Nursing Blog

SURVIVING THE DIFFICULT PATIENT

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“Show respect even to people who don’t deserve it; not as a reflection of their character, but as a reflection of yours.”  David Willis

 

“Yo Nurse!” you hear again coming again from room 311.  You walk in and there he is in all of his glory, your patient from a little town called Hellsville 😈 (population to many to count). You took care of him last night and the night before.  Round three here you go.  “Ain’t it time for my dressing change?  You’re late!”  He says arrogantly. Why yes it is, you say wishing you had a clever retort but you got nothing.  I will be right back.  You smile back gritting your teeth.  I just need to gather some supplies.  “Well I hope you do a better job than last night.” I sure will try my best (eye roll).  You turn and walk out of the room mumbling expletives under your breath.  God, another whole night of this, you think.  How am I going to deal?  

 

In this wonderful profession that we have chosen, who is our clientele?  It’s People. Lots and lots of people.  People from all different walks of life and people from all sorts of different life circumstances.  And not only that but it’s people who also aren’t feeling well.                    

                                                                                                DOUBLE WHAMMY

 

This can make for from pretty tough situations.  Hey look, People can be wonderful.  But Let’s face it, they also can be, as I am sure you have discovered somewhere along the line, completely and utterly awful.  It all just depends.  

And, add to that, we as caregivers are people too. We can be pretty great and also, not so great, depending on the day.  And…… on top of that, we see so many of the same situations in the medical field over and over that we can become desensitized, which can also cause a challenge in a patient nurse relationship.  Every day is different and every one is different.  It’s all a crap shoot.  Sometimes everything just flows and other times absolutely nothing seems to go right.  

 

Here are a few tips for dealing with that difficult, PITA patient that just might be worth a shot.

 

Modify Your Body Language.  It Starts With You……..

 

I am well aware I can look stand offish, and I also suffer from something called  RBS (see definition below).  I have to make modifications at times ( if I catch myself).  You may have to also……..

 

Look at how you’re standing.  Are your arms crossed?  Are you smiling and listening to your patient or are you thinking about the 10,000 other things that you have to do?  Are you making eye contact?  Or are you looking out in the hall to see if the pizza delivery guy arrived at the nurses station yet because you haven’t eaten since you can’t remember when?   

People know when you are disinterested and distracted and they want to be heard.  Let’s start by looking at ourselves and what we can change to make a better impression to get off to a good start.

 

Find Empathy Somewhere.  C’mon You Can Do It.

Even when the patient is so mean and awful and you find yourself having to dig way down deep just to try and be civil.  Think about where they may have come from and/or how they must be feeling.  Maybe they are afraid and lonely. Or maybe they have or have had an awful life.  You just don’t know unless you have walked in their shoes.  You do not have to be a doormat to horrible behavior, but try and think for a moment of what they may be experiencing or have experienced in their past.    

 

Remain Calm…

I realize that this can be extremely difficult sometimes but try not to take their behavior personally.  They do not even know you so how could they hate you this much?  They may be acting out because of an underlying issue like fear of being sick or anxiety over being in the hospital.  Not being home and overall loss of control.  Take a breath before you react.  You are the professional, act like it, or pretend to at least.

 

Let Them Be Heard 

At least for a relatively fair amount of time.  We all know some people could trap you there for eternity.  But try if you can to stop rushing around for a minute.  Appear as though you are interested and really try and listen.  You may come to a better understanding of your patient and that may make caring for them a lot easier.  You may get more of an insight to some other things going on.  You also may connect on some level.  You’d be surprised.

 

Set Boundaries

 You have to protect yourself and your time.  It is unacceptable for anyone even if it is a patient to be abusive and you have a right to PROFESSIONALLY not put up with it.  You can start by telling the patient that it isn’t necessary to speak to you a certain way or yell etc.  Let them know that you are trying to help.  If it continues you may need to discuss with your manager.  Don’t be afraid to ask the other nurses to switch off caring for the patient during the next shift that you work.  That’s how we stay sane….  Rotate the PITAs.

 

Let It Go

 This is your patient.  Not your family or friend.  Try and not take this home with you.  It isn’t worth it.  It won’t be your last bad apple of the bunch so go home and put your feet up, pour a glass of wine or a cup of tea and pat yourself on the back because you are a survivor……  You’re a nurse.  

 

 

Definition: RBS is a current slang term for “Resting Bitch Face”.

Definition: PITA literally stands for “Pain In The Ass”. It’s a code nurses use to warn their fellow nurses about an uncooperative patient or relative.

Example: The patient is very sweet but his wife is a PITA.

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