what they can expect to happen and when, you'll alleviate a lot of fears, stress, and concern about the unknown. You'll also be letting them know that things are under control and not just run-amok chaos.

Perhaps schedules aren't as precisely controlled as many would like, but if you let people know that you individualize your care to meet the needs of the patients, and that when someone needs extra time or care you stop and provide it, then perhaps you can infuse a little humility and humanity into the mix. Command respect by showing that you value quality, not quantity. Patients need to respect the rights of other patients, but they also need to know that they will receive the same quality care and consideration.

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